Park Kye-Yeung, Han Kyungdo, Hwang Hwan-Sik, Park Hoon-Ki, Park Kyongmin
Department of Family Medicine, Hanyang University College of Medicine, South Korea.
Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea.
Nutr Res. 2023 May;113:49-58. doi: 10.1016/j.nutres.2023.02.008. Epub 2023 Mar 5.
Evidence on the association between serum 25-hydroxyvitamin D (25(OH)D) concentration and all-cause and cause-specific mortality in Asians, especially Koreans, is limited. We hypothesized that high concentrations of 25(OH)D are associated with lower all-cause and cause-specific mortality in the general Korean population. This study included 27,846 adults participating in the Fourth and Fifth Korean National Health and Nutrition Examination Survey 2008-2012, followed up through December 31, 2019. Hazard ratios (HR) and 95% confidence intervals (CIs) for mortality from all causes, cardiovascular disease (CVD), and cancer were estimated using multivariable-adjusted Cox proportional hazards regression. The weighted mean serum 25(OH)D of study participants was 17.77 ng/mL; 66.5% had vitamin D deficiency (<20 ng/mL) and 94.2% had insufficient vitamin D (<30 ng/mL). During a median follow-up of 9.4 years (interquartile range, 8.1-10.6 years), 1680 deaths were documented, including 362 CVD deaths and 570 cancer deaths. Serum 25(OH)D levels ≥30 ng/mL were inversely associated with all-cause mortality (HR, 0.57; 95% CI, 0.43-0.75) compared with serum 25(OH)D levels <10 ng/mL. Based on the quartile cutoffs of serum 25(OH)D concentration, the highest quartile of serum 25(OH)D concentration (≥21.8 ng/mL) was associated with the lowest all-cause mortality (HR, 0.72; 95% CI, 0.60-0.85; P trend < .001), and CVD mortality (HR, 0.60; 95% CI, 0.42-0.85; P trend = .006). No association with cancer mortality outcome was found. In conclusion, higher serum 25(OH)D levels were associated with lower all-cause mortality in the general Korean population. An additional association was found between higher quartile of serum 25(OH)D and lower CVD mortality.
关于血清25-羟基维生素D(25(OH)D)浓度与亚洲人(尤其是韩国人)全因死亡率及特定病因死亡率之间关联的证据有限。我们假设,在韩国普通人群中,高浓度的25(OH)D与较低的全因死亡率及特定病因死亡率相关。本研究纳入了2008 - 2012年参加第四次和第五次韩国国家健康与营养检查调查的27,846名成年人,并随访至2019年12月31日。使用多变量调整的Cox比例风险回归估计全因、心血管疾病(CVD)和癌症死亡率的风险比(HR)及95%置信区间(CI)。研究参与者的加权平均血清25(OH)D为17.77 ng/mL;66.5%的人维生素D缺乏(<20 ng/mL),94.2%的人维生素D不足(<30 ng/mL)。在中位随访9.4年(四分位间距,8.1 - 10.6年)期间,记录了1680例死亡,包括362例CVD死亡和570例癌症死亡。与血清25(OH)D水平<10 ng/mL相比,血清25(OH)D水平≥30 ng/mL与全因死亡率呈负相关(HR,0.57;95% CI,0.43 - 0.75)。基于血清25(OH)D浓度的四分位数切点,血清25(OH)D浓度最高四分位数(≥21.8 ng/mL)与最低全因死亡率(HR,0.72;95% CI,0.60 - 0.85;P趋势<0.001)及CVD死亡率(HR,0.60;95% CI,0.42 - 0.85;P趋势 = 0.006)相关。未发现与癌症死亡率结果相关。总之,在韩国普通人群中,较高的血清25(OH)D水平与较低的全因死亡率相关。还发现血清25(OH)D较高四分位数与较低的CVD死亡率之间存在关联。