A reverse J-shaped association of all-cause mortality with serum 25-hydroxyvitamin D in general practice, the CopD study

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A reverse J-shaped association of all-cause mortality with serum 25-hydroxyvitamin D in general practice, the CopD study. / Durup, D; Jørgensen, Henrik Løvendahl; Christensen, J.; Schwarz, P.; Heegaard, Anne-Marie; Lind, Bo.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 97, No. 8, 2012, p. 2644 –2652.

Research output: Contribution to journal › Journal article › Research › peer-review

Harvard

Durup, D, Jørgensen, HL, Christensen, J, Schwarz, P, Heegaard, A-M & Lind, B 2012, 'A reverse J-shaped association of all-cause mortality with serum 25-hydroxyvitamin D in general practice, the CopD study', Journal of Clinical Endocrinology and Metabolism, vol. 97, no. 8, pp. 2644 –2652. https://doi.org/10.1210/jc.2012-1176

APA

Durup, D., Jørgensen, H. L., Christensen, J., Schwarz, P., Heegaard, A-M., & Lind, B. (2012). A reverse J-shaped association of all-cause mortality with serum 25-hydroxyvitamin D in general practice, the CopD study. Journal of Clinical Endocrinology and Metabolism, 97(8), 2644 –2652. https://doi.org/10.1210/jc.2012-1176

Vancouver

Durup D, Jørgensen HL, Christensen J, Schwarz P, Heegaard A-M, Lind B. A reverse J-shaped association of all-cause mortality with serum 25-hydroxyvitamin D in general practice, the CopD study. Journal of Clinical Endocrinology and Metabolism. 2012;97(8):2644 –2652. https://doi.org/10.1210/jc.2012-1176

Author

Durup, D ; Jørgensen, Henrik Løvendahl ; Christensen, J. ; Schwarz, P. ; Heegaard, Anne-Marie ; Lind, Bo. / A reverse J-shaped association of all-cause mortality with serum 25-hydroxyvitamin D in general practice, the CopD study. In: Journal of Clinical Endocrinology and Metabolism. 2012 ; Vol. 97, No. 8. pp. 2644 –2652.

Bibtex

@article{3adda1be31dd483a9ece5bf11977a058,
title = "A reverse J-shaped association of all-cause mortality with serum 25-hydroxyvitamin D in general practice, the CopD study",
abstract = "Context:Optimal levels of vitamin D have been a topic of heavy debate, and the correlation between 25-hydroxyvitamin D [25(OH)D] levels and mortality still remains to be established.Objective:The aim of the study was to determine the association between all-cause mortality and serum levels of 25(OH)D, calcium, and PTH.Design and Setting:We conducted a retrospective, observational cohort study, the CopD Study, in a single laboratory center in Copenhagen, Denmark.Participants:Serum 25(OH)D was analyzed from 247,574 subjects from the Copenhagen general practice sector. In addition, serum levels of calcium, albumin-adjusted calcium, PTH, and creatinine were measured in 111,536; 20,512; 34,996; and 189,496 of the subjects, respectively.Main Outcome Measures:Multivariate Cox regression analysis was used to compute hazard ratios for all-cause mortality.Results:During follow-up (median, 3.07 yr), 15,198 (6.1%) subjects died. A reverse J-shaped association between serum level of 25(OH)D and mortality was observed. A serum 25(OH)D level of 50-60 nmol/liter was associated with the lowest mortality risk. Compared to 50 nmol/liter, the hazard ratios (95% confidence intervals) of all-cause mortality at very low (10 nmol/liter) and high (140 nmol/liter) serum levels of 25(OH)D were 2.13 (2.02-2.24) and 1.42 (1.31-1.53), respectively. Similarly, both high and low levels of albumin-adjusted serum calcium and serum PTH were associated with an increased mortality, and secondary hyperparathyroidism was associated with higher mortality (P <0.0001).Conclusion:In this study from the general practice sector, a reverse J-shaped relation between the serum level of 25(OH)D and all-cause mortality was observed, indicating not only a lower limit but also an upper limit. The lowest mortality risk was at 50-60 nmol/liter. The study did not allow inference of causality, and further studies are needed to elucidate a possible causal relationship between 25(OH)D levels, especially higher levels, and mortality.",
author = "D Durup and J{\o}rgensen, {Henrik L{\o}vendahl} and J. Christensen and P. Schwarz and Anne-Marie Heegaard and Bo Lind",
year = "2012",
doi = "10.1210/jc.2012-1176",
language = "English",
volume = "97",
pages = "2644 –2652",
journal = "Journal of Clinical Endocrinology and Metabolism",
issn = "0021-972X",
publisher = "Oxford University Press",
number = "8",

}

RIS

TY - JOUR

T1 - A reverse J-shaped association of all-cause mortality with serum 25-hydroxyvitamin D in general practice, the CopD study

AU - Durup, D

AU - Jørgensen, Henrik Løvendahl

AU - Christensen, J.

AU - Schwarz, P.

AU - Heegaard, Anne-Marie

AU - Lind, Bo

PY - 2012

Y1 - 2012

N2 - Context:Optimal levels of vitamin D have been a topic of heavy debate, and the correlation between 25-hydroxyvitamin D [25(OH)D] levels and mortality still remains to be established.Objective:The aim of the study was to determine the association between all-cause mortality and serum levels of 25(OH)D, calcium, and PTH.Design and Setting:We conducted a retrospective, observational cohort study, the CopD Study, in a single laboratory center in Copenhagen, Denmark.Participants:Serum 25(OH)D was analyzed from 247,574 subjects from the Copenhagen general practice sector. In addition, serum levels of calcium, albumin-adjusted calcium, PTH, and creatinine were measured in 111,536; 20,512; 34,996; and 189,496 of the subjects, respectively.Main Outcome Measures:Multivariate Cox regression analysis was used to compute hazard ratios for all-cause mortality.Results:During follow-up (median, 3.07 yr), 15,198 (6.1%) subjects died. A reverse J-shaped association between serum level of 25(OH)D and mortality was observed. A serum 25(OH)D level of 50-60 nmol/liter was associated with the lowest mortality risk. Compared to 50 nmol/liter, the hazard ratios (95% confidence intervals) of all-cause mortality at very low (10 nmol/liter) and high (140 nmol/liter) serum levels of 25(OH)D were 2.13 (2.02-2.24) and 1.42 (1.31-1.53), respectively. Similarly, both high and low levels of albumin-adjusted serum calcium and serum PTH were associated with an increased mortality, and secondary hyperparathyroidism was associated with higher mortality (P <0.0001).Conclusion:In this study from the general practice sector, a reverse J-shaped relation between the serum level of 25(OH)D and all-cause mortality was observed, indicating not only a lower limit but also an upper limit. The lowest mortality risk was at 50-60 nmol/liter. The study did not allow inference of causality, and further studies are needed to elucidate a possible causal relationship between 25(OH)D levels, especially higher levels, and mortality.

AB - Context:Optimal levels of vitamin D have been a topic of heavy debate, and the correlation between 25-hydroxyvitamin D [25(OH)D] levels and mortality still remains to be established.Objective:The aim of the study was to determine the association between all-cause mortality and serum levels of 25(OH)D, calcium, and PTH.Design and Setting:We conducted a retrospective, observational cohort study, the CopD Study, in a single laboratory center in Copenhagen, Denmark.Participants:Serum 25(OH)D was analyzed from 247,574 subjects from the Copenhagen general practice sector. In addition, serum levels of calcium, albumin-adjusted calcium, PTH, and creatinine were measured in 111,536; 20,512; 34,996; and 189,496 of the subjects, respectively.Main Outcome Measures:Multivariate Cox regression analysis was used to compute hazard ratios for all-cause mortality.Results:During follow-up (median, 3.07 yr), 15,198 (6.1%) subjects died. A reverse J-shaped association between serum level of 25(OH)D and mortality was observed. A serum 25(OH)D level of 50-60 nmol/liter was associated with the lowest mortality risk. Compared to 50 nmol/liter, the hazard ratios (95% confidence intervals) of all-cause mortality at very low (10 nmol/liter) and high (140 nmol/liter) serum levels of 25(OH)D were 2.13 (2.02-2.24) and 1.42 (1.31-1.53), respectively. Similarly, both high and low levels of albumin-adjusted serum calcium and serum PTH were associated with an increased mortality, and secondary hyperparathyroidism was associated with higher mortality (P <0.0001).Conclusion:In this study from the general practice sector, a reverse J-shaped relation between the serum level of 25(OH)D and all-cause mortality was observed, indicating not only a lower limit but also an upper limit. The lowest mortality risk was at 50-60 nmol/liter. The study did not allow inference of causality, and further studies are needed to elucidate a possible causal relationship between 25(OH)D levels, especially higher levels, and mortality.

U2 - 10.1210/jc.2012-1176

DO - 10.1210/jc.2012-1176

M3 - Journal article

C2 - 22573406

VL - 97

SP - 2644

EP - 2652

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0021-972X

IS - 8

ER -

ID: 38426068