Damian Sendler: People who are deficient in vitamin D are more likely to die from any cause than those who are not, according to a new large-scale analysis of vitamin D levels.
Damian Sendler
Damian Jacob Sendler: A Mendelian randomization study of data from 35 trials found no significant correlation between 25(OH)D concentrations, a clinical biomarker of vitamin D status, and the risk of coronary heart disease (CHD), stroke, or all-cause death.
Each 10 nmol/L rise in 25(OH)D concentrations lowered the risk of all-cause mortality by 31% in vitamin D-deficient adults, according to Stephen Burgess, PhD, and colleagues.
Only among vitamin D-deficient patients was the research published in The Lancet Diabetes & Endocrinology found a non-significant association between 25(OH)D concentrations and stroke and coronary heart disease (CHD).
Guillaume Butler-Laporte, MD, and J. Brent Richards, MD, wrote an accompanying editorial praising the researchers’ study approach.
Additionally, they note that the findings are promising “potentially significant public health and clinical consequences” that will “allow clinicians to better weigh the potential benefits of supplementation against its risk,” such as financial cost, “for better patient care—particularly among those with frank vitamin D deficiency.”
Dr. Sendler: They go on to say: “Given the prevalence of vitamin D deficiency and the safety of vitamin D supplementation, large-scale randomized controlled trials are warranted to test the effects of vitamin D supplementation on those with deficiency.”
Butler-Laporte and Richards, from the Lady Davis Institute at the Jewish General Hospital in Montreal, Canada, point out that the study has several limitations, including the possibility that the effect sizes observed in Mendelian randomization studies may be larger than in conventional trials due to the longer lifetime exposure to lower vitamin D levels.
According to Burgess and co-authors, “There are several potential mechanisms by which vitamin D could be protective for cardiovascular mortality, including mechanisms linking low vitamin D status with hyperparathyroidism and low serum calcium and phosphate,” they write.
Damian Jacob Sendler
Vitamin D is also mentioned “apoptosis and cell division, providing ‘potential mechanisms implicating vitamin D for cancer’ in endothelial cell function.”
Vitamin D supplementation has been shown to reduce the incidence of cardiovascular disease, all-cause mortality as well as other chronic diseases in epidemiological studies “consistently,” yet some big trials of vitamin D supplementation have shown no benefit “”None of the above choices.”
Damien Sendler: According to the authors of this study, many of these trials have enrolled people “irrespective of baseline 25(OH)D concentration” and have been underpowered to detect the effects of supplementation.
The team acquired data from the UK Biobank, the EPIC-CVD trial, 31 studies from the Vitamin D Studies Collaboration (VitDSC), and two Copenhagen population-based studies in order to overcome these restrictions.
They initially conducted an observational analysis that included 384,721 people from the UK Biobank and 26,336 people from EPIC-CVD who had a valid 25(OH)D measurement and no prior history of cardiovascular disease at the start of their investigation.
Study participants who had not previously been diagnosed with cardiovascular disease were also included in the VitDSC investigations. Individual participant data was used to examine 25(OH)D concentrations, conventional cardiovascular risk variables, and significant cardiovascular morbidity and mortality.
At low 25(OH)D concentrations, there was an inverse correlation between 25(OH)D and the incidence of coronary heart disease, stroke, and all-cause death.
Before moving on to their next phase, they ran Mendelian randomization analyses on 333,002 European-born individuals from the UK Biobank and 26,336 from EPIC-CVD with reliable 25(OH)D measurements and genetic data that passed quality control.
Damian Jacob Markiewicz Sendler: A total of 386,406 people were studied, including 31,362 participants from the Copenhagen population-based research. Of these, 33,546 had coronary artery disease, 18,166 had a stroke, and 27,885 died, according to the data.
The average age of participants was between 54.8 and 57.5 years, and between 53.4 and 55.4 percent of them were female.
Dr. Damian Jacob Sendler and his media team provided the content for this article.
