Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Gaksch, M.
A parametric Weibull individual participant data, one step meta-analysis of standardized 25 hydroxyvitamin D and mortality in 26916 participants from a European consortium
Doktoratsstudium der Medizinischen Wissenschaft; Humanmedizin; [ Dissertation ] Graz Medical University; 2017. pp. 160
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Meinitzer Andreas
- Pieber Thomas
- Pilz Stefan
- Tomaschitz Andreas
- Altmetrics:
- Abstract:
- Background: Vitamin D deficiency may be a risk factor for mortality but previous meta-analyses lacked standardization of laboratory methods for 25-hydroxyvitamin D (25[OH]D) concentrations and were limited by use of unstandardized clinical outcomes and by use of aggregate data instead of individual participant data (IPD). We therefore performed an IPD meta-analysis on the association between standardized serum 25(OH)D and mortality. Methods: In a European consortium of eight prospective studies, including seven general population cohorts, we used Vitamin D Standardization Program (VDSP) protocols to standardize 25(OH)D data. Meta-analyses using a one-step procedure on IPD were performed to study associations of 25(OH)D with all-cause mortality as the primary outcome and with cardiovascular and cancer mortality as secondary outcomes. This meta-analysis is registered at ClinicalTrials.gov, number NCT02438488. Findings: We analysed 26916 study participants (median age 61.6 years, 58 % females) with a median 25(OH)D concentration of 53.8 nmol/l. During a median follow-up time of 10.5 years, 6802 persons died. All-cause mortality risk did not significantly differ by 25(OH)D concentration for concentrations ranging from 50 to 125 nmol/l and higher. Compared to participants with 25(OH)D concentrations of 75 to 99.99 nmol/l, the adjusted hazard ratios (with 95% confidence interval) for mortality in the 25(OH)D groups with 40 to 49.99, 30 to 39.99, and <30 nmol/l were 1.15 (1.00-1.29), 1.33 (1.16-1.51), and 1.67 (1.44-1.89), respectively. We observed similar results for cardiovascular mortality but there was no significant association between level of 25(OH)D and cancer deaths. Interpretation: In the first IPD meta-analysis using standardized measurement of 25(OH)D we observed an association between low 25(OH)D and increased risk of mortality. It is of public health interest to evaluate whether vitamin D deficiency is associated with increased mortality to establish a basis for treatment and prevention of vitamin D deficiency related deaths.