Abstract 2533: Inverse association between circulating vitamin D and mortality - dependent on sex and cause of death.

Abstract

Abstract Background: Vitamin D has immune-modulation properties as well as effects on cell differentiation and proliferation, on angiogenesis, but also on blood pressure and glucose tolerance, and in various populations, vitamin D deficiency is associated with chronic diseases and mortality. We examined the association between concentration of circulating 25-hydroxyvitamin D [25(OH)D], a marker of vitamin D status, with all-cause and cause-specific mortality. Methods: The study included 3191 participants of the general adult Swiss population, who were recruited between November 1988 and June 1989 and followed-up until the end of 2008. Serum 25(OH)D was measured by protein-bound assay. Cox proportional hazards regression was used to examine the association between 25(OH)D concentration and overall and cause-specific mortality adjusting for sex, age, season, diet, nationality, blood pressure, and smoking status. Results: Mean serum 25(OH)D concentration was 19.8 ng/mL in men and 20.5 ng/mL in women. Participants with low 25(OH)D (≤13.4 ng/mL) were more likely to have participated during winter months, but less likely to have spent ≥30 minutes outdoors per day or been on vacation in the month prior to blood collection. Individuals with 25(OH)D concentrations ≥25 ng/mL tended to be less often of foreign nationality, current smokers and more frequently in the upper educational level. During the follow-up period, 459 study participants died (188 of cancer and 122 of cardiovascular diseases). Per 10 ng/mL increase in 25(OH)D concentration, all-cause mortality decreased by 20% (HR=0.83; 95% CI 0.74-0.92). Excluding the first five years of follow-up did not materially affect the observed associations. 25(OH)D concentration was inversely associated with cardiovascular mortality in women (0.68, 0.46-1.00), but not in men (0.97; 0.77-1.23). In contrast, 25(OH)D concentration was inversely associated with cancer mortality in men (0.72, 0.57-0.91), but not in women (1.14, 0.93-1.39). Multivariate adjustment only slightly modified the 25(OH)D-mortality association. Conclusion: 25(OH)D was similarly inversely related to all-cause mortality in men and women. However, we observed opposite effects in women and men with respect to cardiovascular- and cancer-related mortality. Citation Format: Sabine Rohrmann, Julia Braun, Matthias Bopp, David Faeh. Inverse association between circulating vitamin D and mortality - dependent on sex and cause of death. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 2533. doi:10.1158/1538-7445.AM2013-2533