TY - JOUR
T1 - Low Vitamin D Status is Associated with Increased Risk of Mortality in Korean Men and Adults with Hypertension
T2 - A Population-Based Cohort Study
AU - Park, Dahyun
AU - Lee, Juhee
AU - Park, Clara Yongjoo
AU - Shin, Min Jeong
N1 - Funding Information:
Funding: This work was supported by the Research Program funded by the Korea Disease Control and Prevention Agency (2019-E3419-00), and also had the support of “The Cooperative Research Program for Agriculture Science and Technology Development (Project No. PJ014709022021)” of the Rural Development Administration, Republic of Korea. This study was also supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science and ICT (NRF-2020R1A2C2005580).
Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/5/1
Y1 - 2022/5/1
N2 - Background Recent randomized controlled trials (RCTs) have shown no effect of vitamin D supplementation on cardiovascular disease, cancer events and mortality or all-cause mortality in Western populations. However, there has been a lack of research on populations with low vitamin D status, including Asians. In addition, there have been indications that an individual’s sex or hypertension status may affect the relationship between vitamin D status and mortality. In this study, we retrospectively assessed the association between vitamin D status and all-cause, cardiovascular, and cancer mortality in Koreans using a national database, and stratified participants according to sex and hypertension status. Methods Participants in the Korean Health and Nutrition Examination Survey 2008–2014, who consented to their data being synthesized with mortality data (up to Dec 2019), were included (n = 22,742; mean follow-up: 8.9 years). Participants’ level of serum 25-hy-droxyvitamin D (25(OH)D) was measured by radioimmunoassay and categorized as <12, 12–19.9, and ≥20 ng/mL. A Cox proportional hazard model was used to assess the risk of mortality. Results In the total sample, risk of all-cause, cancer, and cardiovascular mortality was greater in adults with a serum 25(OH)D level below 12 and 12–19.9 ng/mL than those with ≥20 ng/mL. Men and adults with hypertension, who had low vitamin D status, had a higher risk of cancer and cardiovascular mortality, but not women or adults without hypertension. Similar results were observed when various cutoffs for 25(OH)D were employed, or extrinsic deaths were excluded. Conclusions Vitamin D status below 20 ng/mL is associated with a higher risk of mortality in Korean adults, especially in men and those with hypertension, on the basis of data from a nationally representative sample. Further RCTs on Asian adults with low vitamin D status are warranted.
AB - Background Recent randomized controlled trials (RCTs) have shown no effect of vitamin D supplementation on cardiovascular disease, cancer events and mortality or all-cause mortality in Western populations. However, there has been a lack of research on populations with low vitamin D status, including Asians. In addition, there have been indications that an individual’s sex or hypertension status may affect the relationship between vitamin D status and mortality. In this study, we retrospectively assessed the association between vitamin D status and all-cause, cardiovascular, and cancer mortality in Koreans using a national database, and stratified participants according to sex and hypertension status. Methods Participants in the Korean Health and Nutrition Examination Survey 2008–2014, who consented to their data being synthesized with mortality data (up to Dec 2019), were included (n = 22,742; mean follow-up: 8.9 years). Participants’ level of serum 25-hy-droxyvitamin D (25(OH)D) was measured by radioimmunoassay and categorized as <12, 12–19.9, and ≥20 ng/mL. A Cox proportional hazard model was used to assess the risk of mortality. Results In the total sample, risk of all-cause, cancer, and cardiovascular mortality was greater in adults with a serum 25(OH)D level below 12 and 12–19.9 ng/mL than those with ≥20 ng/mL. Men and adults with hypertension, who had low vitamin D status, had a higher risk of cancer and cardiovascular mortality, but not women or adults without hypertension. Similar results were observed when various cutoffs for 25(OH)D were employed, or extrinsic deaths were excluded. Conclusions Vitamin D status below 20 ng/mL is associated with a higher risk of mortality in Korean adults, especially in men and those with hypertension, on the basis of data from a nationally representative sample. Further RCTs on Asian adults with low vitamin D status are warranted.
KW - cancer
KW - cardiovascular disease
KW - hypertension
KW - mortality
KW - vitamin D
UR - http://www.scopus.com/inward/record.url?scp=85129021972&partnerID=8YFLogxK
U2 - 10.3390/nu14091849
DO - 10.3390/nu14091849
M3 - Article
C2 - 35565816
AN - SCOPUS:85129021972
SN - 2072-6643
VL - 14
JO - Nutrients
JF - Nutrients
IS - 9
M1 - 1849
ER -
