Correlation between serum 25-hydroxyvitamin D levels and all-cause mortality risk among adult women in the United States
10.3760/cma.j.cn115624-20231009-00178
- VernacularTitle:美国成年女性血清25-羟维生素D水平与全因死亡风险的相关性
- Author:
Jing LIU
1
;
Jinping LI
;
Tian TIAN
;
Fang MA
Author Information
1. 宁夏医科大学总医院日间病房，银川 750004
- Keywords:
Female;
Adult;
25-Hydroxyvitamin D;
Mortality;
Correlation
- From:
Chinese Journal of Health Management
2024;18(6):421-427
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To examine the correlation between serum 25-hydroxyvitaminD [25(OH)D] levels and all-cause mortality risk among adult women in the United States.Methods:Data for this retrospective cohort study were obtained from the National Health and Nutrition Examination Survey 2011—2016. A total of 6 452 women with complete data were enrolled and the end point event was all-cause mortality. The subjects were categorized into four groups based on serum 25(OH)D levels: severe deficiency group [25(OH)D<25.0 nmol/L, n=285], deficiency group [25(OH)D 25.0-49.9 nmol/L, n=1 695], insufficient group [25(OH)D 50.0-74.9 nmol/L, n=2 119], and sufficient group [25(OH)D≥75.0 nmol/L, n=2 353]. The serum 25 (OH) D level was included in cox proportional hazards model as a continuous variables and a categorical variables, respectively, to estimate the risk of all-cause mortality. Cox regression model based on restricted cubic splines was used to observe the curve relationship between the continuous change of serum 25(OH)D and the risk of all-cause mortality. A two-piecewise linear regression model was used to analyze the saturation threshold effect and examine the correlation between serum 25(OH)D levels and all-cause mortality risk among adult women in the United States. Results:A total of 6 452 women were enrolled. The mean level of serum 25(OH)D was (68.2±31.6) nmol/L, and only 36.5% (2 353/6 452) of the women had sufficient vitamin D. During the follow-up time of (5.8±1.8) years, 375 women died, and the all-cause mortality rate of 5.8%. After multivariate adjustment, for every 10 nmol/L increase in serum 25(OH)D level, the risk of all-cause mortality was reduced by 5% ( HR=0.95, 95% CI: 0.91-0.98) ( P<0.05). Compared with serum 25(OH)D severe deficiency group, the risk of all-cause mortality in 25(OH)D sufficient group was 54% lower ( HR=0.46, 95% CI: 0.29-0.75) ( P<0.05, Ptrend<0.001). The association between serum 25(OH)D levels and all-cause mortality risk exhibited an L-shaped curve ( P=0.007) and the inflection point was 128.5 nmol/L; when the serum level of 25(OH)D was less than 128.5 nmol/L, for every 10 nmol/L increase in 25(OH)D, the risk of all-cause mortality was reduced by 8% ( HR=0.92, 95% CI: 0.88-0.96) ( P<0.001). Conclusion:High serum 25(OH)D concentrations are non-linearly associated with low risk of all-cause mortality. These findings suggest that maintaining adequate vitamin D status may lower mortality risk in American women individuals.
