Serum 25-hydroxyvitamin D, parathyroid hormone, and mortality in older men
Abstract
CONTEXT: Low 25-hydroxyvitamin D [25(OH)D] and high PTH may contribute to increased mortality risk in older adults.
OBJECTIVE: The aim of the study was to test the association between 25(OH)D, PTH, and mortality in older men.
DESIGN AND SETTING: The prospective Osteoporotic Fractures in Men (MrOS) study was conducted at six U.S. clinical centers.
PARTICIPANTS: We studied community-dwelling men at least 65 yr old (n = 1490).
MAIN OUTCOME MEASURE: Multivariate-adjusted proportional hazards models estimated the hazard ratio (HR) for mortality; cause of death was classified as cancer, cardiovascular, and other by central review of death certificates.
RESULTS: During 7.3 yr of follow-up, 330 (22.2%) participants died: 97 from cancer, 110 from cardiovascular disease, and 106 from other causes. The adjusted HR per sd decrease in 25(OH)D for all-cause mortality was 1.01 (95% CI, 0.89, 1.14); no association between 25(OH)D and cardiovascular or other-cause mortality was seen. Unexpectedly, lower 25(OH)D levels were modestly associated with a decreased risk of cancer mortality (adjusted HR per sd decrease, 0.80; 95% CI, 0.64, 0.99). Analyzing 25(OH)D as a categorical variable did not alter these results. Higher PTH levels (log-transformed) were associated with an increased risk of all-cause mortality (adjusted HR per sd increase, 1.15; 95% CI, 1.03, 1.29) and cardiovascular mortality (adjusted HR per sd increase in PTH, 1.21; 95% CI, 1.00, 1.45).
CONCLUSIONS: In contrast to previous…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 1,490 participants or records.
Read the paper
Related studies
- Effectiveness of Bisphosphonates and Denosumab on Risk of Vertebral Fractures in Prostate Cancer Patients Under Androgen Deprivation Therapies: A Real-World Prospective Study
- Osteoporosis-related fractures after spinal cord injury: a retrospective study from Brazil
- Lack of Association between Vitamin D Insufficiency and Cardiovascular or Fracture Risk: A UK Biobank Study
- Muscle strength and body composition are clinical indicators of osteoporosis
- Incidence of bone protection and associated fragility injuries in patients with proximal femur fractures
- Total 25-hydroxyvitamin D levels predict fracture risk: results from the 15-year follow-up of the Japanese Population-based Osteoporosis (JPOS) Cohort Study
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.