Association of serum vitamin D levels with chronic disease and mortality

• Published in: Nutrición hospitalaria : organo oficial de la Sociedad Española de Nutrición Parenteral y Enteral Vol. 37; no. 2; pp. 335 - 342
• Main Authors: Osorio Landa, Hillary Kimberly, Pérez Díaz, Iván, Laguna Bárcenas, Sara Del Carmen, López Navarro, Juan Manuel, Abella Roa, María Fernanda, Corral Orozco, Mariel, Mancilla Ortega, Juan Pablo, Martínez Duarte, Diana Alheli, Morales Montalvo, Susana Isabel, Múzquiz Aguirre, Sebastián, Sánchez Landa, Elizabet
• Format: Journal Article
• Language: English
• Published: Spain Grupo Arán 16-04-2020
• Subjects: Adult; Chronic Disease - mortality; Diabetes Mellitus, Type 2; Female; Humans; Male; Metabolic Diseases; Nutrition & Dietetics; Obesity; Vitamin D - analogs & derivatives; Vitamin D - biosynthesis; Vitamin D - blood; Vitamina D. Control glucémico. Diabetes mellitus de tipo 2. Enfermedad autoinmune. Mortalidad; Glycemic control; Control glucémico; Enfermedad autoinmune; Vitamin D; Type-2 diabetes mellitus; Mortality; Mortalidad; Autoimmune disease; Diabetes mellitus de tipo 2; Vitamina D
• ISSN: 0212-1611; 1699-5198; 1699-5198
• DOI: 10.20960/nh.02512

Introduction: whether hypovitaminosis D is an overarching cause of increased mortality or a prognostic marker of poor health has not been well elucidated. Objectives: we sought to determine the association of serum 25-hydroxyvitamin D [25-(OH)-D3] levels with the clinical biochemical parameters and mortality risk in chronic diseases. Methods: we reviewed the clinical charts and collected the clinical biochemical parameters of patients diagnosed with chronic conditions who had at least one 25-(OH)-D3 determination, with or without calcium and vitamin D supplementation, and who were selected using a cluster random sampling design (n = 1,705). The analysis was focused on metabolic disorders (type-2 diabetes mellitus [T2DM] and obesity), autoimmune disorders, and mortality. Multivariate logistic regression analyses were performed. Results: low 25-(OH)-D3 levels were reported in 1,433 (84.0%) patients, of which 774 (45.4%) had insufficiency (20-29 ng/mL) and 659 (38.6%) patients had deficiency (< 20 ng/mL). Lower 25-(OH)-D3 levels in T2DM patients were associated with higher glycosylated hemoglobin levels (p < 0.001). Patients with 25-(OH)-D3 levels < 12.5 ng/mL had a higher mortality risk than those with levels ≥ 12.5 ng/mL (HR: 3.339; 95% CI: 1.342-8.308). We observed lower 25-(OH)-D3 levels in patients with grade-III obesity (p = 0.01). We found a higher risk of 25-(OH)-D3 deficiency in rheumatoid arthritis, type-1 diabetes, and systemic lupus erythematosus (p = 0.032, p = 0.002, p = 0.049, respectively). Conclusions: we found a significant relationship between 25-(OH)-D3 levels and glycemic control, body mass index, autoimmune disease, and mortality risk. Nevertheless, whether hypovitaminosis D plays a causal role or is a consequence of chronic disease remains controversial.