Does liver damage explain the inverse association between vitamin D status and mortality?

TY - JOUR

T1 - Does liver damage explain the inverse association between vitamin D status and mortality?

AU - Skaaby, Tea

AU - Husemoen, Lise Lotte N

AU - Linneberg, Allan

PY - 2013/12

Y1 - 2013/12

N2 - Purpose: Several observational studies have linked vitamin D deficiency with an increased risk of all-cause mortality. Vitamin D deficiency is common among patients with liver diseases. In a random sample of the general population, we investigated whether the inverse association between vitamin D status and all-cause mortality could be explained by liver damage as reflected by increased levels of liver enzymes. Methods: We included a total of 2649 persons examined in 1993-1994. Vitamin D status was assessed as serum 25-hydroxyvitamin D and liver enzyme levels were measured. Information on all-cause mortality was obtained from the Danish Central Personal Register until July 2011. Median follow-up time was 17.0 years, and there were 736 deaths. Results: Multivariable Cox regression analyses with age as underlying time axis and delayed entry showed lower mortality risk with higher vitamin D levels and this was essentially unaffected by adjustment for liver enzyme levels with hazard ratio, 0.96 (95% confidence interval, 0.93-0.99) for a 10 nmol/L higher vitamin D level. Conclusions: The present study did not support our hypothesis that the well-known association between low vitamin D status and mortality is explained by liver damage as reflected by levels of liver enzymes.

AB - Purpose: Several observational studies have linked vitamin D deficiency with an increased risk of all-cause mortality. Vitamin D deficiency is common among patients with liver diseases. In a random sample of the general population, we investigated whether the inverse association between vitamin D status and all-cause mortality could be explained by liver damage as reflected by increased levels of liver enzymes. Methods: We included a total of 2649 persons examined in 1993-1994. Vitamin D status was assessed as serum 25-hydroxyvitamin D and liver enzyme levels were measured. Information on all-cause mortality was obtained from the Danish Central Personal Register until July 2011. Median follow-up time was 17.0 years, and there were 736 deaths. Results: Multivariable Cox regression analyses with age as underlying time axis and delayed entry showed lower mortality risk with higher vitamin D levels and this was essentially unaffected by adjustment for liver enzyme levels with hazard ratio, 0.96 (95% confidence interval, 0.93-0.99) for a 10 nmol/L higher vitamin D level. Conclusions: The present study did not support our hypothesis that the well-known association between low vitamin D status and mortality is explained by liver damage as reflected by levels of liver enzymes.

U2 - 10.1016/j.annepidem.2013.10.002

DO - 10.1016/j.annepidem.2013.10.002

M3 - Journal article

SN - 1047-2797

VL - 23

SP - 812

EP - 814

JO - Annals of Epidemiology

JF - Annals of Epidemiology

IS - 12

ER -