Diabetics with high vitamin D have 40 pcnt less all-cause mortality – Nov 2020

Association of Serum 25-Hydroxyvitamin D Concentrations With All-Cause and Cause-Specific Mortality Among Individuals With Diabetes

Diabetes Care, . 2020 Nov 8;dc201485., doi: 10.2337/dc20-1485. .
Zhenzhen Wan 1 2, Jingyu Guo 3, An Pan 4, Chen Chen 4, Liegang Liu 5 2, Gang Liu 5 2

Objective: The evidence regarding vitamin D status and mortality among diabetes is scarce. This study aimed to examine the association of serum 25-hydroxyvitamin D [25(OH)D] concentrations with all-cause and cause-specific mortality among adults with diabetes.

Research design and methods: This study included 6,329 adults with diabetes from the Third National Health and Nutrition Examination Survey (NHANES III) and NHANES 2001-2014. Death outcomes were ascertained by linkage to National Death Index records through 31 December 2015. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% CIs for mortality from all causes, cardiovascular disease (CVD), and cancer.

Results: The weighted mean (95% CI) level of serum 25(OH)D was 57.7 (56.6, 58.8) nmol/L, and 46.6% had deficient vitamin D (<50 nmol/L [20 ng/mL]). Higher serum 25(OH)D levels were significantly associated with lower levels of glucose, insulin, HOMA of insulin resistance, HbA1c, blood lipids, and C-reactive protein at baseline (all P trend < 0.05). During 55,126 person-years of follow-up, 2,056 deaths were documented, including 605 CVD deaths and 309 cancer deaths.
After multivariate adjustment, higher serum 25(OH)D levels were significantly and linearly associated with lower all-cause and CVD mortality: there was a

• 31% reduced risk of all-cause mortality and a
• 38% reduced risk of CVD mortality

per one-unit increment in natural log-transformed 25(OH)D (both P < 0.001).
Compared with participants with 25(OH)D <25 nmol/L, the multivariate-adjusted HRs and 95% CI for participants with 25(OH)D >75 nmol/L were

• 0.59 (0.43, 0.83) for all-cause mortality (P trend = 0.003),
• 0.50 (0.29, 0.86) for CVD mortality (P trend = 0.02), and
• 0.49 (0.23, 1.04) for cancer mortality (P trend = 0.12).

Conclusions: Higher serum 25(OH)D levels were significantly associated with lower all-cause and CVD mortality. These findings suggest that maintaining adequate vitamin D status may lower mortality risk in individuals with diabetes.