Serum 25-hydroxyvitamin D level, chronic diseases and all-cause mortality in a population-based prospective cohort: the HUNT Study, Norway

Abstract

Objective: To investigate the association of vitamin D status with all-cause mortality in a Norwegian population and the potential influences of existing chronic diseases on the association. Design: A population-based prospective cohort study Setting: Nord-Trøndelag County, Norway. Participants: A random sample (n = 6613) of adults aged 20 years or older in a cohort. Methods: Serum 25-hydroxyvitamin D [25(OH)D] levels were measured in blood samples collected at baseline (n = 6377). Mortality was ascertained from the Norwegian National Registry. Cox regression models were applied to estimate the hazard ratios (HRs) with 95% confidence intervals (CIs) for all-cause mortality in association with serum 25(OH)D levels after adjustment for a wide-spectrum of confounding factors as well as chronic diseases at baseline. Results: The median follow-up time was 18.5 years, during which 1539 subjects died. The HRs for all-cause mortality associated with the 1st quartile level of 25(OH)D (<34.5 nmol/L) as compared with the 4th quartile (≥58.1 nmol/L) before and after adjustment for chronic diseases at baseline were 1.30 (95% CI 1.11–1.51) and 1.27 (1.09–1.48), respectively. In the subjects without chronic diseases at baseline and with further exclusion of the first 3 years of follow-up, the corresponding adjusted HR was 1.34 (95% CI 1.09–1.66). Conclusions: Low serum 25(OH)D level was associated with increased all-cause mortality in a general Norwegian population. The association was not notably influenced by existing chronic diseases.