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Vitamin D supplementation early in life in diabetics may prevent premature mortality, finds study

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Vitamin D supplementation early in life in diabetics may prevent premature mortality, finds study

Vitamin D now has extensive research supporting its role in immune function, healthy cell division, and bone health. Vitamin D deficiency is major health risk factor for people of all ages and has been associated with chronic adverse health conditions. Majority of studies on Vitamin D deficiency and mortality have looked into only the older population.

In a study presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) in Barcelona, Spain revealed that low vitamin D levels are associated with 4.4 times higher risk of death in patients aged 45 to 60 years with diabetes or high blood sugar. Widespread Vitamin D supplementation early in life in diabetics may prevent premature mortality, the researchers suggest.

The study also found that vitamin D levels of 10 nmol/L or less were associated with a 2-3 fold increase in the risk of death, with the largest effect being observed in patients aged 45 to 60 years (2.9 times increased risk) without considering the cardiovascular and non-cardiovascular risk factors. However, the strongest associations of vitamin D were with causes of death other than cardiovascular disease and cancer.

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The research was conducted by Dr Rodrig Marculescu and colleagues at the Medical University of Vienna, Austria. It analyzed the effects of low 25-hydroxyvitamin D (25D) (referred to as vitamin D) levels in the blood on overall and cause-specific mortality in a large study cohort covering all age groups and taken from a population with minimal vitamin D supplementation in old age. They also note: “Cause-specific mortalities and the impact of age on the association of vitamin D with the risk of death have not yet been reported in detail.”

The researchers took their data from the records of all 78,581 patients (mean age 51.0 years, 31.5% male) who had a vitamin D (25D) measurement taken at the Department of Laboratory Medicine, General Hospital of Vienna between 1991 and 2011, which was then matched with the Austrian national register of deaths. The first 3 years of mortality following the vitamin D measurement were excluded from the analysis, and patients were followed for up to 20 years where possible, with a median follow-up of 10.5 years.

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The authors used a blood level of vitamin D 50 nmol/L, a commonly used cut-off value for vitamin D deficiency, as their reference value to which other levels would be compared, and set their low and high levels for which risk would be calculated at 10 nmol/L and 90 nmol/L respectively.

Key Findings of the study are as follows:

  • The study found that vitamin D levels of 10 nmol/L or less were associated with a 2-3 fold increase in the risk of death, with the largest effect being observed in patients aged 45 to 60 years (2.9 times increased risk).
  • Levels of 90 nmol/L or greater were associated with a reduction in all-cause mortality of 30-40%, again with the largest effect being found in the 45 to 60-years-old age group (a 40% reduction in risk).
  • No statistically significant associations between vitamin D levels and mortality were observed in patients over the age of 75
  • Differences between the age groups were even more pronounced for these causes of death and, again, the largest effect was found in patients aged 45 to 60 years.
  • Further subdivision of these non-cardiovascular, non-cancer causes of death revealed the largest effect of vitamin for diabetes with a 4.4 times higher risk of death from the disease in the vitamin D deficient group (less than or equal to 50 nmol/L) than for study participants whose serum vitamin D was above 50 nmol/L.

Plotting the risk of death according to vitamin D level in the various subgroups did not support a risk resurgence at higher vitamin D levels above 100 nmol/L. The authors say this further diminishes concerns about a possible negative effect of vitamin D in the higher concentration range, as have been shown in some previous studies reporting “inverse J-shaped” risk association (meaning risk decreased to a certain level of vitamin D and then started increasing again at higher levels).

The team conclude: “Our survival data from a large cohort, covering all age groups, from a population with minimal vitamin D supplementation at old age, confirm a strong association of vitamin D deficiency (under 50 nmol/L) with increased mortality. This association is most pronounced in the younger and middle-aged groups and for causes of deaths other than cancer and cardiovascular disease, especially diabetes.”

The researchers go on to suggest that: “Our findings strengthen the rationale for widespread vitamin D supplementation to prevent premature mortality, emphasize the need for it early in life and mitigate concerns about a possible negative effect at higher levels.”




Source: self

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