Nutrición Hospitalaria
ISSN 1699-5198 ISSN 0212-1611
OSORIO-LANDA, Hillary K. et al. Association of serum vitamin D levels with chronic disease and mortality. []. , 37, 2, pp.335-342. 03--2020. ISSN 1699-5198. https://dx.doi.org/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.
: Vitamin D; Glycemic control; Type-2 diabetes mellitus; Autoimmune disease; Mortality.