title: Serum 25-hydroxyvitamin D, parathyroid hormone, and mortality in older men.
abstract: BACKGROUND
  Low 25-hydroxyvitamin D [25(OH)D] and high PTH may contribute to increased mortality risk in older adults.
  
  
  OBJECTIVE
  The aim of the study was to test the association between 25(OH)D, PTH, and mortality in older men.
  
  
  METHODS
  The prospective Osteoporotic Fractures in Men (MrOS) study was conducted at six U.S. clinical centers.
  
  
  METHODS
  We studied community-dwelling men at least 65 yr old (n = 1490).
  
  
  METHODS
  Multivariate-adjusted proportional hazards models estimated the hazard ratio (HR) for mortality; cause of death was classified as cancer, cardiovascular, and other by central review of death certificates.
  
  
  RESULTS
  During 7.3 yr of follow-up, 330 (22.2%) participants died: 97 from cancer, 110 from cardiovascular disease, and 106 from other causes. The adjusted HR per sd decrease in 25(OH)D for all-cause mortality was 1.01 (95% CI, 0.89, 1.14); no association between 25(OH)D and cardiovascular or other-cause mortality was seen. Unexpectedly, lower 25(OH)D levels were modestly associated with a decreased risk of cancer mortality (adjusted HR per sd decrease, 0.80; 95% CI, 0.64, 0.99). Analyzing 25(OH)D as a categorical variable did not alter these results. Higher PTH levels (log-transformed) were associated with an increased risk of all-cause mortality (adjusted HR per sd increase, 1.15; 95% CI, 1.03, 1.29) and cardiovascular mortality (adjusted HR per sd increase in PTH, 1.21; 95% CI, 1.00, 1.45).
  
  
  CONCLUSIONS
  In contrast to previous studies, lower 25(OH)D levels were not associated with an increased risk of all-cause or cause-specific mortality in older men. Higher PTH levels were associated with a modest increase in mortality risk.
authors.affiliation: California Pacific Medical Center Research Institute, California Pacific Medical Center, San Francisco, California 94107-1762, USA. pcawthon@sfcc-cpmc.net
authors.forename: Peggy M
authors.initials: PM
authors.lastname: Cawthon
authors.forename: Neeta
authors.initials: N
authors.lastname: Parimi
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barrett-Connor
authors.forename: Gail A
authors.initials: GA
authors.lastname: Laughlin
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Ensrud
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Hoffman
authors.forename: James M
authors.initials: JM
authors.lastname: Shikany
authors.forename: Jane A
authors.initials: JA
authors.lastname: Cauley
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Lane
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Bauer
authors.forename: Eric S
authors.initials: ES
authors.lastname: Orwoll
authors.forename: Steven R
authors.initials: SR
authors.lastname: Cummings
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000401:mortality; D002423:Cause of Death; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000097:blood / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009026:Mortality; D010281:Parathyroid Hormone / Q000097:blood*; D016019:Survival Analysis; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D