title: Vitamin D status and cause-specific mortality: a general population study.
abstract: BACKGROUND
  Vitamin D deficiency is associated with an increased risk of all-cause mortality in observational studies. The specific causes of death underlying this association lack clarity. We investigated the association between vitamin D status and cause-specific mortality.
  
  
  METHODS
  We included a total of 9,146 individuals from the two population-based studies, Monica10 and Inter99, conducted in 1993-94 and 1999-2001, respectively. Vitamin D status was assessed as serum 25-hydroxyvitamin D. Information on causes of death was obtained from The Danish Register of Causes of Death until 31 December 2009. There were a total of 832 deaths (median follow-up 10.3 years).
  
  
  RESULTS
  Multivariable Cox regression analyses with age as underlying time axis and vitamin D quartiles showed significant associations between vitamin D status and death caused by diseases of the respiratory system, the digestive system, and endocrine, nutritional and metabolic diseases with hazard ratios (HRs) 0.26 (p(trend) = 0.0042), 0.28 (p(trend) = 0.0040), and 0.21 (p(trend) = 0.035), respectively, for the fourth vitamin D quartile compared to the first. We found non-significantly lower HRs for death caused by mental and behavioural diseases and diseases of the nervous system, but no association between vitamin D status and death caused by neoplasms or diseases of the circulatory system.
  
  
  CONCLUSIONS
  The associations of vitamin D status and cause-specific mortality suggest that we also look elsewhere (than to cardiovascular disease and cancer) to explain the inverse association between vitamin D status and mortality.
authors.affiliation: Research Centre for Prevention and Health, Glostrup Hospital, Glostrup, Denmark. tea.skaaby.01@regionh.dk
authors.forename: Tea
authors.initials: T
authors.lastname: Skaaby
authors.forename: Lise Lotte Nystrup
authors.initials: LL
authors.lastname: Husemoen
authors.forename: Charlotta
authors.initials: C
authors.lastname: Pisinger
authors.forename: Torben
authors.initials: T
authors.lastname: Jørgensen
authors.forename: Betina Heinsbæk
authors.initials: BH
authors.lastname: Thuesen
authors.forename: Mogens
authors.initials: M
authors.lastname: Fenger
authors.forename: Allan
authors.initials: A
authors.lastname: Linneberg
mesh_terms: D002423:Cause of Death; D016001:Confidence Intervals; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D016016:Proportional Hazards Models; D012307:Risk Factors; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood*
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D