Low levels of vitamin D are associated with multimorbidity: results from the LifeLines Cohort Study.
BACKGROUND
The prevalence of multimorbidity (≥ 1 disease within an individual) is rapidly increasing. So far, studies on the relationship between vitamin D and morbidity are mainly focusing on effects on single disease domains only, while vitamin D biology is associated with several diseases throughout the human body.


METHODS
We studied 8,726 participants from the LifeLines Cohort Study (a cross-sectional, population-based cohort study) and used the self-developed composite morbidity score to study the association between vitamin D levels and multimorbidity.


RESULTS
Study participants (mean age 45 ± 13 years, 73% females) had a mean plasma vitamin D level of 59 ± 22 nmol/L. In participants aged between 50 and 60 years, 58% had ≥ 2 affected disease domains, while morbidity score increased with age (70-80 years: 82% morbidity score > 1; > 80 years: 89% morbidity score > 1). Each incremental reduction by 1 standard deviation (SD) of vitamin D level was associated with an 8% higher morbidity score (full model OR 0.92, 95% CI 0.88-0.97, P = 0.001). Participants with vitamin D levels < 25 nmol/L were at highest risk for increasing morbidity prevalence (versus > 80 nmol/L, OR 1.34, 95% CI 1.07-1.67, P = 0.01).


CONCLUSIONS
Low levels of vitamin D are associated with higher prevalence of multimorbidity, especially in participants with vitamin D levels < 25 nmol/L. Collectively, our results favor a general, rather than an organ-specific, approach when assessing the impact of vitamin D deficiency.
a Department of Cardiology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.
Laura M G
LM
Meems
b Department of Internal Medicine , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.
Martin H
MH
de Borst
c Department of Pulmonology , Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.
Dirkje S
DS
Postma
c Department of Pulmonology , Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.
Judith M
JM
Vonk
d Department of Neurology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.
Hubertus P H
HP
Kremer
e Department of Dermatology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.
Marie-Louise A
ML
Schuttelaar
b Department of Internal Medicine , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.|f Department of Psychiatry , Department of Internal Medicine, University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.
Judith G M
JG
Rosmalen
g Department of Gastroenterology and Hepatology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.
Rinse K
RK
Weersma
h Department of Endocrinology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.
Bruce H R
BH
Wolffenbuttel
i Department of LifeLines Cohort Study & Biobank , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.
Salome
S
Scholtens
i Department of LifeLines Cohort Study & Biobank , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.
Ronald P
RP
Stolk
j Department of Laboratory Medicine , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.
Ido P
IP
Kema
b Department of Internal Medicine , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.
Gerjan
G
Navis
a Department of Cardiology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.
Mohsin A F
MA
Khan
a Department of Cardiology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.
Pim
P
van der Harst
a Department of Cardiology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.
Rudolf A
RA
de Boer
D000328:Adult; D000368:Aged; D002112:Calcifediol / Q000097:blood; D002853:Chromatography, Liquid / Q000379:methods; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D053719:Tandem Mass Spectrometry / Q000379:methods; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood* / Q000453:epidemiology
D014807:Vitamin D; D002112:Calcifediol
25-hydroxyvitamin D; Co-morbidity; LifeLines Cohort Study; morbidity; multimorbidity; vitamin D; vitamin D deficiency