title: Vitamin D, PTH and the risk of overall and disease-specific mortality: Results of the Longitudinal Aging Study Amsterdam.
abstract: Observational studies suggest that low concentrations of serum 25-hydroxyvitamin D (25(OH)D) and high concentrations of parathyroid hormone (PTH) are associated with a higher risk of mortality. The aim of this study was to examine whether 25(OH)D and PTH concentrations are independently associated with overall and disease-specific (cardiovascular and cancer-related) mortality in a large, prospective population-based cohort of older adults. Data from 1317 men and women (65-85 years) of the Longitudinal Aging Study Amsterdam were used. Cox proportional hazard analyses were used to examine whether 25(OH)D and PTH at baseline were associated with overall mortality (with a follow-up of 18 years) and disease-specific mortality (with a follow-up of 13 years). Compared to persons in the reference category of ≥75nmol/L, persons with serum 25(OH)D <25nmol/L (HR 1.46; 95% CI: 1.12-1.91) and 25-49.9nmol/L (HR 1.24; 95% CI: 1.01-1.53) had a significantly higher risk of overall mortality, as well as men with baseline PTH concentrations ≥7pmol/L (HR 2.54 (95% CI: 1.58-4.08)), compared to the reference category of <2.33pmol/L. The relationship of 25(OH)D with overall mortality was partly mediated by PTH. Furthermore, men with PTH concentrations of ≥7pmol/L (HR 3.22; 95% CI: 1.40-7.42) had a higher risk of cardiovascular mortality, compared to the reference category. No significant associations of 25(OH)D or PTH with cancer-related mortality were observed. Both 25(OH)D and PTH should be considered as important health markers.
authors.affiliation: Department of Epidemiology and Biostatistics, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands. Electronic address: j.elhilali@hotmail.nl.
authors.forename: Jamila
authors.initials: J
authors.lastname: El Hilali
authors.affiliation: Department of Epidemiology and Biostatistics, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands; EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands. Electronic address: ej.dekoning@vumc.nl.
authors.forename: Elisa J
authors.initials: EJ
authors.lastname: de Koning
authors.affiliation: EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands; Department of Health Sciences, VU University, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands. Electronic address: a.j.van.ballegooijen@vu.nl.
authors.forename: Adriana J
authors.initials: AJ
authors.lastname: van Ballegooijen
authors.affiliation: EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands; Department of Internal Medicine, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands. Electronic address: p.lips@vumc.nl.
authors.forename: Paul
authors.initials: P
authors.lastname: Lips
authors.affiliation: Department of Epidemiology and Biostatistics, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands; EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands. Electronic address: e.sohl@vumc.nl.
authors.forename: Evelien
authors.initials: E
authors.lastname: Sohl
authors.affiliation: EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands; Department of General Practice and Elderly Care Medicine, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands; Primary Care Research Center, Institute of Population Health, University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom. Electronic address: harm.vanmarwijk@manchester.ac.uk.
authors.forename: Harm W J
authors.initials: HWJ
authors.lastname: van Marwijk
authors.affiliation: EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands; Department of Health Sciences, VU University, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands; Department of Internal Medicine, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands. Electronic address: m.visser@vu.nl.
authors.forename: Marjolein
authors.initials: M
authors.lastname: Visser
authors.affiliation: Department of Epidemiology and Biostatistics, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands; EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands. Electronic address: nm.vanschoor@vumc.nl.
authors.forename: Natasja M
authors.initials: NM
authors.lastname: van Schoor
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood*; D000428:Alcohol Drinking / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D009426:Netherlands / Q000453:epidemiology; D010281:Parathyroid Hormone / Q000097:blood*; D016016:Proportional Hazards Models; D011788:Quality of Life; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000503:physiopathology; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: All-cause mortality; Cancer mortality; Cardiovascular mortality; Older adults; PTH; Vitamin D