Association of serum 25-hydroxyvitamin D with influenza in case-control study nested in a cohort of Japanese employees.
Several intervention studies have examined the effect of vitamin D supplementation on influenza or influenza-like illness, but their results have been inconsistent. We prospectively examined the association of serum 25-hydroxyvitamin D with influenza among Japanese workers.



We conducted a nested case-control study in a cohort of workers in 4 companies in the Kanto and Tokai areas of Japan. Physician-diagnosed influenza that occurred during the winter season was ascertained using a self-administered questionnaire. Two controls matched by company, sex, and age (and checkup date in 1 company) were selected for each case. Serum 25-hydroxyvitamin D concentrations at baseline were measured using a competitive protein binding assay. Odds ratio of influenza were estimated by conditional logistic regression with adjustment for covariates.



Of 182 cases and 364 controls, 179 cases and 353 controls with complete data were included in the analysis. Serum 25-hydroxyvitamin D concentrations were not associated with a significantly lower risk of influenza; the multivariable-adjusted odds ratio for the highest (≥30 ng/mL) versus lowest category (<20 ng/mL) was 0.77 (95% confidence interval 0.37-1.59) (P for trend = 0.80). In a subgroup of participants without vaccination, vitamin D sufficiency (≥30 ng/mL) was associated with a significantly lower risk of influenza (odds ratio 0.14; 95% confidence interval 0.03-0.74).



Overall, circulating 25-hydroxyvitamin D concentrations were not appreciably associated with influenza episodes. However, the lower influenza risk associated with vitamin D sufficiency among unvaccinated participants warrants further investigation.
Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan. Electronic address: nanri@ri.ncgm.go.jp.
Akiko
A
Nanri
NGK Insulators, Ltd., Aichi, Japan.
Kengo
K
Nakamoto
Health Design Inc., Tokyo, Japan.
Nobuaki
N
Sakamoto
Azbil Corporation, Tokyo, Japan.
Teppei
T
Imai
Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan.
Shamima
S
Akter
Department of Global Health, School of Health Sciences, University of the Ryukyus, Okinawa, Japan.
Daisuke
D
Nonaka
Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan.
Tetsuya
T
Mizoue
D000328:Adult; D044466:Asian People; D015992:Body Mass Index; D016022:Case-Control Studies; D015331:Cohort Studies; D015444:Exercise; D005260:Female; D006801:Humans; D007251:Influenza, Human / Q000097:blood* / Q000453:epidemiology; D007564:Japan; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012621:Seasons; D011795:Surveys and Questionnaires; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood
D014807:Vitamin D; C104450:25-hydroxyvitamin D
Influenza; Japanese; Nested case-control studies; Serum 25-hydroxyvitamin D; Vitamin D