Vitamin D and mortality: meta-analysis of individual participant data from a large consortium of cohort studies from Europe and the United States

Objective: To investigate the association between serum 25-hydroxyvitamin D concentrations (25(OH)D) and mortality in a large consortium of cohort studies paying particular attention to potential age, sex, season, and country differences.

Design: Meta-analysis of individual participant data of eight prospective cohort studies from Europe and the US.

Setting: General population.

Participants: 26 018 men and women aged 50-79 years

Main outcome measures: All-cause, cardiovascular, and cancer mortality.

Results: 25(OH)D concentrations varied strongly by season (higher in summer), country (higher in US and northern Europe) and sex (higher in men), but no consistent trend with age was observed. During follow-up, 6695 study participants died, among whom 2624 died of cardiovascular diseases and 2227 died of cancer. For each cohort and analysis, 25(OH)D quintiles were defined with cohort and subgroup specific cut-off values. Comparing bottom versus top quintiles resulted in a pooled risk ratio of 1.57 (95% CI 1.36 to 1.81) for all-cause mortality. Risk ratios for cardiovascular mortality were similar in magnitude to that for all-cause mortality in subjects both with and without a history of cardiovascular disease at baseline. With respect to cancer mortality, an association was only observed among subjects with a history of cancer (risk ratio, 1.70 (1.00 to 2.88)). Analyses using all quintiles suggest curvilinear, inverse, dose-response curves for the aforementioned relationships. No strong age, sex, season, or country specific differences were detected. Heterogeneity was low in most meta-analyses.

Conclusions: Despite levels of 25(OH)D strongly varying with country, sex, and season, the association between 25(OH)D level and all-cause and cause-specific mortality was remarkably consistent. Results from a long term randomised controlled trial addressing longevity are being awaited before vitamin D supplementation can be recommended in most individuals with low 25(OH)D levels.

Captain Lewis Warrington and others : memorial of Lewis Warrington, Captain in the U.S. Navy, (in behalf of himself and the officers and crew of the U.S. sloop-of-war Peacock); praying that the one half of the proceeds of the Epervier and goods which went into the officers and crew of said vessel, it having been decreed to them by the United States court as captors. April 26, 1848.--

Caption title.

Letter from the Secretary of the Navy, transmitting the official account of the capture of the British sloop of War, Reindeer, by the United States sloop Wasp, commanded by Captain Johnston Blakeley, on the twenty-eighth June last.--

"A list of British vessels captured by the United States' sloop of War Wasp, J. Blakeley esg. commander, between May 1st and July 6th, 1814".Folded table at end.

Message from the President of the United States, transmitting documents relative to the commencement and progress of any acts or system of retaliation upon prisoners of war, by the Governments of Great Britain and the United States. --

13th Congress, 3d session. House. Doc. no. 13.

Message from the President of the United States, transmitting communications from the plenipotentiaries of the United States charged with negotiating peace with Great Britain : showing the conditions on which alone that government is willing to put an end to the war. --

13th Congress, 3d session. House. Doc. 6.

Message from the President of the United States, transmitting copies of the instructions given to the ministers of the United States appointed to negotiate a peace with Great Britain. --

13th Congress, 3d session. House. Doc. no. 8.

Message from the President of the United States, transmitting a report of the Secretary of State, in obedience to a resolution of the thirteenth inst. "requesting the President to lay before this House such documents relative to the Russian mediation as in his opinion it may not be improper to communicate." --

United States,13th Congress, 2d session, 1813-1814. House. Doc. no. 35.

Message from the President of the United States to both Houses of Congress at the commencement of the second session of the twelfth Congress. --

November 4, 1812. Read, and ordered to be printed.

Report of the Committee to whom was Referred the Correspondence between Mr. Monroe and Mr. Canning, and between Mr. Madison and Mr. Rose, relative to the attacked of Chesapeake : and also a communication from the President of the United States of the 30 March last, with a letter from Mr. Erskine to the Secretary of State, and a letter from M. Champagny to Gen. Armstrong.--

April 16, 1808. Printed by Order of the Senate.

Letter from the Secretary of the Navy, transmitting the official account of the capture of the British sloop of War, Reindeer, by the United States sloop Wasp, commanded by Captain Johnston Blakeley, on the twenty-eighth June last

"A list of British vessels captured by the United States' sloop of War Wasp, J. Blakeley esg. commander, between May 1st and July 6th, 1814".Folded table at end. October 17, 1814. Printed by order of the Senate of the United States.

Message from the President of the United States to both Houses of Congress at the commencement of the second session of the twelfth Congress

November 4, 1812. Read, and ordered to be printed. Includes Documents accompanying the Message of the President of the United States to the two Houses of Congress, at the opening of the second session of the twelfth Congress United States. 12th Congress, 2nd session, 1812-1813. House.; United States. 12th Congress, 2nd session, 1812-1813. Senate.; United States. Congress. House.; United States. Congress. Senate. Printed by A. and C. Way

Message from the President of the United States, transmitting a report of the Secretary of State, in obedience to a resolution of the thirteenth inst.

Full Title: 47. Message from the President of the United States, transmitting a report of the Secretary of State, in obedience to a resolution of the thirteenth inst. "requesting the President to lay before this House such documents relative to the Russian mediation as in his opinion it may not be improper to communicate." United States,13th Congress, 2d session, 1813-1814. House. Doc. no. 35. January 18, 1814. Ordered to lie on the table. One letter in French with English translation Printed by Roger C. Weightman