Vitamin D and Risk of All-cause and Cause-specific Mortality

Sarfaroj Khan 

July 14, 2020


  • Higher serum 25-hydroxyvitamin D (25[OH]D) concentrations are non-linearly associated with a lower risk of all-cause, cardiovascular disease (CVD) and cancer mortality.

Why this matters

  • Findings suggest that thresholds of 45-60 nmol/L may represent a potential target to reduce the risk of premature death, which needs to be confirmed in future randomised controlled trials.

Study design

  • This UK Biobank study included 365,530 participants with 25(OH)D measurements and no history of CVD, cancer or diabetes between 2006 and 2010.

  • Primary outcome: all-cause and cause-specific mortality.

  • Funding: National Natural Science Foundation of China and others.

Key results

  • During a median follow-up of 8.9 (interquartile range, 8.3-9.5) years, 10,175 deaths were reported, including 1841 (18.1%) from CVD, 5737 (56.4%) from cancer and 2597 (25.5%) from other causes.

  • Compared with participants with 25(OH)D <60 nmol/L, those with ≥60 nmol/L had a lower risk of:

    • all-cause mortality (HR, 0.83; 95% CI, 0.79-0.86);

    • CVD mortality (HR, 0.77; 95% CI, 0.68-0.86); and

    • other mortality (HR, 0.66; 95% CI, 0.60-0.73).

  • Participants with 25(OH)D ≥45 nmol/L vs those with <45 nmol/L were at a lower risk of cancer mortality (HR, 0.89; 95% CI, 0.84-0.95).

  • In the cancer-specific analysis, participants with 25(OH)D ≥45 nmol/L had a reduced risk of lung cancer mortality (HR, 0.82; 95% CI, 0.72-0.93) compared with those with <45 nmol/L.


  • Reverse causality cannot be excluded.


Fan X, Wang J, Song M, Giovannucci EL, Ma H, Jin G, Hu Z, Shen H, Hang D. Vitamin D status and risk of all-cause and cause-specific mortality in a large cohort: results from the UK Biobank. J Clin Endocrinol Metab. 2020 Jul 4 [Epub ahead of print]. doi: 10.1210/clinem/dgaa432. PMID: 32620963 Abstract. 

This clinical summary first appeared on Univadis, part of the Medscape Professional Network.


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