Vitamin D and Health

All-cause mortality
Table 44: Systematic reviews of RCTs and prospective studies of vitamin D supplementation/25(OH)D concentration on all-cause mortality risk
Study Methods Results Author’s conclusions
Bjelakovic et al (2014)
Chowdhury et al
(2014)
Schottker et al (2014)
Selection criteria:
Inclusion: RCTs of vitamin D (any type & any route)
vs placebo/no intervention in the general
population or patients in stable phase of disease.
Exclusion: Patients with secondary induced
osteoporosis or cancer, pregnant &lactating
women.
Selection criteria:
Inclusion: Cohort studies on association of 25(OH)D
with cause specific or all cause deaths in healthy
adults. Randomised intervention studies which
assessed effects of vit D supplements alone with
placebo/no treatment & collected cause specific or
all-cause mortality endpoints.
Exclusion: no relevant exposure of outcome data,
reviews, letter or editorials, case reports, in
vitro/functional studies, non-adult population,
inappropriate baseline population, non-randomised
trials.
Meta-analysis of individual participant data
Selection criteria:
Inclusion: Cohort studies with participants aged 50-
79 y
Exclusion: Smokers, participants without 25(OH)D
measurement, missing values for covariates used in
main model, or lost to follow up due to unknown
reasons.
56 trials (n=95,286); age range, 18-107 y; mean duration, 4.4 y).
All trials
RR = 0.97 (95% CI, 0.94-0.99) p=0.02
Vitamin D3 alone vs placebo/no intervention (13 trials, n=12609)
RR = 0.92 (95% CI, 0.85-1.00) p=0.06; ; I 2 =0%
Vitamin D3 + Ca vs placebo/no intervention (27 trials, n=63051)
RR = 0.96 (95% CI, 0.92-0.99) p=0.03);
Vitamin D2 alone vs placebo/no intervention (8 trials; n=17079)
RR = 1.03 (95% CI, 0.96-1.12) p=0.37 ; I 2 =14%
Vitamin D2 + Ca vs placebo/no intervention (5 trials; n=1307)
RR = 1.0 (95% CI, 0.64-1.57) p=1.00 ; I 2 =11%
Trials (n=45) which recruited participants on basis of 25(OH)D concentration:
25(OH)D < 50 nmol/L (26 trials): RR=0.95 (95% CI, 0.91-0.99) p=0.01; I 2 =0%
25(OH)D ≥ 50 nmol/L (19 trials): RR=0.95 (95 CI, 0.87-1.05); P=0.30; I 2 =0%
Cohort studies: Bottom vs top thirds of baseline 25(OH)D
27 primary prevention cohorts (n=780,990); RR = 1.35 (95% CI, 1.22- 1.49)
41 secondary prevention cohorts (n=59,918); RR = 1.50 (95% CI, 1.36-1.65)
All cohorts (n=840,908); RR = 1.44 (95% CI, 1.34-1.55)
Association of 25(OH)D (nmol/L) with all cause mortality (based on 1ᵒ
prevention cohorts)
52-72 vs ≥ 75: RR = 1.07 (95% CI, 1.01–1.15)
25-50 vs ≥ 75: RR = 1.20 (95% CI, 1.12–1.27)