Serum 25-hydroxyvitamin D, parathyroid hormone, and mortality in older men

Peggy M. Cawthon, Neeta Parimi, Elizabeth Barrett-Connor, Gail A. Laughlin, Kristine E. Ensrud, Andrew R. Hoffman, James M. Shikany, Jane A. Cauley, Nancy E. Lane, Douglas C. Bauer, Eric S. Orwoll, Steven R. Cummings

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90 Scopus citations

Abstract

Context: Low 25-hydroxyvitamin D [25(OH)D] and high PTH may contribute to increased mortality risk in older adults. Objective: The aim of the study was to test the association between 25(OH)D, PTH, and mortality in older men. Design and Setting: The prospective Osteoporotic Fractures in Men (MrOS) study was conducted at six U.S. clinical centers. Participants: We studied community-dwelling men at least 65 yr old (n = 1490). Main Outcome Measure: Multivariate-adjusted proportional hazards models estimated the hazard ratio (HR) for mortality; cause of death was classified as cancer, cardiovascular, and other by central review of death certificates. Results: During 7.3 yr of follow-up, 330 (22.2%) participants died: 97 from cancer, 110 from cardiovascular disease, and 106 from other causes. The adjusted HR per SD decrease in 25(OH)D for all-cause mortality was 1.01 (95% CI, 0.89, 1.14); no association between 25(OH)D and cardiovascular or other-cause mortality was seen. Unexpectedly, lower 25(OH)D levels were modestly associated with a decreased risk of cancer mortality (adjusted HR per SD decrease, 0.80; 95% CI, 0.64, 0.99). Analyzing 25(OH)D as a categorical variable did not alter these results. Higher PTH levels (log-transformed) were associated with an increased risk of all-cause mortality (adjusted HR per SD increase, 1.15; 95% CI, 1.03, 1.29) and cardiovascular mortality (adjusted HR per SD increase in PTH, 1.21; 95% CI, 1.00, 1.45). Conclusions: In contrast to previous studies, lower 25(OH)D levels were not associated with an increased risk of all-cause or cause-specific mortality in older men. Higher PTH levels were associated with a modest increase in mortality risk.

Original languageEnglish (US)
Pages (from-to)4625-4634
Number of pages10
JournalJournal of Clinical Endocrinology and Metabolism
Volume95
Issue number10
DOIs
StatePublished - Oct 2010

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ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Cawthon, P. M., Parimi, N., Barrett-Connor, E., Laughlin, G. A., Ensrud, K. E., Hoffman, A. R., Shikany, J. M., Cauley, J. A., Lane, N. E., Bauer, D. C., Orwoll, E. S., & Cummings, S. R. (2010). Serum 25-hydroxyvitamin D, parathyroid hormone, and mortality in older men. Journal of Clinical Endocrinology and Metabolism, 95(10), 4625-4634. https://doi.org/10.1210/jc.2010-0638