OBJECTIVE To investigate the associations between low and high concentrations of baseline serum 25-hydroxyvitamin D [25(OH)D] and all-cause mortality in very old (≥85 years) men and women over 6 years. DESIGN, SETTING AND SUBJECTS Prospective mortality data from 775 participants in the Newcastle 85+ Study were analysed for survival in relation to 25(OH)D (season-specific quartiles and predefined cut-off values) and sex using Cox proportional hazards models. The models were fitted to the entire and restricted (nonusers of vitamin D-containing supplements and medication) cohorts. RESULTS For the entire cohort, mortality was higher in both the lowest and highest 25(OH)D season-specific quartiles [SQ1: hazard ratio (HR) 1.31, 95% confidence interval (CI) 1.01-1.69, P = 0.04; SQ4: HR 1.44, 95% CI 1.12-1.85, P = 0.004] compared with the combined middle quartiles (SQ2 + SQ3), after adjustment for sociodemographic factors. The increased risk for the highest quartile remained significant after further adjustment for lifestyle variables (SQ4: HR 1.37, 95% CI 1.06-1.77, P = 0.02) and was seen only in women in sex-specific analyses. Similarly, in sensitivity analyses with predefined 25(OH)D cut-off values, the highest 25(OH)D concentration (≥75 nmol L(-1) ) was associated with a 2.4-fold increased risk of mortality in women (restricted cohort) after adjusting for all covariates. CONCLUSION Low and high season-specific 25(OH)D quartiles were associated with increased risks of mortality over 6 years in the very old; this effect was particularly noticeable in women, including those who reported taking vitamin D-containing supplements/medication.

中文翻译：

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25-羟基维生素 D 和老年妇女全因死亡率增加：纽卡斯尔 85+ 研究。

目的 研究 6 岁以上高龄（≥85 岁）男性和女性基线血清 25-羟基维生素 D [25(OH)D] 的低浓度和高浓度与全因死亡率之间的关系。设计、设置和主题 使用 Cox 比例风险模型对来自 775 名纽卡斯尔 85+ 研究参与者的前瞻性死亡率数据进行了与 25(OH)D（特定季节的四分位数和预定义的截止值）和性别相关的生存率分析。这些模型适用于整个和受限（非维生素 D 补充剂和药物的使用者）队列。结果 对于整个队列，最低和最高 25(OH)D 季节特异性四分位数的死亡率均较高 [SQ1：风险比 (HR) 1.31，95% 置信区间 (CI) 1.01-1.69，P = 0.04；SQ4：HR 1.44，95% CI 1.12-1.85，P = 0。004] 与综合中间四分位数 (SQ2 + SQ3) 相比，在调整社会人口因素后。在对生活方式变量进行进一步调整后，最高四分位数的风险增加仍然显着（SQ4：HR 1.37, 95% CI 1.06-1.77, P = 0.02），并且仅在性别特异性分析中见于女性。同样，在预先定义的 25(OH)D 临界值的敏感性分析中，最高 25(OH)D 浓度 (≥75 nmol L(-1) ) 与女性死亡风险增加 2.4 倍相关（受限队列）调整所有协变量后。结 这种影响在女性中尤其明显，包括那些报告服用含维生素 D 补充剂/药物的女性。