Vitamin D deficiency is associated with higher all-cause mortality, but associations with specific causes of death are unclear. We investigated the association between circulating 25-hydroxyvitamin D (25(OH)D) concentration and cause-specific mortality using a case-cohort study within the Melbourne Collaborative Cohort Study (MCCS). Eligibility for the case-cohort study was restricted to participants with baseline dried blood spot samples and no pre-baseline diagnosis of cancer. These analyses included participants who died (n = 2307) during a mean follow-up of 14 years and a sex-stratified random sample of eligible cohort participants ('subcohort', n = 2923). Concentration of 25(OH)D was measured using liquid chromatography-tandem mass spectrometry. Cox regression, with Barlow weights and robust standard errors to account for the case-cohort design, was used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for cause-specific mortality in relation to 25(OH)D concentration with adjustment for confounders. Circulating 25(OH)D concentration was inversely associated with risk of death due to cancer (HR per 25 nmol/L increment = 0.88, 95 % CI 0.78-0.99), particularly colorectal cancer (HR = 0.75, 95 % CI 0.57-0.99). Higher 25(OH)D concentrations were also associated with a lower risk of death due to diseases of the respiratory system (HR = 0.62, 95 % CI 0.43-0.88), particularly chronic obstructive pulmonary disease (HR = 0.53, 95 % CI 0.30-0.94), and diseases of the digestive system (HR = 0.44, 95 % CI 0.26-0.76). Estimates for diabetes mortality (HR = 0.64, 95 % CI 0.33-1.26) and cardiovascular disease mortality (HR = 0.90, 95 % CI 0.76-1.07) lacked precision. The findings suggest that vitamin D might be important for preventing death due to some cancers, respiratory diseases, and digestive diseases.

中文翻译：

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在墨尔本合作研究中循环使用25-羟基维生素D浓度和特定病因死亡率。

维生素D缺乏与更高的全因死亡率相关，但尚不清楚与特定死亡原因的相关性。我们使用墨尔本协作队列研究（MCCS）中的病例队列研究调查了循环中的25-羟基维生素D（25（OH）D）浓度与特定原因死亡率之间的关联。病例队列研究的资格仅限于基线干血斑样本且无基线前癌症诊断的参与者。这些分析包括在平均随访14年内死亡的参与者（n = 2307）和符合条件的队列参与者的按性别分层的随机样本（'subcohort'，n = 2923）。使用液相色谱-串联质谱法测量25（OH）D的浓度。考克斯回归 结合Barlow权重和稳健的标准误差来考虑病例队列设计，用于估计因25（OH）D浓度引起的特定原因死亡率的危险比（HRs）和95％置信区间（CIs），混杂因素。循环中的25（OH）D浓度与因癌症致死的风险呈负相关（每25 nmol / L的HR = 0.88，95％CI 0.78-0.99），特别是结直肠癌（HR = 0.75，95％CI 0.57-0.99） ）。较高的25（OH）D浓度还可以降低因呼吸系统疾病引起的死亡风险（HR = 0.62，95％CI 0.43-0.88），特别是慢性阻塞性肺疾病（HR = 0.53，95％CI 0.30 -0.94）和消化系统疾病（HR = 0.44，95％CI 0.26-0.76）。糖尿病死亡率的估计值（HR = 0.64，95％CI 0.33-1。26）和心血管疾病死亡率（HR = 0.90，95％CI 0.76-1.07）缺乏准确性。研究结果表明，维生素D对于预防由于某些癌症，呼吸系统疾病和消化系统疾病引起的死亡可能很重要。