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Obesity and Association of Serum 25(OH)D Levels with All-Cause Mortality

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Abstract

Sequestration of vitamin D in adipose tissue is the main cause of the lower serum 25(OH)D levels in obese subjects. However, it remains unknown whether the adipose tissue stores of vitamin D are readily mobilized for meeting body needs. We aimed to examine whether the association between serum 25(OH)D and all-cause mortality differs by body weight. Using the computerized database of the largest health care provider in Israel, we identified a cohort of subjects ≥20-years old with serum 25(OH)D levels measured between January 2008 and December 2009. Mortality was ascertained through April-2013. Cox regression with restricted cubic-spline function was used to assess the association between serum 25(OH)D and mortality. Median follow-up was 48 months (IQR 43–53 months); 12,337 of 175,781 participants (7.0 %) died. The association between 25(OH)D and mortality was not linear (P < 0.001), and differed between BMI categories (P = 0.019). The lowest adjusted risk for mortality was observed at serum 25(OH)D levels of 73.0, 68.0, and 66.5 nmol/L among subjects with BMI <25, 25–29.9, and ≥30 kg/m2, respectively. Compared to reference level of 75 nmol/L, increased adjusted HR as evident by 95 % confidence interval lower bound >1.0 was observed at serum 25(OH)D levels less than; 61.0, 48.0, and 40.0 nmol/L among subjects with BMI <25, 25–29.9, and ≥30 kg/m2, respectively. Serum 25(OH)D levels associated with increased all-cause mortality were inversely related to BMI. However, this observational cohort study may still suffer from residual confounding; therefore, cause and effect relationship cannot be established from this study.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Community Medicine and Epidemiology, Carmel Medical Center, Clalit Health Services, and Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel

    Walid Saliba, Ofra Barnett-Griness & Gad Rennert

  2. Internal Medicine C, Ha’emek Medical Center, 18101, Afula, Israel

    Walid Saliba

  3. Department of Epidemiology and Disease Prevention, Office of the Chief Physician, Clalit Health Services Headquarters, Tel Aviv, Israel

    Gad Rennert

Authors
  1. Walid Saliba
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  2. Ofra Barnett-Griness
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  3. Gad Rennert
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Correspondence to Walid Saliba.

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Walid Saliba, Ofra Barnett-Griness, and Gad Rennert declare no conflict of interest

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Saliba, W., Barnett-Griness, O. & Rennert, G. Obesity and Association of Serum 25(OH)D Levels with All-Cause Mortality. Calcif Tissue Int 95, 222–228 (2014). https://doi.org/10.1007/s00223-014-9885-0

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  • DOI: https://doi.org/10.1007/s00223-014-9885-0

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