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Epidemiology

Airway obstruction, serum vitamin D and mortality in a 33-year follow-up study

European Journal of Clinical Nutrition volume 73, pages 1024–1032 (2019)Cite this article

Abstract

Background and objective:

Chronic obstructive pulmonary disease and low vitamin D status predict mortality, but their combined effect on mortality remains inconclusive. We aimed to investigate a joint effect of airway obstruction and vitamin D status on mortality in a nationally representative cohort.

Methods:

We analysed data of 6676 Finnish adults participating between 1978 and 1980 in a national health examination survey, undergoing spirometry and having all necessary data collected. We followed them up in national registers through record linkage until 31 December 2011. We categorised the subjects with obstruction using the lower limit of normal (LLN) and the measured serum 25-hydroxyvitamin-D (s-25(OH)D) into tertiles.

Results:

Both obstruction and low s-25(OH)D independently predicted mortality in a multivariate model adjusted also for age, sex, smoking, education, leisure physical activity, body mass index, asthma and serum C-reactive protein. However, a statistically significant (p = 0.007) interaction emerged: the adjusted mortality HRs (95% CI’s) for s-25(OH)D in tertiles among the subjects without and with obstruction were 1.00 (lowest), 0.96 (0.87–1.05) and 0.89 (0.81–0.98); and 1.00, 0.96 (0.71–1.31) and 0.57 (0.40–0.80), respectively.

Conclusions:

In conclusion, obstruction and low s-25(OH)D predict mortality independently of each other. Our findings suggest that low vitamin D status might be particularly detrimental among subjects with obstruction.

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Acknowledgements

The University of Helsinki/Hospital District of Helsinki and Uusimaa awarded to the first author a Doctoral Candidate Position (from June 2016 to December 2017) which allowed for the write-up of our analysis.

Funding

The University of Helsinki/Hospital District of Helsinki and Uusimaa awarded to the first author a doctoral candidate position from June 2016 to December 2017.

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Authors and Affiliations

  1. Department of Pulmonary Diseases, Heart and Lung Center, Meilahti Triangle Hospital, Helsinki University Hospital, Helsinki, Finland

    Tiina Mattila

  2. Doctoral Programme in Clinical Research, University of Helsinki, Helsinki, Finland

    Tiina Mattila

  3. National Institute for Health and Welfare, Helsinki, Finland

    Tiina Mattila, Harri Rissanen, Paul Knekt, Laura Sares-Jäske, Tuija Jääskeläinen & Markku Heliövaara

  4. Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital and University of Turku, Turku, Finland

    Tuula Vasankari

  5. Finnish Lung Health Association (FILHA), Helsinki, Finland

    Tuula Vasankari

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Correspondence to Tiina Mattila.

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Conflict of interest

TM completed this study through financial support from the Hospital District of Helsinki and Uusimaa (a Doctoral Candidate Position in the Doctoral Programme of Clinical Research at the University of Helsinki/Hospital District of Helsinki and Uusimaa from June 2016 to December 2017). The remaining authors declare that they have no conflict of interest.

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Mattila, T., Vasankari, T., Rissanen, H. et al. Airway obstruction, serum vitamin D and mortality in a 33-year follow-up study. Eur J Clin Nutr 73, 1024–1032 (2019). https://doi.org/10.1038/s41430-018-0299-3

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