The vast majority of studies reported inverse associations between 25(OH)D concentration and all-cause mortality .
This association appeared to be non-linear , with progressively lower mortality with increasing 25(OH)D up to a point , beyond which there was no further decrease .
There is moderate evidence that vitamin D status is inversely associated with cancer mortality and death due to respiratory diseases , while for cardiovascular mortality , there is weak evidence of an association in observational studies , which is not supported by the data from intervention or Mendelian r and omization studies .
Epidemiological evidence suggests that vitamin D deficiency is associated with increased mortality , but it is unclear whether this is explained by reverse causation , and if there are specific causes of death for which vitamin D might be important .
Bone Mineral Density and Parathyroid Hormone as Independent Risk Factors for Mortality in Community-Dwelling Older Adults: A Population-Based Prospective Cohort Study in Brazil. The São Paulo Ageing & Health (SPAH) Study.
Previous studies have shown a relationship between osteoporosis and increased mortality risk . However , none of these studies performed a concomitant evaluation of the parathyroid hormone (PTH)-calcium-vitamin D axis and bone mass to accurately determine the contribution of each of these parameters to survival in older subjects . Thus , we sought to investigate the association between bone parameters and mortality in a longitudinal , prospect i ve , population -based cohort of 839 elderly subjects . Clinical data ( including history of fractures and cardiovascular events ) were assessed using a specific question naire . Laboratory exams , including serum 25OHD and PTH  , were also performed .  Bone mineral density ( BMD ) at the lumbar spine and hip were evaluated using DXA . All analyses were performed at baseline ( 2005 to 2007 ) . Mortality was recorded during follow-up . Multivariate Cox proportional regression was used to compute hazard ratios for all-cause and cardiovascular mortality . Over a mean 4.06 ± 1.07 years , there were 132 ( 15.7 % ) deaths . These individuals were compared to 707 subjects who were alive at the end of the coverage period for mortality data collection . In a multivariate Cox proportional hazards model , age ( HR 1.32 ; 95 % CI , 1.13 to 1.55 ; p = 0.001 , for each 5-year increase ) , male gender ( HR 1.90 ; 95 % CI , 1.30 to 2.79 ; p = 0.001 ) , recurrent falls ( more than two in the previous year ; HR 1.65 ; 95 % CI , 1.06 to 2.56 ; p = 0.026 ) , diabetes mellitus ( HR 2.17 ; 95 % CI , 1.46 to 3.21 ; p < 0.001 ) , low physical activity score ( HR 1.78 ; 95 % CI , 1.14 to 2.79 ; p = 0.011 ) , prior cardiovascular event ( HR 1.76 ; 95 % CI , 1.18 to 2.63 ; p = 0.006 ) , total hip BMD ( HR 1.41 ; 95 % CI , 1.15 to 1.72 ; p = 0.001 , per each 1 SD decrease ) , and intact PTH ( iPTH ) ( HR 1.06 ; 95 % CI , 1.04 to 1.08 ; p < 0.001 , per each 10 pg/mL increase ) were independently associated with all-cause mortality . The subjects in the highest quartile of PTH ( > 49 pg/mL ) were at a higher risk of cardiovascular death ( HR 3.09 ; 95 % CI , 1.36 to 6.99 ; p = 0.007 ) compared with the subjects in the lowest quartile ( < 26 pg/mL ) . Low BMD and higher PTH were significantly associated with mortality  in community-dwelling older adults . These findings support the notion that careful screening of these bone parameters might lead to better management of older patients and improve outcomes in this population . © 2016 American Society for Bone and Mineral Research
The vast majority of studies reported inverse associations between 25(OH)D concentration and all-cause mortality .
This association appeared to be non-linear , with progressively lower mortality with increasing 25(OH)D up to a point , beyond which there was no further decrease .
There is moderate evidence that vitamin D status is inversely associated with cancer mortality and death due to respiratory diseases , while for cardiovascular mortality , there is weak evidence of an association in observational studies , which is not supported by the data from intervention or Mendelian r and omization studies .
Epidemiological evidence suggests that vitamin D deficiency is associated with increased mortality , but it is unclear whether this is explained by reverse causation , and if there are specific causes of death for which vitamin D might be important .