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 .
A Reverse J-Shaped Association Between Serum 25-Hydroxyvitamin D and Cardiovascular Disease Mortality: The CopD Study.
CONTEXT Cardiovascular disease is the major cause of death in the Western world , but the association between 25-hydroxyvitamin D [ 25(OH)D ] levels and the risk of cardiovascular disease mortality remains unclear . OBJECTIVE The objective of the study was to determine the association between cardiovascular , stroke , and acute myocardial infa rct mortality and serum levels of 25(OH)D.  DESIGN This was an observational cohort study , the Copenhagen vitamin D study , data from a single laboratory center in Copenhagen , Denmark . Follow-up was from 2004 to 2011 . SETTING  Serum 25(OH)D  was analyzed from 247 574 subjects from the Copenhagen general practice sector . PARTICIPANTS Examination of the association 25(OH)D levels and mortality from cardiovascular disease , stroke , and acute myocardial infa rct was performed among 161 428 women and 86 146 men . MAIN OUTCOME MEASURES A multivariate Cox regression analysis was used to compute hazard ratios for cardiovascular , stroke , and acute myocardial infa rct mortality . RESULTS Of 247 574 subjects , a total of 16 645 subjects died  in the ensuing 0 - 7 years . A total of 5454 died from cardiovascular disease including 1574 from stroke and 702 from acute myocardial infa rct . The 25(OH)D level of 70 nmol/L was associated with the lowest cardiovascular disease mortality risk . Compared with that level , the hazard ratio for cardiovascular disease mortality was 2.0 [ 95 % confidence interval ( CI ) 1.8 - 2.1 ] at the lower extreme ( ∼ 12.5 nmol/L ) with a higher risk for men [ 2.5 ( 95 % CI 2.2 - 2.9 ) ] than for women [ 1.7 ( 95 % CI 1.5 - 1.9 ) ] . At the higher extreme ( ∼ 125 nmol/L ) , the hazard ratio of cardiovascular disease mortality was 1.3 ( 95 % CI 1.2 - 1.4 ) , with a similar risk among men and women . Results were similar for stroke and acute myocardial subgroups . CONCLUSIONS In this large observational study , low and high levels of 25(OH)D were associated with cardiovascular disease , stroke , and acute myocardial mortality in a nonlinear , reverse J-shaped manner , with the highest risk at lower levels . Whether this was a causal or associational finding can not be determined from our data . There is a need for r and omized clinical trials that include information on the effects of 25(OH)D levels greater than 100
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 .