Laura M G Meems1, Martin H de Borst2, Dirkje S Postma3, Judith M Vonk3, Hubertus P H Kremer4, Marie-Louise A Schuttelaar5, Judith G M Rosmalen2,6, Rinse K Weersma7, Bruce H R Wolffenbuttel8, Salome Scholtens9, Ronald P Stolk9, Ido P Kema10, Gerjan Navis2, Mohsin A F Khan1, Pim van der Harst1, Rudolf A de Boer1. 1. a Department of Cardiology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands. 2. b Department of Internal Medicine , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands. 3. c Department of Pulmonology , Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen , Groningen , the Netherlands. 4. d Department of Neurology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands. 5. e Department of Dermatology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands. 6. f Department of Psychiatry , Department of Internal Medicine, University of Groningen, University Medical Center Groningen , Groningen , the Netherlands. 7. g Department of Gastroenterology and Hepatology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands. 8. h Department of Endocrinology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands. 9. i Department of LifeLines Cohort Study & Biobank , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands. 10. j Department of Laboratory Medicine , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.
Abstract
BACKGROUND: The prevalence of multimorbidity (≥ 1 disease within an individual) is rapidly increasing. So far, studies on the relationship between vitamin D and morbidity are mainly focusing on effects on single disease domains only, while vitamin D biology is associated with several diseases throughout the human body. METHODS: We studied 8,726 participants from the LifeLines Cohort Study (a cross-sectional, population-based cohort study) and used the self-developed composite morbidity score to study the association between vitamin D levels and multimorbidity. RESULTS: Study participants (mean age 45 ± 13 years, 73% females) had a mean plasma vitamin D level of 59 ± 22 nmol/L. In participants aged between 50 and 60 years, 58% had ≥ 2 affected disease domains, while morbidity score increased with age (70-80 years: 82% morbidity score > 1; > 80 years: 89% morbidity score > 1). Each incremental reduction by 1 standard deviation (SD) of vitamin D level was associated with an 8% higher morbidity score (full model OR 0.92, 95% CI 0.88-0.97, P = 0.001). Participants with vitamin D levels < 25 nmol/L were at highest risk for increasing morbidity prevalence (versus > 80 nmol/L, OR 1.34, 95% CI 1.07-1.67, P = 0.01). CONCLUSIONS: Low levels of vitamin D are associated with higher prevalence of multimorbidity, especially in participants with vitamin D levels < 25 nmol/L. Collectively, our results favor a general, rather than an organ-specific, approach when assessing the impact of vitamin D deficiency.
BACKGROUND: The prevalence of multimorbidity (≥ 1 disease within an individual) is rapidly increasing. So far, studies on the relationship between vitamin D and morbidity are mainly focusing on effects on single disease domains only, while vitamin D biology is associated with several diseases throughout the human body. METHODS: We studied 8,726 participants from the LifeLines Cohort Study (a cross-sectional, population-based cohort study) and used the self-developed composite morbidity score to study the association between vitamin D levels and multimorbidity. RESULTS: Study participants (mean age 45 ± 13 years, 73% females) had a mean plasma vitamin D level of 59 ± 22 nmol/L. In participants aged between 50 and 60 years, 58% had ≥ 2 affected disease domains, while morbidity score increased with age (70-80 years: 82% morbidity score > 1; > 80 years: 89% morbidity score > 1). Each incremental reduction by 1 standard deviation (SD) of vitamin D level was associated with an 8% higher morbidity score (full model OR 0.92, 95% CI 0.88-0.97, P = 0.001). Participants with vitamin D levels < 25 nmol/L were at highest risk for increasing morbidity prevalence (versus > 80 nmol/L, OR 1.34, 95% CI 1.07-1.67, P = 0.01). CONCLUSIONS: Low levels of vitamin D are associated with higher prevalence of multimorbidity, especially in participants with vitamin D levels < 25 nmol/L. Collectively, our results favor a general, rather than an organ-specific, approach when assessing the impact of vitamin D deficiency.
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