Tiina Mattila1,2,3, Tuula Vasankari4,5, Harri Rissanen6, Paul Knekt6, Laura Sares-Jäske6, Tuija Jääskeläinen6, Markku Heliövaara6. 1. Department of Pulmonary Diseases, Heart and Lung Center, Meilahti Triangle Hospital, Helsinki University Hospital, Helsinki, Finland. tiina.m.mattila@fimnet.fi. 2. Doctoral Programme in Clinical Research, University of Helsinki, Helsinki, Finland. tiina.m.mattila@fimnet.fi. 3. National Institute for Health and Welfare, Helsinki, Finland. tiina.m.mattila@fimnet.fi. 4. Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital and University of Turku, Turku, Finland. 5. Finnish Lung Health Association (FILHA), Helsinki, Finland. 6. National Institute for Health and Welfare, Helsinki, Finland.
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.
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.
Authors: Tuija Jääskeläinen; Suvi T Itkonen; Annamari Lundqvist; Maijaliisa Erkkola; Tapani Koskela; Kaisa Lakkala; Kirsten G Dowling; George Lj Hull; Heikki Kröger; Jaro Karppinen; Eero Kyllönen; Tommi Härkänen; Kevin D Cashman; Satu Männistö; Christel Lamberg-Allardt Journal: Am J Clin Nutr Date: 2017-05-10 Impact factor: 7.045
Authors: Paivi M Salo; Angelico Mendy; Jesse Wilkerson; Samantha A Molsberry; Lydia Feinstein; Stephanie J London; Michael B Fessler; Peter S Thorne; Darryl C Zeldin Journal: Respir Res Date: 2022-06-09