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Non-linear Association between Serum 25-Hydroxyvitamin D and All-cause Mortality in Adults with Inflammatory Bowel Disease in a Prospective Cohort Study

Dan, Lintao; Chen, Xuejie; Xie, Ying; Sun, Yuhao; Hesketh, Therese; Wang, Xiaoyan; Chen, Jie; (2022) Non-linear Association between Serum 25-Hydroxyvitamin D and All-cause Mortality in Adults with Inflammatory Bowel Disease in a Prospective Cohort Study. The Journal of Nutrition , 152 (9) pp. 2125-2134. 10.1093/jn/nxac148. Green open access

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Abstract

Background: Nonlinear association between serum 25-hydroxyvitamin D [25(OH)D] concentration and all-cause mortality has been widely reported for the general population, but this association has not been quantified for individuals with inflammatory bowel disease (IBD). Objectives: The aim was to explore the association between serum 25(OH)D and all-cause mortality in individuals with IBD. Methods: We identified 2690 females and 2532 males aged 40–69 y with diagnosed IBD at baseline in the UK Biobank. Serum 25(OH)D concentration was measured by direct competitive chemiluminescent immunoassay. The outcome was all-cause mortality, ascertained via the death registry. Cox proportional hazard regression was used to evaluate associations between serum 25(OH)D in quintiles and all-cause mortality among individuals with IBD [Crohn disease (CD; n = 1760) and ulcerative colitis (UC; n = 3462)]. Restricted cubic splines were used to investigate potential nonlinearity. Results: During the mean follow-up period of 11.9 y, 529 deaths (198 in CD and 331 in UC) were documented among 5222 individuals with IBD. Compared with the lowest quintile of serum 25(OH)D, HRs for the second to the highest quintiles were 0.82 (95% CI: 0.63, 1.06), 0.63 (95% CI: 0.47, 0.83), 0.64 (95% CI: 0.48, 0.85), and 0.74 (95% CI: 0.55, 0.99), respectively. Nonlinearity was detected in the dose–response association between serum 25(OH)D concentration and all-cause mortality (P-nonlinearity < 0.001), and 25(OH)D concentrations of 44–78 nmol/L were associated with a 50% lower risk of all-cause mortality (than 10 nmol/L). Subgroup analyses showed that the nonlinear association mostly applied to females (P-nonlinearity < 0.001 compared with 0.080 in males). Conclusions: We observed a nonlinear association, mostly applicable to females, between serum 25(OH)D concentrations and all-cause mortality among individuals with IBD. A 25(OH)D concentration range of 44–78 nmol/L can serve as a starting point for future research to confirm recommended 25(OH)D concentrations for individuals with IBD.

Type: Article
Title: Non-linear Association between Serum 25-Hydroxyvitamin D and All-cause Mortality in Adults with Inflammatory Bowel Disease in a Prospective Cohort Study
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/jn/nxac148
Publisher version: https://doi.org/10.1093/jn/nxac148
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
Keywords: inflammatory bowel disease, Crohn disease, ulcerative colitis, vitamin D, 25-hydroxyvitamin D, all-cause mortality
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10152220
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