The Role of Vitamin D in the All-Cause Mortality of General Population 公开

Wang, Yi (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/hh63sw02g?locale=zh
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Abstract

This thesis is focused on investigating the association between vitamin D deficiency and all-cause mortality. We conducted analyses among a retrospective cohort of 1159 patients, who were admitted to Emory hospital from 2008-2012 and had vitamin D tests. Of the1159 subjects, 77% had vitamin D deficiency (25-hydroxyvitamin D (25(OH)D) <30 ng/mL); 44% had chronic kidney disease (CKD) (defined as estimated glomerular filtration rate (eGFR) <=60 mL/min/1.73 m2); and 380 died during an average follow-up of 427.3 days. We conducted survival analysis with the primary time-to-event outcome specified as time from admission to death. Based on multivariate Cox regression, we find that older age and lower eGFR are significantly associated with a higher risk of mortality (P<0.001 for age; P<0.001 for eGFR). Although no statistically significant association between vitamin D deficiency and mortality is found after adjusting for age and eGFR (Hazard ratio, 1.049; 95% confidence interval, 0.822-1.337), our multivariate analysis detects a significant interaction effect between vitamin D deficiency and eGFR on mortality risk (P=0.0208). A further analysis stratified on vitamin D deficiency status suggests that a decrease in eGFR in patients with vitamin D deficiency has a significant negative impact on mortality risk (Hazard ratio, 0.997; 95% confidence interval, 0.994-1.000), while the effect of eGFR diminishes in patients with normal vitamin D level.

Table of Contents

I Introduction .......................................................................................................................1

II Methods ............................................................................................................................4

III Results .............................................................................................................................9

IV Discussion .....................................................................................................................13

References ..........................................................................................................................15

Appendix A ........................................................................................................................19

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