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Autier P, Gandini S. Vitamin D supplementation and total mortality: A meta-analysis of randomized controlled trials. Arch Intern Med 167: 1730

International Agency for Research on Cancer, 150 cours Albert Thomas, F-69372 Lyon, France.
Archives of Internal Medicine (Impact Factor: 13.25). 10/2007; 167(16):1730-7. DOI: 10.1001/archinte.167.16.1730
Source: PubMed

ABSTRACT Ecological and observational studies suggest that low vitamin D status could be associated with higher mortality from life-threatening conditions including cancer, cardiovascular disease, and diabetes mellitus that account for 60% to 70% of total mortality in high-income countries. We examined the risk of dying from any cause in subjects who participated in randomized trials testing the impact of vitamin D supplementation (ergocalciferol [vitamin D(2)] or cholecalciferol [vitamin D(3)]) on any health condition.
The literature up to November 2006 was searched without language restriction using the following databases: PubMed, ISI Web of Science (Science Citation Index Expanded), EMBASE, and the Cochrane Library.
We identified 18 independent randomized controlled trials, including 57 311 participants. A total of 4777 deaths from any cause occurred during a trial size-adjusted mean of 5.7 years. Daily doses of vitamin D supplements varied from 300 to 2000 IU. The trial size-adjusted mean daily vitamin D dose was 528 IU. In 9 trials, there was a 1.4- to 5.2-fold difference in serum 25-hydroxyvitamin D between the intervention and control groups. The summary relative risk for mortality from any cause was 0.93 (95% confidence interval, 0.87-0.99). There was neither indication for heterogeneity nor indication for publication biases. The summary relative risk did not change according to the addition of calcium supplements in the intervention.
Intake of ordinary doses of vitamin D supplements seems to be associated with decreases in total mortality rates. The relationship between baseline vitamin D status, dose of vitamin D supplements, and total mortality rates remains to be investigated. Population-based, placebo-controlled randomized trials with total mortality as the main end point should be organized for confirming these findings.

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    • "A subsequent small study in stage IV melanoma patients reported that lower vitamin D levels were associated with poorer survival (Nurnberg et al., 2009), but in the absence of further published data, the Leeds study remains unvalidated. The role of vitamin D in bone health is clear, and there is much evidence in the literature that it plays an important role in many other aspects of health, including cancer survival (Goodwin et al., 2009) (Autier and Gandini, 2007). A meta-analysis of all eligible randomized controlled trials (RCTs) for vitamin D given for a variety of reasons showed an overall survival advantage for supplementation (Autier and Gandini , 2007), but as vitamin D levels tend to be higher in leaner fitter people, vitamin D levels, in observational studies at least, may simply be a marker of better health, rather than causally related to survival. "
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    • "The authors of this commentary judge that the position of Mursu et al. (2011) should be viewed as a hypothesis that warrants further research to validate whether some risks are indeed present. It is also important to note that the findings of Mursu et al. (2011) contradict other clinical findings for nutrients, such as vitamin D, for which at least two highly regarded studies, a meta-analysis and systematic review, show a protective effect against mortality (Autier & Gandini, 2007; Bjelakovic, Gluud, & Nikolova, 2011). The Senior Scientific Advisory Committee of the CRN encourages the authors , the National Institutes of Health, and the principal investigator of the Iowa Women's Health Study to develop a data-sharing plan of this publicly funded dataset (concealing the identity of the participants) so that other academic researchers and epidemiologists can independently examine the data. "
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