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: 17.33). 10/2007; 167(16):1730-7. DOI: 10.1001/archinte.167.16.1730
Source: PubMed


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.

Download full-text


Available from: Sara Gandini
    • "Initially thought to play a limited role in bone and skeletal health [8], benefits now being ascribed to vitamin D include the prevention of some cancers, autoimmune disorders and possibly cardiovascular diseases [9] [10] [11]. Vitamin D deficiency may be independently associated with all-cause mortality in the general population [12] [13], suggesting it plays an important role in overall health and may be an important public health measure. Vitamin D status is determined using blood testing. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Online continuing medical education (CME) offers a number of advantages for physicians including flexibility with regards to location and timing of use. In order to effect physician practices and improve patient outcomes, it is important that the development of online CME is theory and evidence-based. This paper aims to describe the development of an online CME program for practising general practitioners (GPs) on vitamin D and sun health called "The ABC's of Vitamin D for GPs" using elements of design principles for physician-education web sites as a framework. The paper will also report the program's usability and acceptability pilot test results. The ABC's of Vitamin D program was developed following nine principles: needs assessment; evidence-based content development; multimodal program and modularisation; clinical cases; tailoring and interactivity; audit and feedback; credibility of the web site host; patient education materials; ease of use and navigation. Among the 20 GPs invited, acceptability and useability was tested with 12 GPs (60%) who agreed to participate and were interviewed following use of the program. The study was conducted between 2011 and 2013. An online CME program consisting of eight modules was constructed. Of the 12 participating GPs, most (n=11) reported that the program was clear and easy to understand, logical, easy to navigate, and took a reasonable amount of time (estimated between 1 and 3h) to complete. Eleven of 12 participants said they would use the program as an accredited CME activity and all participants indicated that the program was 'very or somewhat' likely to lead to changes in the advice patients are given. This study found that a theory and evidence based approach for the development of an online CME program for GPs was acceptable to users. Further research is needed to examine whether the online CME program is effective at changing GP practices and improving patient outcomes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    No preview · Article · Jan 2015 · International Journal of Medical Informatics
  • Source
    • "Vitamin D may play a beneficial role in improving the innate immune system against chronic respiratory infections by up-regulating specific antimicrobial peptides (human cathelicidin antimicrobial peptide (hCAP-18) [33]. In addition, a meta-analysis of randomized controlled trials concluded that use of vitamin D supplements is associated with a decrease in total mortality rates [34]. The second aim of the present study was to evaluate the effect of vitamin D supplements in addition to the regular therapy among COPD patients. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Evidence is increasing that suggests an expanded role of vitamin D in health outcomes apart from its classic actions on the bone and calcium homeostasis. Vitamin D deficiency has been associated with some chronic respiratory illnesses; one of them is chronic obstructive pulmonary disease (COPD).
    Preview · Article · Jan 2015
    • "The overall impact of these mechanisms results into further lowering of vitamin D levels, which have been associated with fatigue in patients with cancer[6], and myasthenia gravis.[8] Low vitamin D levels are also associated with cardiovascular diseases[2223242526], hypertension[27], congestive heart failure[28], cancer[29], diabetes mellitus[30], neuromuscular disorders[31], pneumonia[21], upper respiratory tract infections[21], chronic obstructive pulmonary disease[32], and all-cause mortality.[33] A meta-analysis of 18 randomized clinical trials concluded that vitamin D supplementation was associated with lower all-cause mortality.[33] "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background:Fatigue is a common presenting complaint of patients in the primary care offices. Low levels of vitamin D have been associated with fatigue in cancer patients. Normalization of vitamin D level improves their fatigue. Whether low vitamin D plays a role in fatigue in medically stable patients is not known.Aims:This prospective non-randomized therapeutic study observed the prevalence of low vitamin D in fatigue and the effect of normalization of vitamin D on fatigue.Material and Methods:One hundred and seventy four adult patients, who presented in our primary care office with fatigue and stable chronic medical conditions,completed fatigue assessment questionnaires. Patients with low vitamin D levels received ergocalciferol therapy for 5 weeks. Scores of pre- and post-treatment fatigue assessment questionnaires were compared.Results:Prevalence of low vitamin D was 77.2% in patients who presented with fatigue. After normalization of vitamin D levels fatigue symptom scores improved significantly (P < 0.001) in all five subscale categories of fatigue assessment questionnaires.Conclusion:The prevalence of low vitamin D is high in patients who present with fatigue and stable chronic medical conditions, if any. Normalization of vitamin D levels with ergocalciferol therapy significantly improves the severity of their fatigue symptoms.
    No preview · Article · Aug 2014 · North American Journal of Medical Sciences
Show more