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The full report is titled “Serum 25-Hydroxyvitamin D Concentration and Risk for Major Clinical Disease Events in a Community-Based Population of Older Adults. A Cohort Study.” It is in the 1 May 2012 issue of Annals of Internal Medicine (volume 156, pages 627-634). The authors are I.H. de Boer, G. Levin, C. Robinson-Cohen, M.L. Biggs, A.N. Hoofnagle, D.S. Siscovick, and B. Kestenbaum.
Vitamin D Levels and Risk for Major Clinical Disease Events. Ann Intern Med. 2012;156:I-36. doi: 10.7326/0003-4819-156-9-201205010-00001
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Published: Ann Intern Med. 2012;156(9):I-36.
Although we know that vitamin D deficiency causes some medical problems and investigators are studying it as a possible cause of others, experts disagree about how to define deficiency. Most experts believe that vitamin D deficiency begins when blood levels get low enough to change how fast the body creates and breaks down bone, which we evaluate by measuring blood constituents that are produced and used during bone remodeling.
To evaluate the relationship of vitamin D levels with clinical outcomes that may be related to vitamin D deficiency.
More than 1500 white, elderly persons who were living in 4 U.S. communities.
The researchers took blood samples from study participants at the beginning of the study and then followed them to see whether they developed any of the more important clinical outcomes that may be related to vitamin D deficiency (for example, hip fracture). They used blood levels of a precursor to vitamin D (known as 25-hydroxyvitamin D) to represent vitamin D levels.
The outcomes they were looking for began to occur more often as blood levels of 25-hydroxyvitamin D decreased from higher than 20 ng/mL to lower than 20 ng/mL.
Observational studies such as this one cannot establish cause and effect, so additional studies will be necessary to resolve these discrepancies.
Most professional societies and expert panels recommend that 30 ng/mL be considered the threshold level below which vitamin D deficiency begins. This study found a lower threshold, which is the same level recently recommended by the Institute of Medicine.
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