25-Hydroxyvitamin D, parathyroid hormone, and mortality in black and white older adults: The health ABC study

Stephen B. Kritchevsky, Janet A. Tooze, Rebecca H. Neiberg, Gary G. Schwartz, Dorothy B. Hausman, Mary Ann Johnson, Douglas C. Bauer, Jane A. Cauley, M. Kyla Shea, Peggy M. Cawthon, Tamara B. Harris, Susan M. Rubin, Francis A. Tylavsky, Denise K. Houston

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Context: Previous 25-hydroxyvitamin D [25(OH)D] and mortality studies have included mostly individuals of European descent. Whether the relationship is similar in Blacks and to what extent differences in 25(OH)D explain racial disparities in mortality is unclear. Objective: The objective of the study was to examine the relationship between 25(OH)D, PTH, and mortality in Black and white community-dwelling older adults over 8.5 yr of follow-up. Design and Setting: Health ABC is a prospective cohort study conducted in Memphis, TN, and Pittsburgh, PA. Participants: Well-functioning Blacks and whites aged 71-80 yr with measured 25(OH)D and PTH (n = 2638; 49% male, 39% Black) were included in the study. Main Outcome Measure: Multivariate-adjusted proportional hazards models estimated the hazard ratios (HR) for all-cause, cardiovascular, cancer, and noncancer, noncardiovascular mortality (n = 691 deaths). Results: Mean 25(OH)D concentrations were higher in whites than in Blacks [mean (SD): 29.0 (9.9) and 20.8 (8.7) ng/ml, respectively; P < 0.001]. Serum 25(OH)D by race interactions were not significant, however. Lower 25(OH)D concentrations were associated with higher mortality in Blacks and whites combined [HR (95% confidence interval [CI] 2.27 (1.59-3.24), 1.48 (1.20-1.84), and 1.25 (1.02-1.52) for < 10, 10 to < 20, and 20 to < 30 vs. ≥30 ng/ml]. In the multivariate model without 25(OH)D, Blacks had 22% higher mortality than whites [HR (95% CI) 1.22 (1.01, 1.48)]; after including 25(OH)D in the model, the association was attenuated [1.09 (0.90-1.33)]. The mortality population attributable risks (95% CI) for 25(OH)D concentrations less than 20 ng/ml and less than 30 ng/ml in Blacks were 16.4% (3.1-26.6%) and 37.7% (11.6-55.1%) and in whites were 8.9% (3.9-12.7%) and 11.1% (-2.7 to 22.0%), respectively. PTH was also associated with mortality [HR (95% CI) 1.80 (1.33-2.43) for ≥70 vs. <23 pg/ml]. Conclusions: Low 25(OH)D and high PTH concentrations were associated with increased mortality in Black and white community-dwelling older adults. Because 25(OH)D concentrations were much lower in Blacks, the potential impact of remediating low 25(OH)D concentrations was greater in Blacks than whites.

Original languageEnglish (US)
Pages (from-to)4156-4165
Number of pages10
JournalJournal of Clinical Endocrinology and Metabolism
Volume97
Issue number11
DOIs
StatePublished - Nov 1 2012
Externally publishedYes

Fingerprint

Parathyroid Hormone
Hazards
Health
Mortality
Confidence Intervals
Independent Living
hydroquinone
25-hydroxyvitamin D
Proportional Hazards Models
Cohort Studies
Outcome Assessment (Health Care)
Prospective Studies
Serum
Population

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

25-Hydroxyvitamin D, parathyroid hormone, and mortality in black and white older adults : The health ABC study. / Kritchevsky, Stephen B.; Tooze, Janet A.; Neiberg, Rebecca H.; Schwartz, Gary G.; Hausman, Dorothy B.; Johnson, Mary Ann; Bauer, Douglas C.; Cauley, Jane A.; Shea, M. Kyla; Cawthon, Peggy M.; Harris, Tamara B.; Rubin, Susan M.; Tylavsky, Francis A.; Houston, Denise K.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 97, No. 11, 01.11.2012, p. 4156-4165.

Research output: Contribution to journalArticle

Kritchevsky, SB, Tooze, JA, Neiberg, RH, Schwartz, GG, Hausman, DB, Johnson, MA, Bauer, DC, Cauley, JA, Shea, MK, Cawthon, PM, Harris, TB, Rubin, SM, Tylavsky, FA & Houston, DK 2012, '25-Hydroxyvitamin D, parathyroid hormone, and mortality in black and white older adults: The health ABC study', Journal of Clinical Endocrinology and Metabolism, vol. 97, no. 11, pp. 4156-4165. https://doi.org/10.1210/jc.2012-1551
Kritchevsky, Stephen B. ; Tooze, Janet A. ; Neiberg, Rebecca H. ; Schwartz, Gary G. ; Hausman, Dorothy B. ; Johnson, Mary Ann ; Bauer, Douglas C. ; Cauley, Jane A. ; Shea, M. Kyla ; Cawthon, Peggy M. ; Harris, Tamara B. ; Rubin, Susan M. ; Tylavsky, Francis A. ; Houston, Denise K. / 25-Hydroxyvitamin D, parathyroid hormone, and mortality in black and white older adults : The health ABC study. In: Journal of Clinical Endocrinology and Metabolism. 2012 ; Vol. 97, No. 11. pp. 4156-4165.
@article{248ba13c0f564fd0813d2eb5f84200bf,
title = "25-Hydroxyvitamin D, parathyroid hormone, and mortality in black and white older adults: The health ABC study",
abstract = "Context: Previous 25-hydroxyvitamin D [25(OH)D] and mortality studies have included mostly individuals of European descent. Whether the relationship is similar in Blacks and to what extent differences in 25(OH)D explain racial disparities in mortality is unclear. Objective: The objective of the study was to examine the relationship between 25(OH)D, PTH, and mortality in Black and white community-dwelling older adults over 8.5 yr of follow-up. Design and Setting: Health ABC is a prospective cohort study conducted in Memphis, TN, and Pittsburgh, PA. Participants: Well-functioning Blacks and whites aged 71-80 yr with measured 25(OH)D and PTH (n = 2638; 49{\%} male, 39{\%} Black) were included in the study. Main Outcome Measure: Multivariate-adjusted proportional hazards models estimated the hazard ratios (HR) for all-cause, cardiovascular, cancer, and noncancer, noncardiovascular mortality (n = 691 deaths). Results: Mean 25(OH)D concentrations were higher in whites than in Blacks [mean (SD): 29.0 (9.9) and 20.8 (8.7) ng/ml, respectively; P < 0.001]. Serum 25(OH)D by race interactions were not significant, however. Lower 25(OH)D concentrations were associated with higher mortality in Blacks and whites combined [HR (95{\%} confidence interval [CI] 2.27 (1.59-3.24), 1.48 (1.20-1.84), and 1.25 (1.02-1.52) for < 10, 10 to < 20, and 20 to < 30 vs. ≥30 ng/ml]. In the multivariate model without 25(OH)D, Blacks had 22{\%} higher mortality than whites [HR (95{\%} CI) 1.22 (1.01, 1.48)]; after including 25(OH)D in the model, the association was attenuated [1.09 (0.90-1.33)]. The mortality population attributable risks (95{\%} CI) for 25(OH)D concentrations less than 20 ng/ml and less than 30 ng/ml in Blacks were 16.4{\%} (3.1-26.6{\%}) and 37.7{\%} (11.6-55.1{\%}) and in whites were 8.9{\%} (3.9-12.7{\%}) and 11.1{\%} (-2.7 to 22.0{\%}), respectively. PTH was also associated with mortality [HR (95{\%} CI) 1.80 (1.33-2.43) for ≥70 vs. <23 pg/ml]. Conclusions: Low 25(OH)D and high PTH concentrations were associated with increased mortality in Black and white community-dwelling older adults. Because 25(OH)D concentrations were much lower in Blacks, the potential impact of remediating low 25(OH)D concentrations was greater in Blacks than whites.",
author = "Kritchevsky, {Stephen B.} and Tooze, {Janet A.} and Neiberg, {Rebecca H.} and Schwartz, {Gary G.} and Hausman, {Dorothy B.} and Johnson, {Mary Ann} and Bauer, {Douglas C.} and Cauley, {Jane A.} and Shea, {M. Kyla} and Cawthon, {Peggy M.} and Harris, {Tamara B.} and Rubin, {Susan M.} and Tylavsky, {Francis A.} and Houston, {Denise K.}",
year = "2012",
month = "11",
day = "1",
doi = "10.1210/jc.2012-1551",
language = "English (US)",
volume = "97",
pages = "4156--4165",
journal = "Journal of Clinical Endocrinology and Metabolism",
issn = "0021-972X",
publisher = "The Endocrine Society",
number = "11",

}

TY - JOUR

T1 - 25-Hydroxyvitamin D, parathyroid hormone, and mortality in black and white older adults

T2 - The health ABC study

AU - Kritchevsky, Stephen B.

AU - Tooze, Janet A.

AU - Neiberg, Rebecca H.

AU - Schwartz, Gary G.

AU - Hausman, Dorothy B.

AU - Johnson, Mary Ann

AU - Bauer, Douglas C.

AU - Cauley, Jane A.

AU - Shea, M. Kyla

AU - Cawthon, Peggy M.

AU - Harris, Tamara B.

AU - Rubin, Susan M.

AU - Tylavsky, Francis A.

AU - Houston, Denise K.

PY - 2012/11/1

Y1 - 2012/11/1

N2 - Context: Previous 25-hydroxyvitamin D [25(OH)D] and mortality studies have included mostly individuals of European descent. Whether the relationship is similar in Blacks and to what extent differences in 25(OH)D explain racial disparities in mortality is unclear. Objective: The objective of the study was to examine the relationship between 25(OH)D, PTH, and mortality in Black and white community-dwelling older adults over 8.5 yr of follow-up. Design and Setting: Health ABC is a prospective cohort study conducted in Memphis, TN, and Pittsburgh, PA. Participants: Well-functioning Blacks and whites aged 71-80 yr with measured 25(OH)D and PTH (n = 2638; 49% male, 39% Black) were included in the study. Main Outcome Measure: Multivariate-adjusted proportional hazards models estimated the hazard ratios (HR) for all-cause, cardiovascular, cancer, and noncancer, noncardiovascular mortality (n = 691 deaths). Results: Mean 25(OH)D concentrations were higher in whites than in Blacks [mean (SD): 29.0 (9.9) and 20.8 (8.7) ng/ml, respectively; P < 0.001]. Serum 25(OH)D by race interactions were not significant, however. Lower 25(OH)D concentrations were associated with higher mortality in Blacks and whites combined [HR (95% confidence interval [CI] 2.27 (1.59-3.24), 1.48 (1.20-1.84), and 1.25 (1.02-1.52) for < 10, 10 to < 20, and 20 to < 30 vs. ≥30 ng/ml]. In the multivariate model without 25(OH)D, Blacks had 22% higher mortality than whites [HR (95% CI) 1.22 (1.01, 1.48)]; after including 25(OH)D in the model, the association was attenuated [1.09 (0.90-1.33)]. The mortality population attributable risks (95% CI) for 25(OH)D concentrations less than 20 ng/ml and less than 30 ng/ml in Blacks were 16.4% (3.1-26.6%) and 37.7% (11.6-55.1%) and in whites were 8.9% (3.9-12.7%) and 11.1% (-2.7 to 22.0%), respectively. PTH was also associated with mortality [HR (95% CI) 1.80 (1.33-2.43) for ≥70 vs. <23 pg/ml]. Conclusions: Low 25(OH)D and high PTH concentrations were associated with increased mortality in Black and white community-dwelling older adults. Because 25(OH)D concentrations were much lower in Blacks, the potential impact of remediating low 25(OH)D concentrations was greater in Blacks than whites.

AB - Context: Previous 25-hydroxyvitamin D [25(OH)D] and mortality studies have included mostly individuals of European descent. Whether the relationship is similar in Blacks and to what extent differences in 25(OH)D explain racial disparities in mortality is unclear. Objective: The objective of the study was to examine the relationship between 25(OH)D, PTH, and mortality in Black and white community-dwelling older adults over 8.5 yr of follow-up. Design and Setting: Health ABC is a prospective cohort study conducted in Memphis, TN, and Pittsburgh, PA. Participants: Well-functioning Blacks and whites aged 71-80 yr with measured 25(OH)D and PTH (n = 2638; 49% male, 39% Black) were included in the study. Main Outcome Measure: Multivariate-adjusted proportional hazards models estimated the hazard ratios (HR) for all-cause, cardiovascular, cancer, and noncancer, noncardiovascular mortality (n = 691 deaths). Results: Mean 25(OH)D concentrations were higher in whites than in Blacks [mean (SD): 29.0 (9.9) and 20.8 (8.7) ng/ml, respectively; P < 0.001]. Serum 25(OH)D by race interactions were not significant, however. Lower 25(OH)D concentrations were associated with higher mortality in Blacks and whites combined [HR (95% confidence interval [CI] 2.27 (1.59-3.24), 1.48 (1.20-1.84), and 1.25 (1.02-1.52) for < 10, 10 to < 20, and 20 to < 30 vs. ≥30 ng/ml]. In the multivariate model without 25(OH)D, Blacks had 22% higher mortality than whites [HR (95% CI) 1.22 (1.01, 1.48)]; after including 25(OH)D in the model, the association was attenuated [1.09 (0.90-1.33)]. The mortality population attributable risks (95% CI) for 25(OH)D concentrations less than 20 ng/ml and less than 30 ng/ml in Blacks were 16.4% (3.1-26.6%) and 37.7% (11.6-55.1%) and in whites were 8.9% (3.9-12.7%) and 11.1% (-2.7 to 22.0%), respectively. PTH was also associated with mortality [HR (95% CI) 1.80 (1.33-2.43) for ≥70 vs. <23 pg/ml]. Conclusions: Low 25(OH)D and high PTH concentrations were associated with increased mortality in Black and white community-dwelling older adults. Because 25(OH)D concentrations were much lower in Blacks, the potential impact of remediating low 25(OH)D concentrations was greater in Blacks than whites.

UR - http://www.scopus.com/inward/record.url?scp=84868609822&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84868609822&partnerID=8YFLogxK

U2 - 10.1210/jc.2012-1551

DO - 10.1210/jc.2012-1551

M3 - Article

C2 - 22942386

AN - SCOPUS:84868609822

VL - 97

SP - 4156

EP - 4165

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0021-972X

IS - 11

ER -