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

Title25-Hydroxyvitamin D, parathyroid hormone, and mortality in black and white older adults: the health ABC study
Publication TypeJournal Article
Year of Publication2012
AuthorsKritchevsky, 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
JournalJ Clin Endocrinol MetabJ Clin Endocrinol Metab
Date PublishedNov
ISBN Number1945-7197 (Electronic)<br/>0021-972X (Linking)
Accession Number22942386
KeywordsAfrican Continental Ancestry Group, Aged, Aged, 80 and Over, Cause of Death, European Continental Ancestry Group, Female, Humans, Hyperparathyroidism/blood/ mortality, Male, Parathyroid Hormone/ blood, Pennsylvania/epidemiology, Prospective Studies, Tennessee/epidemiology, Vitamin D Deficiency/blood/ mortality, Vitamin D/ analogs & derivatives/blood
AbstractCONTEXT: 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 /=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.
Short TitleThe Journal of clinical endocrinology and metabolism
Ethno Med: