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Vitamin D supplementation as a potential cause of U-shaped associations between vitamin D levels and negative health outcomes: a decision tree analysis for risk of frailty.
Kojima, Gotaro; Iliffe, Steve; Tanabe, Marianne.
Afiliação
  • Kojima G; Department of Primary Care and Population Health, University College London (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK. gotarokojima@yahoo.co.jp.
  • Iliffe S; Department of Primary Care and Population Health, University College London (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK.
  • Tanabe M; Veterans Affairs Pacific Islands Health Care System, Honolulu, Hawaii, USA.
BMC Geriatr ; 17(1): 236, 2017 10 16.
Article em En | MEDLINE | ID: mdl-29037174
BACKGROUND: A recent controversy in vitamin D research is a "U-shaped association", with elevated disease risks at both high and low 25-hydroxyvitamin D (25 (OH) D) levels. METHODS: This is a cross-sectional study of 238 male nursing home veterans in Hawaii. Classification and regression tree (CART) analysis identified groups based on 25 (OH) D and vitamin D supplementation for frailty risk. Characteristics were examined and compared across the groups using logistic regression and receiver operating characteristic (ROC) curve analyses. RESULTS: CART analysis identified three distinct groups: vitamin D supplement users (n = 86), non-users with low vitamin D (n = 55), and non-users with high vitamin D (n = 97). Supplement users were the most frail, but had high mean 25 (OH) D of 26.6 ng/mL, which was compatible with 27.1 ng/mL in non-users with high vitamin D, while mean 25 (OH) D of non-users with low vitamin D was 11.7 ng/mL. Supplement users and non-users with low vitamin D were significantly more likely to be frail (odds ratio (OR) = 9.90, 95% CI = 2.18-44.86, p = 0.003; OR = 4.28, 95% CI = 1.44-12.68, p = 0.009, respectively), compared with non-users with low vitamin D. ROC curve analysis showed the three groups significantly predicted frailty (area under the curve = 0.73), with sensitivity of 64.4% and specificity of 76.7%, while 25 (OH) D did not predict frailty. CONCLUSIONS: In these nursing home veterans, vitamin D supplement users were the most frail but with high 25 (OH) D. This can potentially be a cause of U-shaped associations between vitamin D levels and negative health outcomes.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Vitamina D / Árvores de Decisões / Fragilidade Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Vitamina D / Árvores de Decisões / Fragilidade Idioma: En Ano de publicação: 2017 Tipo de documento: Article