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Brief Report

An estimate of the survival benefit of improving vitamin D status in the adult German population

Armin Zittermann, Raimund von Helden, William Grant, Christoph Kipshoven and Johann D. Ringe

Background: Inadequate vitamin D status is a worldwide problem. Evidence is accumulating that individuals with low vitamin D status have excess mortality rates. We calculated to which extent annual mortality rates can be reduced in the German population by optimizing vitamin D status.

Methods: Our calculations are based on (i) an annual mortality rate of 1.34% in the adult German population as provided by the Statistical Yearbook, (ii) the actual vitamin D status in German adults with a high mortality risk as assessed in 1,343 individuals from 264 general practitioners in different German regions (DEVID study), and (iii) data from two very large prospective cohorts (Dobnig et al., 2008; Melamed et al, 2008) about the excess mortality in individuals with inadequate vitamin D status.

Results: Mean serum concentrations of 25-hydroxyvitamin D in the DEVID study cohort were 41 nmol/l (SD: 22 nmol/l). More than 90% of individuals had 25-hydroxyvitamin D concentrations below the threshold that was associated with lowest mortality risk in the two aforementioned trials (75 nmol/l). According to conservative estimations, at least 2.2% of all deaths or 18,300 lives annually can be saved by achieving 25(OH)D concentrations of at least 75 nmol/l in the entire adult German population. Available data provide evidence for an exponential increase in total mortality with deficient 25-hydroxyvitamin D concentrations.

Conclusion: Improving vitamin D status in a population with inadequate vitamin D status might be an effective strategy to reduce annual mortality rates.

Authors

Armin Zittermann

Department of Cardio-Thoracic Surgery; Heart Center North Rhine-Westfalia; Ruhr University Bochum; Bad Oeynhausen, Germany

Raimund von Helden

Gerneral Practitioner; Lennestadt, Germany

William Grant

Sunlight, Nutrition, and Health Research Center (SUNARC); San Francisco, CA USA

Christoph Kipshoven

Department of Medical Affairs; Madaus GmbH; Cologne, Germany

Johann D. Ringe

5West German Osteoporosis Center; Klinikum Leverkusen; University of Cologne; Cologne, Germany