Association between serum 25-hydroxyvitamin D concentrations
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This study aimed to investigate the association of circulating 25-hydroxyvitamin D [25(OH)D] levels with mortality among adults with prediabetes.

This retrospective cohort study included 15195 adults with prediabetes (aged more than 20 years) from the National Health and Nutrition Examination Survey (NHANES) III and NHANES 2001-2014. Mortality from all causes, cardiovascular disease (CVD), and cancer was linked to National Death Index mortality data.

-- The median (interquartile range) concentration of serum 25(OH)D was 60.5 (45.3, 77.4) nmol/L, and only 23.1% had sufficient vitamin D (more than 75 nmol/L).

-- Elevated serum 25(OH)D concentrations were significantly associated with lower levels of insulin, HOMA-IR, triglyceride, and C-reactive protein, and higher levels of high-density lipoprotein at baseline.

-- During a median follow up of 10.7 years, 3765 deaths (including 1080 CVD deaths and 863 cancer deaths) were identified.

-- Compared with participants with 25(OH)D less than 30 nmol/L, the multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for participants with 25(OH)D more than 75 nmol/L were 0.66 (0.53, 0.82) for all-cause mortality, 0.66 (0.48, 0.89) for CVD mortality, and 0.82 (0.49, 1.35) for cancer mortality.

-- For per unit increment in ln-transformed 25(OH)D, there was a 27% lower risk of all-cause mortality and a 34% lower risk of CVD mortality.

Conclusively, these findings suggested that higher serum 25(OH)D concentrations were associated with lower all-cause and CVD mortality among individuals with prediabetes.

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