Habitual vitamin D supplementation and mortality across diabetes and chronic kidney disease status
A prospective UK Biobank study
DOI:
https://doi.org/10.24252/diversity.v7i1.70839Keywords:
cardiovascular diseases, chronic disease, diabetes mellitus, dietary supplements, vitamin dAbstract
Habitual vitamin D supplementation is increasingly common for chronic disease prevention, yet evidence regarding its long-term mortality effects across combined diabetes and chronic kidney disease (CKD) status remains limited, making this study novel in evaluating disease-specific heterogeneity and interaction. This prospective cohort study investigated associations between habitual vitamin D supplementation and all-cause, cardiovascular disease (CVD), and cancer mortality among 350,817 UK Biobank participants classified as having neither diabetes nor CKD, diabetes only, CKD only, or both conditions. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs), while additive and multiplicative interactions were assessed using relative excess risk due to interaction, attributable proportion, Cox models, and Aalen additive hazard models. During a median 15.3-year follow-up, 24,636 deaths occurred, including 7,748 CVD and 12,214 cancer deaths. Vitamin D supplementation was associated with lower cancer mortality among participants without diabetes or CKD (HR 0.88, 95% CI 0.80–0.98), but higher all-cause mortality in diabetes alone (HR 1.38, 95% CI 1.09–1.75), with the greatest risks observed among participants with both diabetes and CKD for all-cause mortality (HR 1.87, 95% CI 1.27–2.76) and CVD mortality (HR 1.81, 95% CI 1.11–2.95). These findings support individualized supplementation strategies, careful clinical monitoring, and family-centered health education, consistent with Islamic principles of preserving health, preventing harm, and promoting responsible use of health interventions.
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