ReviewVitamin D, PTH and the risk of overall and disease-specific mortality: Results of the Longitudinal Aging Study Amsterdam

•Low 25(OH)D levels were associated with a higher risk of overall mortality.•Men with high PTH levels had a higher risk of overall and cardiovascular mortality.•No associations of 25(OH)D or PTH with cancer mortality were observed.•The association of 25(OH)D with overall mortality was (partly) mediated by PTH.•Serum 25(OH)D and PTH should be regarded as important health markers.

Observational studies suggest that low concentrations of serum 25-hydroxyvitamin D (25(OH)D) and high concentrations of parathyroid hormone (PTH) are associated with a higher risk of mortality. The aim of this study was to examine whether 25(OH)D and PTH concentrations are independently associated with overall and disease-specific (cardiovascular and cancer-related) mortality in a large, prospective population-based cohort of older adults. Data from 1317 men and women (65-85 years) of the Longitudinal Aging Study Amsterdam were used. Cox proportional hazard analyses were used to examine whether 25(OH)D and PTH at baseline were associated with overall mortality (with a follow-up of 18 years) and disease-specific mortality (with a follow-up of 13 years).Compared to persons in the reference category of ≥75 nmol/L, persons with serum 25(OH)D <25 nmol/L (HR 1.46; 95% CI: 1.12-1.91) and 25-49.9 nmol/L (HR 1.24; 95% CI: 1.01-1.53) had a significantly higher risk of overall mortality, as well as men with baseline PTH concentrations ≥7 pmol/L (HR 2.54 (95% CI: 1.58-4.08)), compared to the reference category of <2.33 pmol/L. The relationship of 25(OH)D with overall mortality was partly mediated by PTH. Furthermore, men with PTH concentrations of ≥7 pmol/L (HR 3.22; 95% CI: 1.40-7.42) had a higher risk of cardiovascular mortality, compared to the reference category. No significant associations of 25(OH)D or PTH with cancer-related mortality were observed.Both 25(OH)D and PTH should be considered as important health markers.