Vitamin D deficiency and mortality

Curr Opin Clin Nutr Metab Care. 2009 Nov;12(6):634-9. doi: 10.1097/MCO.0b013e3283310767.


Purpose of review: To summarize recent findings on vitamin D deficiency and mortality. The serum concentration of 25-hydroxyvitamin D [25(OH)D], the metabolic precursor of the vitamin D hormone calcitriol, is the standard for assessing vitamin D status. Deficient 25(OH)D concentrations (<25 nmol/l) are prevalent in Europe and North America.

Recent findings: Several large nonrandomized studies indicate that different from adequate 25(OH)D concentrations (>75 nmol/l), deficient 25(OH)D concentrations are associated with excess mortality in the general population and in patients with increased cardiovascular disease risk. Results support an earlier meta-analysis of controlled trials that were not primarily designed to assess mortality showing a survival benefit of vitamin D supplementation over no supplementation in middle-aged and elderly persons. In patients with advanced chronic diseases such as end-stage heart failure, however, circulating calcitriol predicts mid-term mortality better than 25(OH)D does. Available data indicate that these patients may enter a vicious cycle of low calcitriol, increased inflammation markers, and renal impairment, which may be difficult to escape by simple vitamin D supplementation.

Summary: Accumulating evidence suggests that vitamin D deficiency is linked to excess mortality. However, future studies should clarify to which extent vitamin D supplementation can improve survival in the aging population and in specific patient groups.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Calcitriol / blood*
  • Calcitriol / therapeutic use
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / mortality*
  • Dietary Supplements
  • Europe / epidemiology
  • Humans
  • Kidney Failure, Chronic / drug therapy
  • Middle Aged
  • North America / epidemiology
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D / therapeutic use*
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / complications
  • Vitamin D Deficiency / mortality*


  • Vitamin D
  • 25-hydroxyvitamin D
  • Calcitriol