Observational studyThe lancet. Diabetes & endocrinology2024
Estimating dose-response relationships for vitamin D with coronary heart disease, stroke, and all-cause mortality: observational and Mendelian randomisation analyses.
Observational study in The lancet. Diabetes & endocrinology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 38 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 4 syntheses or guidelines pooled it, 68 citations in OpenAlex.
- Investigating the Inflammatory Link Between Vitamin D and Hidradenitis Suppurativa: A Systematic Review and Causal Inference Analysis.International journal of molecular sciences · 2026Pooled it
- Genome-wide gene-sleep interaction study identifies novel lipid loci in 732,564 participants.Atherosclerosis · 2026Pooled it
- New Insight into the Role of Vitamin D in the Stroke Risk: A Meta-Analysis of Stratified Data by 25(OH)D Levels.Current vascular pharmacology · 2025Pooled it
- The association between the triglyceride-glucose index and vitamin D status: a systematic review and meta-analysis.BMC endocrine disorders · 2024Pooled it
- Context-Stratified Mendelian Randomization: Exploiting Regional Exposure Variation to Explore Causal Effect Heterogeneity and Nonlinearity.Statistics in medicine · 2026Article
- Article
- From the Vitamin D Paradox to Precision Nutrition: Targeted Supplementation, Assay Pitfalls, and Clinical Decision-Making.Current nutrition reports · 2026Review
- Decreased Serum Vitamin D Is Not Associated With Sjögren Disease in European and Asian Subjects.ACR open rheumatology · 2026Article
- Impact of serum vitamin (Vitamin D, Vitamin B12) and trace element (Fe, Zn, Cu) levels on major adverse cardiovascular events and poor prognosis in STEMI patients undergoing primary PCI.Journal of clinical biochemistry and nutrition · 2026Article
- 25-Hydroxyvitamin D levels are associated with mortality and cardiovascular events in systemic lupus erythematosus.Annals of the rheumatic diseases · 2026Article
- Lack of Association between Vitamin D Insufficiency and Cardiovascular or Fracture Risk: A UK Biobank Study.Endocrinology and metabolism (Seoul, Korea) · 2026Article
- Association of Vitamin D Levels and Mortality in Overactive Bladder: Nonlinear Dose-Response and Threshold Effect.Food science & nutrition · 2026Article
- The vitamin D-cardiovascular nexus unraveling mechanistic promise and trial reality.Nutrition & metabolism · 2026Review
- Association of 25-hydroxyvitamin D with all-cause and cardiovascular disease mortality among individuals incardiovascular-kidney-metabolic syndrome stages 0-3: a cohort study from the NHANES 2001-2018.Diabetology & metabolic syndrome · 2026Article
- Risk of Cardiovascular Disease Mortality in Patients With Diagnosed Cancer and Associated Genetic and Proteomic Mechanisms: A UK Biobank-Based Cohort Study.Journal of the American Heart Association · 2026Article
- Temporal trend of serum vitamin profiles and the association with non-alcoholic fatty liver disease.Frontiers in nutrition · 2026Article
- Stratification-based instrumental variable analysis framework for nonlinear effect analysis.Biostatistics (Oxford, England) · 2025Article
- Association between serum 25(OH)D, oxidative balance score, and mortality among individuals with metabolic syndrome: a cohort study.Diabetology & metabolic syndrome · 2025Article
- Serum Vitamin D Levels Over Time and the Incidence of Atrial Fibrillation in the HUNT Study.Journal of the Endocrine Society · 2025Article
- Circulating vitamin D concentrations and the risk of urticaria: A bidirectional two-sample Mendelian randomization study.Asia Pacific journal of clinical nutrition · 2025Article
Corrections and comments
- Commented on by
- Erratum issued
- RetractedandRepublishedFrom
Authors and funding
1 author at 2 institutions in 1 country.
Funding
Abstract
backgroundRandomised trials of vitamin D supplementation for cardiovascular disease and all-cause mortality have generally reported null findings. However, generalisability of results to individuals with low vitamin D status is unclear. We aimed to characterise dose-response relationships between 25-hydroxyvitamin D (25[OH]D) concentrations and risk of coronary heart disease, stroke, and all-cause mortality in observational and Mendelian randomisation frameworks.
methodsObservational analyses were undertaken using data from 33 prospective studies comprising 500 962 individuals with no known history of coronary heart disease or stroke at baseline. Mendelian randomisation analyses were performed in four population-based cohort studies (UK Biobank, EPIC-CVD, and two Copenhagen population-based studies) comprising 386 406 middle-aged individuals of European ancestries, including 33 546 people who developed coronary heart disease, 18 166 people who had a stroke, and 27 885 people who died. Primary outcomes were coronary heart disease, defined as fatal ischaemic heart disease (International Classification of Diseases 10th revision code I20-I25) or non-fatal myocardial infarction (I21-I23); stroke, defined as any cerebrovascular disease (I60-I69); and all-cause mortality.
findingsObservational analyses suggested inverse associations between incident coronary heart disease, stroke, and all-cause mortality outcomes with 25(OH)D concentration at low 25(OH)D concentrations. In population-wide genetic analyses, there were no associations of genetically predicted 25(OH)D with coronary heart disease (odds ratio [OR] per 10 nmol/L higher genetically-predicted 25(OH)D concentration 0·98, 95% CI 0·95-1·01), stroke (1·01, [0·97-1·05]), or all-cause mortality (0·99, 0·95-1·02). Null findings were also observed in genetic analyses for cause-specific mortality outcomes, and in stratified genetic analyses for all outcomes at all observed levels of 25(OH)D concentrations.
interpretationStratified Mendelian randomisation analyses suggest a lack of causal relationship for 25(OH)D concentrations with both cardiovascular and mortality outcomes for individuals at all levels of 25(OH)D. Our findings suggest that substantial reductions in mortality and cardiovascular morbidity due to long-term low-dose vitamin D supplementation are unlikely even if targeted at individuals with low vitamin D status.
fundingBritish Heart Foundation, Medical Research Council, National Institute for Health Research, Health Data Research UK, Cancer Research UK, and International Agency for Research on Cancer.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.