{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T16:51:18Z","timestamp":1793206278666,"version":"4.5.0"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T00:00:00Z","timestamp":1684368000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The prevalence of vitamin D deficiency varied among populations and regions worldwide. In addition, the association between vitamin D deficiency and health outcomes remained controversial. Our study aimed to investigate the prevalence of vitamin D deficiency and its association with mortality risk among non-institutional middle-aged and older adults in the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The study population included 11,119 adult participants aged between 50 and 79 years in the 2007\u20132016 National Health and Nutrition Examination Survey (NHANES). Vitamin D status was divided as \u2264\u200930 (severely deficient), 30.1\u201350 (moderately deficient), 50.1\u201375 (insufficient), 75.1\u2013100 (sufficient), and &amp;gt;\u2009100 nmol\/L (very sufficient). NHANES data were linked to National Death Index to ascertain the survival status and cause of death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The population aged 61.5 years (survey-weighted) and 47.9% were men. Among them, 4.6% were severely vitamin D deficient, 15.2% moderately deficient, and 33.6% insufficient. Individuals with higher vitamin D levels tended to be female, older, white people, non-smoker, non-single, more educated, with higher family income, and lower body mass index. During a median follow-up of 97.0\u2009months, a total of 1,585 participants died (15.9 per 10,000 person-months). The crude analysis showed that vitamin D deficiency, but not vitamin D insufficiency, correlated to higher all-cause mortality risk. The association remained similar after adjusting for potential confounders, showing that vitamin D deficiency (HR: 1.38, 95% CI 1.15\u20131.66), but not vitamin D insufficiency (HR: 1.03, 95% CI 0.88\u20131.20), correlated to higher all-cause mortality risk. In addition, we showed that vitamin D deficiency was an independent risk factor for death from pneumonia (HR: 3.82, 95% CI 1.14\u201312.86) but not from cardiovascular diseases, cancer, or cerebrovascular diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In summary, among middle-aged and older adults in the United States, nearly 20% were vitamin D deficient. Vitamin D deficiency, but not vitamin D insufficiency, correlated to increased mortality risk.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2023.1163737","type":"journal-article","created":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T05:56:46Z","timestamp":1684389406000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":37,"title":["Prevalence of vitamin D deficiency and associated risk of all-cause and cause-specific mortality among middle-aged and older adults in the United States"],"prefix":"10.3389","volume":"10","author":[{"given":"Ting-Yi","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung-Wei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Yan","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,5,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"9276380","DOI":"10.1155\/2018\/9276380","article-title":"The biological activities of Vitamin D and its receptor in relation to calcium and bone homeostasis, Cancer, immune and cardiovascular systems, skin biology, and Oral health","author":"Khammissa","year":"2018","journal-title":"Biomed Res Int"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"346","DOI":"10.14336\/AD.2016.1021","article-title":"Vitamin D and chronic diseases","volume":"8","author":"Wang","year":"2017","journal-title":"Aging Dis"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"2097","DOI":"10.3390\/nu12072097","article-title":"Immunologic effects of Vitamin D on human health and disease","volume":"12","author":"Charoenngam","year":"2020","journal-title":"Nutrients"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1007\/s00391-017-1237-z","article-title":"Link between community-acquired pneumonia and vitamin D levels in older patients. 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