{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T12:47:19Z","timestamp":1778244439019,"version":"3.51.4"},"reference-count":33,"publisher":"Korean Endocrine Society","issue":"2","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002635","name":"Inha University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002635","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-enm.org"],"crossmark-restriction":true},"short-container-title":["Endocrinol Metab"],"published-print":{"date-parts":[[2026,4,30]]},"abstract":"<jats:p>Background: Vitamin D deficiency has been linked to increased risks of fractures and cardiovascular (CV) events, but the clinical relevance of the \u2018insufficiency\u2019 range remains unclear. We investigated CV and fracture risks across vitamin D levels, with a focus on the insufficiency range.Methods: Using UK Biobank data, we analyzed 375,044 participants aged 40 to 69 years. Vitamin D status was categorized as deficient (&lt;50 nmol\/L), insufficient (\u226550 to &lt;75 nmol\/L), or sufficient (\u226575 nmol\/L). Outcomes included three-point major adverse cardiovascular events (3P-MACE; myocardial infarction, stroke, and CV mortality) and major osteoporotic fractures, assessed via hospital records, registries, and death certificates.Results: The vitamin D-deficient group had an increased risk of CV events (adjusted hazard ratio [aHR], 1.17; 95% confidence interval [CI], 1.11 to 1.24) and fractures (aHR, 1.09; 95% CI, 1.01 to 1.18) compared to the vitamin D-sufficient group. Within the deficient group, the severely deficient group (&lt;30 nmol\/L) exhibited a markedly higher risk (aHR, 1.29; 95% CI, 1.21 to 1.37 for 3PMACE; and aHR, 1.20; 95% CI, 1.10 to 1.32 for fractures). In contrast, the vitamin D-insufficient group (50 to 75 nmol\/L) showed no significant increase in the risk of either outcome, with no clear benefit or harm observed. Spline curve analysis revealed a negative correlation between vitamin D levels and risk, which was observed only within the deficient range and not within the insufficient range.Conclusion: Vitamin D deficiency is strongly associated with increased CV disease and fracture risks, whereas the insufficiency range shows no significant risk or benefit, raising questions about its clinical relevance.<\/jats:p>","DOI":"10.3803\/enm.2025.2482","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T07:38:08Z","timestamp":1760513888000},"page":"308-318","update-policy":"https:\/\/doi.org\/10.3803\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Lack of Association between Vitamin D Insufficiency and Cardiovascular or Fracture Risk: A UK Biobank Study"],"prefix":"10.3803","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4645-816X","authenticated-orcid":true,"given":"Yongin","family":"Cho","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism, Inha University College of Medicine, Incheon, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1255-1323","authenticated-orcid":true,"given":"Jong Hyun","family":"Jhee","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong Ho","family":"Jhee","sequence":"additional","affiliation":[{"name":"Inria, Inserm, Paris Cit\u00e9 University (Universit\u00e9 Paris Cit\u00e9), UMR 1346, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5757-6233","authenticated-orcid":true,"given":"Hye-Sun","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2119","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmra070553"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.107.706127"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.168.15.1629"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2003.12.029"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.3390\/nu9111244"},{"key":"ref6","first-page":"246","volume-title":"Vitamin D supplementation guidelines for general population and groups at risk of vitamin D deficiency 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