The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment).
A Cochrane review [Abstract] 1 included 56 studies with a total of 95 286 subjects to assess the beneficial and harmful effects of vitamin D for prevention of mortality in adults. Most trials included elderly women (older than 70 years). Vitamin D was administered for a median of two years.
When different forms of vitamin D were assessed in separate analyses, only vitamin D3 decreased mortality (11.0% vs 11.4%); RR 0.94 (95% CI 0.91 to 0.98); 75 927 participants; 38 trials. Vitamin D2, alfacalcidol and calcitriol did not significantly affect mortality. On the other hand, vitamin D3 combined with calcium significantly increased the risk of nephrolithiasis RR 1.17 (95% CI 1.02 to 1.34); 42876 participants; 4 trials (Table 1).
Most of the trials had a low risk of bias. Data on health-related quality of life and health economics were inconclusive.
| Outcome | Participants(Studies) | Assumed risk -Control | Corresponding risk- Vitamin D | RR (95% CI) |
|---|---|---|---|---|
| All-cause mortality (vitamin D3) | 75 927(38) | 114 / 1000 | 107 / 1000 | 0.94 (0.91 to 0.98) |
| Cardiovascular mortality | 47 267(10) | 42/1000 | 41/1000 | 0.98 (0.90 to 1.07) |
| Cancer mortality | 42 876(4) | 29/1000 | 25/1000 | 0.88 (0.78 to 0.98) |
| Nephrolithiasis (D3 and calcium) | 42 876(4) | 18/1000 | 21/1000(18 to 24) | 1.17 (1.02 to 1.34) |
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