Low levels of vitamin D are associated with multimorbidity: results from the LifeLines Cohort Study

Laura M G Meems, Martin H de Borst, Dirkje S Postma, Judith M Vonk, Hubertus P H Kremer, Marie-Louise A Schuttelaar, Judith G M Rosmalen, Rinse K Weersma, Bruce H R Wolffenbuttel, Salome Scholtens, Ronald P Stolk, Ido P Kema, Gerjan Navis, Mohsin A F Khan, Pim van der Harst, Rudolf A de Boer

Research output: Contribution to journalArticleAcademicpeer-review


BACKGROUND: The prevalence of multimorbidity (≥ 1 disease within an individual) is rapidly increasing. So far, studies on the relationship between vitamin D and morbidity are mainly focusing on effects on single disease domains only, while vitamin D biology is associated with several diseases throughout the human body.

METHODS: We studied 8,726 participants from the LifeLines Cohort Study (a cross-sectional, population-based cohort study) and used the self-developed composite morbidity score to study the association between vitamin D levels and multimorbidity.

RESULTS: Study participants (mean age 45 ± 13 years, 73% females) had a mean plasma vitamin D level of 59 ± 22 nmol/L. In participants aged between 50 and 60 years, 58% had ≥ 2 affected disease domains, while morbidity score increased with age (70-80 years: 82% morbidity score > 1; > 80 years: 89% morbidity score > 1). Each incremental reduction by 1 standard deviation (SD) of vitamin D level was associated with an 8% higher morbidity score (full model OR 0.92, 95% CI 0.88-0.97, P = 0.001). Participants with vitamin D levels < 25 nmol/L were at highest risk for increasing morbidity prevalence (versus > 80 nmol/L, OR 1.34, 95% CI 1.07-1.67, P = 0.01).

CONCLUSIONS: Low levels of vitamin D are associated with higher prevalence of multimorbidity, especially in participants with vitamin D levels < 25 nmol/L. Collectively, our results favor a general, rather than an organ-specific, approach when assessing the impact of vitamin D deficiency.

Original languageEnglish
Pages (from-to)474-81
Number of pages8
JournalAnnals of Medicine
Issue number6
Publication statusPublished - 2015
Externally publishedYes


  • Adult
  • Aged
  • Calcifediol/blood
  • Chromatography, Liquid/methods
  • Cohort Studies
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Netherlands/epidemiology
  • Prevalence
  • Risk Factors
  • Tandem Mass Spectrometry/methods
  • Vitamin D/blood
  • Vitamin D Deficiency/blood


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