Article Text

Download PDFPDF
Original article
The role of vitamin D supplementation in the risk of developing pneumonia: three independent case–control studies
  1. Hilde H F Remmelts1,2,3,
  2. Simone M C Spoorenberg1,
  3. Jan Jelrik Oosterheert2,
  4. Willem Jan W Bos1,
  5. Mark C H de Groot4,
  6. Ewoudt M W van de Garde4,5
  1. 1Department of Internal Medicine, St Antonius Hospital, Nieuwegein, The Netherlands
  2. 2Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands
  3. 3Department of Internal Medicine, Gelderse Vallei Hospital, Ede, The Netherlands
  4. 4Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, University of Utrecht, Utrecht, The Netherlands
  5. 5Department of Clinical Pharmacy, St Antonius Hospital, Nieuwegein, The Netherlands
  1. Correspondence to Hilde H F Remmelts, Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Heidelberglaan 100, PO Box 85500, Utrecht 3508 GA, The Netherlands; h.h.f.remmelts-3{at}


Background Vitamin D plays a role in host defence against infection. Vitamin D deficiency has been associated with an increased risk of respiratory tract infections in children and adults. This study aimed to examine whether vitamin D supplementation is associated with a lower pneumonia risk in adults.

Methods Three independent case–control studies were performed including a total of 33 726 cases with pneumonia in different settings with respect to hospitalisation status and a total of 105 243 controls. Cases and controls were matched by year of birth, gender and index date. The major outcome measure was exposure to vitamin D supplementation at the time of pneumonia diagnosis. Conditional logistic regression was used to compute ORs for the association between vitamin D supplementation and occurrence of pneumonia.

Results Vitamin D supplementation was not associated with a lower risk of pneumonia. In studies 1 and 2, adjustment for confounding resulted in non-significant ORs of 1.814 (95% CI 0.865 to 3.803) and 1.007 (95% CI 0.888 to 1.142), respectively. In study 3, after adjustment for confounding, the risk of pneumonia remained significantly higher among vitamin D users (OR 1.496, 95% CI 1.208 to 1.853). Additional analyses showed significant modification of the association through co-use of corticosteroids and drugs that affect bone mineralisation. For patients using these drugs, ORs below one were found combined with higher ORs for patients not using these drugs.

Conclusions This study showed no preventive association between vitamin D supplementation and the risk of pneumonia in adults.

  • Respiratory Infection

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • Airwaves
    Andrew Bush Ian Pavord