Association between fat-soluble vitamins and self-reported health status: a cross-sectional analysis of the MARK-AGE cohort

Self-rated health (SRH) is associated with higher risk of death. Since low plasma levels of fat-soluble vitamins are related to mortality, we aimed to assess whether plasma concentrations of vitamins A, D and E were associated with SRH in the MARK-AGE study. We included 3158 participants (52 % female) aged between 35 and 75 years. Cross-sectional data were collected via questionnaires. An enzyme immunoassay quantified 25-hydroxyvitamin D and HPLC determined alpha-tocopherol and retinol plasma concentrations. The median 25-hydroxyvitamin D and retinol concentrations differed significantly (P < 0.001) between SRH categories and were lower in the combined fair/poor category v. the excellent, very good and good categories (25-hydroxvitamin D: 40.8 v. 51.9, 49.3, 46.7 nmol/l, respectively; retinol: 1.67 v. 1.75, 1.74, 1.70 mu mol/l, respectively). Both vitamin D and retinol status were independently associated with fair/poor SRH in multiple regression analyses: adjusted OR (95 % CI) for the vitamin D insufficiency, deficiency and severe deficiency categories were 1.33 (1.06-1.68), 1.50 (1.17-1.93) and 1.83 (1.34-2.50), respectively; P = 0.015, P = 0.001 and P < 0.001, and for the second/third/fourth retinol quartiles: 1.44 (1.18-1.75), 1.57 (1. 28-1.93) and 1.49 (1.20-1.84); all P < 0.001. No significant associations were reported for a-tocopherol quartiles. Lower vitamin A and D status emerged as independent markers for fair/poor SRH. Further insights into the long-term implications of these modifiable nutrients on health status are warranted.