Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland.
Department of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland.
Eur J Nutr. 2016 Feb;55(1):393-402. doi: 10.1007/s00394-015-0860-y. Epub 2015 Feb 21.
Low serum 25-hydroxyvitamin D [25(OH)D] levels have been associated with higher risk of many diseases that affect mortality, including cardiovascular disease (CVD) and cancer. The inverse association between serum 25(OH)D and mortality may be modified by excess circulating vitamin A, due to interactions of vitamin A at the level of the vitamin D nuclear receptor. In this prospective cohort study, we investigated whether the association of 25(OH)D with all-cause, cancer, and CVD mortality was modified by circulating vitamin A or preformed vitamin A intake from supplements.
We analyzed 15,998 adults in the Third National Health and Nutrition Examination Survey (NHANES III), 1988-1994. Mortality data for all-cause (n = 3890), cancer (n = 844), and CVD mortality (n = 1715) were assessed through December 2006. Serum 25(OH)D was measured using a radioimmunoassay kit, vitamin A biomarkers were measured by HPLC, and information on supplement use was obtained by self-report. Multivariable hazard ratios (HRs) and corresponding 95% confidence intervals (CI) were estimated by proportional hazards regression.
Serum 25(OH)D was significantly inversely associated with all-cause mortality (HR 0.93, 95% CI 0.89, 0.97, per 10 ng/mL increase) and also with CVD mortality and mortality due to non-cancer/non-cardiovascular causes, but not with cancer mortality. The observed inverse associations remained statistically significant only among participants with serum retinyl esters <7.0 μg/dL. High intake (>5000 IU/day) of preformed vitamin A from supplements attenuated the inverse association of 25(OH)D with overall mortality. The observed interactions were not statistically significant.
25(OH)D was inversely associated with overall mortality, CVD mortality, and mortality due to non-cancer/non-CVD causes, but not with cancer mortality. A possible interaction between vitamin A exposure and 25(OH)D concentration appears to be associated with an attenuation of the inverse association between risk of death and quartile of 25(OH)D concentration.
血清 25-羟维生素 D [25(OH)D] 水平较低与许多影响死亡率的疾病（包括心血管疾病 [CVD] 和癌症）的风险增加有关。由于维生素 A 在维生素 D 核受体水平的相互作用，血清 25(OH)D 与死亡率之间的负相关关系可能会因循环中维生素 A 过多而改变。在这项前瞻性队列研究中，我们调查了血清 25(OH)D 与全因、癌症和 CVD 死亡率之间的关联是否因循环维生素 A 或补充剂中预先形成的维生素 A 摄入而发生变化。
我们分析了 1988-1994 年第三次全国健康和营养检查调查（NHANES III）中的 15998 名成年人。通过 2006 年 12 月对全因（n=3890）、癌症（n=844）和 CVD 死亡率（n=1715）进行死亡率评估。使用放射免疫测定试剂盒测量血清 25(OH)D，使用高效液相色谱法测量维生素 A 生物标志物，并通过自我报告获取补充剂使用信息。通过比例风险回归估计多变量风险比（HR）和相应的 95%置信区间（CI）。
血清 25(OH)D 与全因死亡率呈显著负相关（每增加 10ng/mL，HR0.93，95%CI0.89，0.97），与 CVD 死亡率和非癌症/非心血管原因死亡率也呈负相关，但与癌症死亡率无关。仅在血清视黄酯<7.0μg/dL 的参与者中，观察到的负相关关系仍然具有统计学意义。来自补充剂的预先形成的维生素 A 的高摄入量（>5000IU/天）减弱了 25(OH)D 与总死亡率之间的负相关关系。观察到的相互作用没有统计学意义。
血清 25(OH)D 与全因死亡率、CVD 死亡率和非癌症/非 CVD 原因死亡率呈负相关，但与癌症死亡率无关。维生素 A 暴露和 25(OH)D 浓度之间的可能相互作用似乎与死亡风险与 25(OH)D 浓度四分位之间的负相关关系减弱有关。
Zotero 插件