Department of Clinical Laboratory, the First Affiliated Hospital of Kunming Medical University, Kunming, China.
Yunnan Province Clinical Research Center for Laboratory Medicine, Kunming, China.
J Clin Hypertens (Greenwich). 2022 Jul;24(7):945-954. doi: 10.1111/jch.14516. Epub 2022 Jun 14.
We aimed to evaluate the prospective association of vitamin B5 with all-cause mortality and explore its potential modifiers in Chinese adults with hypertension. A nested, case-control study was conducted in the China Stroke Primary Prevention Trial, including 505 deaths of all causes and 505 matched controls. The median follow-up duration was 4.5 years. The primary outcome measure in this investigation was all-cause mortality, which encompassed deaths for any reason. The mean plasma vitamin B5 concentration for cases (43.7 ng/mL) was higher than that in controls (40.9 ng/mL) (p = .001). When vitamin B5 was further assessed as quintiles, compared with the reference group (Q1: < 33.0 ng/mL), the risk of all-cause mortality increased by 29% (OR = 1.29, 95% CI: 0.83-2.01) in Q2, 22% (OR = 1.22, 95% CI: 0.77-1.94) in Q3, 62% (OR = 1.62, 95% CI: 1.00-2.62) in Q4, and 77% (OR = 1.77, 95% CI: 1.06-2.95) in Q5. The trend test was significant (p = .022). When Q4-Q5 were combined, a significant 41% increment (OR = 1.41, 95% CI: 1.03-1.95) in all-cause death risk was found compared with Q1-Q3. The adverse effects were more pronounced in those with normal folate levels (p-interaction = .019) and older people (p-interaction = .037). This study suggests that higher baseline levels of plasma vitamin B5 are a risk factor for all-cause mortality among Chinese patients with hypertension, especially among older adults and those with adequate folate levels. The findings, if confirmed, may inform novel clinical and nutritional guidelines and interventions to optimize vitamin B5 levels.
我们旨在评估维生素 B5 与全因死亡率的前瞻性关联，并探讨其在中国高血压成年人中的潜在调节剂。在中国脑卒中一级预防试验中进行了一项嵌套病例对照研究，包括 505 例全因死亡和 505 例匹配对照。中位随访时间为 4.5 年。本研究的主要观察终点为全因死亡率，包括任何原因导致的死亡。病例组的平均血浆维生素 B5 浓度（43.7ng/mL）高于对照组（40.9ng/mL）（p=0.001）。当维生素 B5 进一步评估为五分位数时，与参考组（Q1：<33.0ng/mL）相比，全因死亡率的风险增加了 29%（OR=1.29，95%CI：0.83-2.01）在 Q2 中，增加了 22%（OR=1.22，95%CI：0.77-1.94），在 Q3 中，增加了 62%（OR=1.62，95%CI：1.00-2.62），在 Q4 中，增加了 77%（OR=1.77，95%CI：1.06-2.95）。趋势检验有统计学意义（p=0.022）。当 Q4-Q5 合并时，与 Q1-Q3 相比，全因死亡风险显著增加 41%（OR=1.41，95%CI：1.03-1.95）。在叶酸水平正常的患者（p 交互=0.019）和老年人（p 交互=0.037）中，不良影响更为明显。本研究表明，中国高血压患者基线血浆维生素 B5 水平较高是全因死亡率的危险因素，尤其是在老年人和叶酸水平充足的人群中。如果得到证实，这些发现可能为优化维生素 B5 水平提供新的临床和营养指南和干预措施。
