血清丝氨酸与全因死亡率风险：来自中国卒中一级预防试验（CSPPT）的一项巢式病例对照研究。

Serum Serine and the Risk of All-Cause Mortality: A Nested Case-Control Study From the China Stroke Primary Prevention Trial (CSPPT).

作者信息

He Qiangqiang, Zhang Nan, Liang Qiongyue, Wang Zhuo, Chen Ping, Song Yun, Zhou Ziyi, Wei Yaping, Duan Yong, Wang Binyan, Qin Peiwu, Qin Xianhui, Xu Xiping

机构信息

Graduate School at Shenzhen, Tsinghua University, Shenzhen, China.

Shenzhen Evergreen Medical Institute, Shenzhen, China.

出版信息

Front Nutr. 2022 Jul 12;9:946277. doi: 10.3389/fnut.2022.946277. eCollection 2022.

DOI:10.3389/fnut.2022.946277

PMID:35903445

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9315370/

Abstract

BACKGROUND

Serine plays a key role in numerous cellular processes, the levels and metabolism is therefore of critical importance. However, few data are available to illustrate the association of serine with long-term health effects, especially, the predictive value for long-term mortality.

OBJECTIVE

This study was conducted to evaluate the relationship between serum serine levels and all-cause mortality in general hypertensive patients in a longitudinal cohort, and to examine the potential effect modifiers.

METHODS

A nested case-control (NCC) study was conducted utilizing 20702 hypertensive participants from the China Stroke Primary Prevention Trial (CSPPT), a randomized, double-blind, actively controlled trial conducted from May 2008 to August 2013 in China. The current study included 291 cases of all-cause mortality and 291 controls matched on age (≤ 1 year), sex and treatment group. All-cause mortality was the main outcome in this analysis, which included death due to any reason.

RESULTS

With the increase in serum serine levels, the risk of all-cause mortality first increased before flattening. After adjusting for related variables, the risk of mortality increased significantly with the increase of serum serine levels. Compared with group Q1, the mortality risk of group Q2, Q3 and Q4 were significantly increased [ORs, 95% CI: Q2: 2.32, (1.32-4.07); Q3: 2.59, (1.48-4.54); and Q4: 1.85, (1.07-3.22)]. In the exploratory analysis, we observed three effect modifiers, total homocysteine, 5-Methyltetrahydrofolate, and estimated glomerular filtration rate significantly modified the serum serine and all-cause mortality association.

CONCLUSION

Serum serine levels were significantly associated with an increased risk of all-cause mortality in hypertensive patients. Our results and findings, if confirmed further, suggest that serum serine should be considered as a marker for screening risk factors of mortality.

CLINICAL TRIAL REGISTRATION

[https://www.clinicaltrials.gov/ct2/show/study/NCT00794885.], identifier [CSPPT, NCT00794885].

摘要

背景

丝氨酸在众多细胞过程中发挥关键作用，因此其水平和代谢至关重要。然而，鲜有数据可说明丝氨酸与长期健康影响之间的关联，尤其是对长期死亡率的预测价值。

目的

本研究旨在评估纵向队列中一般高血压患者血清丝氨酸水平与全因死亡率之间的关系，并检验潜在的效应修饰因素。

方法

利用来自中国脑卒中一级预防试验（CSPPT）的20702名高血压参与者开展了一项巢式病例对照（NCC）研究，CSPPT是一项于2008年5月至2013年8月在中国进行的随机、双盲、积极对照试验。本研究纳入了291例全因死亡病例和291名在年龄（≤1岁）、性别和治疗组方面匹配的对照。全因死亡率是本分析中的主要结局，包括因任何原因导致的死亡。

结果

随着血清丝氨酸水平的升高，全因死亡风险先升高后趋于平稳。在调整相关变量后，死亡率风险随血清丝氨酸水平的升高而显著增加。与Q1组相比，Q2、Q3和Q4组的死亡风险显著增加[比值比，95%置信区间：Q2：2.32，（1.32 - 4.07）；Q3：2.59，（1.48 - 4.54）；Q4：1.85，（1.07 - 3.22）]。在探索性分析中，我们观察到三种效应修饰因素，即总同型半胱氨酸、5 - 甲基四氢叶酸和估计肾小球滤过率显著改变了血清丝氨酸与全因死亡率之间的关联。