Chen Xueqin, Zhou Mingge, Yan Hui, Chen Jiatian, Wang Yuetao, Mo Xiaofei
Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China.
Changzhou Key Laboratory of Molecular Imaging, Changzhou, China.
Front Nutr. 2022 Oct 20;9:971720. doi: 10.3389/fnut.2022.971720. eCollection 2022.
Vitamin D (VD) plays an important role in decreasing the risk of adverse events for various metabolic diseases. However, for patients with hyperlipidemia, the relationship between the main VD storage within the body known as serum 25-hydroxy-VD [25(OH)VD] and the risk of all-cause, cardiovascular and malignancies-specific mortality is still unclear.
A total of 6740 participants above the age of 20 years with hyperlipidemia who completed the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2016 and were followed up until 2019 were included in the study. The weighted Cox proportional hazards regression model and weighted competing risk regression model were used to evaluate the risk for all-cause, cardiovascular and malignancy-related mortality in relation to the serum 25(OH)VD. The model was adjusted according to age, gender, race, body mass index, lipids status, medication usage, the Charlson comorbidity index and healthy eating index. The last restricted cubic spline (RCS) method was used to present the relationship between hazard ratios (HR) associated with diverse cause-specified modalities and the serum 25(OH)VD levels.
Serum 25(OH)VD was identified as an independent factor for mortality. Lower serum 25(OH)VD under the threshold of 25.6 and 25.2 ng/ml were significantly associated with a higher risk for all-cause and cardiovascular mortalities, respectively. However, no association was found between malignancy-specific mortality and serum 25(OH)VD.
Serum 25(OH)VD were identified as an independent factor associated with risks of all-cause and cardiovascular mortalities in patient with hyperlipidemia. Moreover, lower serum 25(OH)VD than 25.6 and 25.2 ng/mL were, respectively, associated with a gradual increase in a risk for all-cause and cardiovascular mortality in patients with hyperlipidemia, and therefore regular monitoring of VD levels and correction of VD deficiency is recommended in those patients.
维生素D（VD）在降低各种代谢性疾病不良事件风险方面发挥着重要作用。然而，对于高脂血症患者，体内主要的VD储存形式即血清25-羟基维生素D[25(OH)VD]与全因、心血管及特定恶性肿瘤死亡率之间的关系仍不明确。
本研究纳入了2007年至2016年间完成美国国家健康与营养检查调查（NHANES）且年龄在20岁以上的6740例高脂血症参与者，并随访至2019年。采用加权Cox比例风险回归模型和加权竞争风险回归模型评估血清25(OH)VD与全因、心血管及恶性肿瘤相关死亡率的风险。模型根据年龄、性别、种族、体重指数、血脂状况、药物使用情况、Charlson合并症指数和健康饮食指数进行调整。采用末次受限立方样条（RCS）方法呈现与不同病因特异性模式相关的风险比（HR）与血清25(OH)VD水平之间的关系。
血清25(OH)VD被确定为死亡率的独立因素。血清25(OH)VD低于25.6和25.2 ng/ml的阈值分别与全因和心血管死亡率的较高风险显著相关。然而，未发现特定恶性肿瘤死亡率与血清25(OH)VD之间存在关联。
血清25(OH)VD被确定为高脂血症患者全因和心血管死亡率风险的独立相关因素。此外，血清25(OH)VD低于25.6和25.2 ng/mL分别与高脂血症患者全因和心血管死亡率风险的逐渐增加相关，因此建议对这些患者定期监测VD水平并纠正VD缺乏。
