血清 25(OH)D、PTH 和 β-CTX 水平与中国社区百岁老人全因死亡率的相关性研究。
Associations of Serum 25(OH)D, PTH, and β-CTX Levels with All-Cause Mortality in Chinese Community-Dwelling Centenarians.
机构信息
Department of Nephrology, Hainan Hospital of Chinese PLA General Hospital, Hainan Province Academician Team Innovation Center, Sanya 572013, China.
Senior Department of Nephrology, The First Medical Center of Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing 100853, China.
出版信息
Nutrients. 2022 Dec 24;15(1):94. doi: 10.3390/nu15010094.
This longitudinal cohort study explored the associations of 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH), and β-C-terminal telopeptide of type 1 collagen (β-CTX) levels with all-cause mortality in centenarians. The study included 952 centenarians (81.4% female). During a median follow-up of 32 months, 752 (78.9%) centenarians died. The estimated 1-year, 3-year, and 5-year survival rates were 80.0%, 45.7%, and 23.6%, respectively. The association of mortality with 25(OH)D was linear, whereas the associations with PTH and β-CTX were J-shaped, with a lower risk below the median levels. Compared with 25(OH)D of ≥30 ng/mL, 25(OH)D < 30 ng/mL was associated with increased mortality (HR 1.52, 95% CI 1.24−1.86, p < 0.001). Compared with PTH of ≤65 pg/mL, PTH > 65 pg/mL was associated with increased mortality (HR 1.30, 95% CI 1.08−1.56, p = 0.005). Compared with β-CTX of <0.55 ng/mL, β-CTX ≥ 0.55 ng/mL was associated with increased mortality (HR 1.30, 95% CI 1.10−1.54, p = 0.002). A higher β-CTX level (even in the clinical reference range of 0.55−1.01 ng/mL) was associated with increased mortality (HR 1.23, 95% CI 1.04−1.47, p = 0.018). Centenarians with 25(OH)D < 30 ng/mL, PTH > 65 pg/mL, and β-CTX ≥ 0.55 ng/mL had a 2.77-fold (95% CI 1.99−3.85, p < 0.001) increased risk of mortality when compared with those with 25(OH)D of >30 ng/mL, PTH < 65 pg/mL, and β-CTX < 0.55 ng/mL. Lower serum 25(OH)D and higher PTH and β-CTX were independently correlated with increased all-cause mortality in Chinese community-dwelling centenarians.
这项纵向队列研究探讨了 25-羟维生素 D [25(OH)D]、甲状旁腺激素 (PTH) 和 1 型胶原 β-末端肽 (β-CTX) 水平与百岁老人全因死亡率的关系。该研究纳入了 952 名百岁老人（81.4%为女性）。在中位随访 32 个月期间，752 名（78.9%）百岁老人死亡。估计 1 年、3 年和 5 年的生存率分别为 80.0%、45.7%和 23.6%。死亡率与 25(OH)D 呈线性相关，而与 PTH 和 β-CTX 的关系呈 J 型，中位数以下死亡率风险较低。与 25(OH)D≥30ng/mL 相比，25(OH)D＜30ng/mL 与死亡率增加相关（HR 1.52，95%CI 1.24-1.86，p＜0.001）。与 PTH≤65pg/mL 相比，PTH＞65pg/mL 与死亡率增加相关（HR 1.30，95%CI 1.08-1.56，p=0.005）。与 β-CTX＜0.55ng/mL 相比，β-CTX≥0.55ng/mL 与死亡率增加相关（HR 1.30，95%CI 1.10-1.54，p=0.002）。即使在β-CTX 的临床参考范围（0.55-1.01ng/mL）内，较高的β-CTX 水平也与死亡率增加相关（HR 1.23，95%CI 1.04-1.47，p=0.018）。与 25(OH)D＞30ng/mL、PTH＜65pg/mL 和 β-CTX＜0.55ng/mL 的百岁老人相比，25(OH)D＜30ng/mL、PTH＞65pg/mL 和 β-CTX≥0.55ng/mL 的百岁老人死亡率增加风险高 2.77 倍（95%CI 1.99-3.85，p＜0.001）。
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