Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China.
Department of Cardiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Suzhou, 215002, China.
Hypertens Res. 2023 May;46(5):1276-1286. doi: 10.1038/s41440-023-01218-w. Epub 2023 Feb 20.
Our study aims to evaluate the associations between the serum cobalamin (vitamin B12) and related biomarkers with mortality in hypertensive adults. Data on serum cobalamin from the National Health and Nutrition Examination Survey (NHANES) 1999-2006 and 2011-2014 were included. Mortality status was linked to National Death Index mortality data through 31 December, 2019. Cox regression and restricted cubic spline (RCS) analyses were used to determine the hazard ratios (HRs) and 95% CIs for mortality risk. A total of 9934 hypertensive adults were included in the analysis (mean age, 58.1 ± 17.5 years; 4899 [49.3%] men). At 11.0 years of mean follow-up, 935 cardiovascular deaths and 3096 all-cause deaths were identified. Compared to the third quartiles, the first and fourth quartiles of serum cobalamin were associated with risk of cardiovascular mortality, with multivariable-adjusted HRs of 1.26 (1.05-1.53) and 1.40 (1.17-1.68). Similar results were observed in the relationship between serum cobalamin and all-cause mortality. These results were supported by the RCS analysis. The inflection points for the nonlinear associations of serum cobalamin with cardiovascular and all-cause mortality were 649.9 pg/mL and 577.2 pg/mL, respectively. In addition, compared with the second quartile of circulating methylmalonic acid (MMA, a cobalamin-deficiency marker), this association with the fourth quartile was evident for an increased rate of cardiovascular and all-cause mortality, with 111% (HR = 2.11, 1.71-2.61) and 73% (HR = 1.73, 1.55-1.93) increase. Findings suggest that both lower and higher serum cobalamin concentrations were associated with a higher risk of cardiovascular and all-cause mortality in hypertensive adults. This study was a prospective cohort study that included serum cobalamin data from 9934 hypertensive adults from the NHANES from 1999-2006 and 20011-2014. Findings suggested that both lower and higher serum cobalamin concentrations were associated with a higher risk of cardiovascular and all-cause mortality in hypertensive adults.
我们的研究旨在评估血清钴胺素（维生素 B12）及其相关生物标志物与高血压成年人死亡率之间的关联。研究数据来自于 1999-2006 年和 2011-2014 年的国家健康与营养调查（NHANES）。通过国家死亡指数死亡率数据，将死亡率状态与 2019 年 12 月 31 日进行关联。使用 Cox 回归和限制三次样条（RCS）分析来确定死亡率风险的风险比（HRs）和 95%置信区间。共纳入 9934 例高血压成年人进行分析（平均年龄 58.1±17.5 岁；4899[49.3%]为男性）。在平均 11.0 年的随访期间，共发生 935 例心血管死亡和 3096 例全因死亡。与血清钴胺素的第三四分位相比，第一和第四四分位与心血管死亡风险相关，多变量调整后的 HR 分别为 1.26（1.05-1.53）和 1.40（1.17-1.68）。在血清钴胺素与全因死亡率之间也观察到类似的关系。RCS 分析支持这些结果。血清钴胺素与心血管和全因死亡率的非线性关联的拐点分别为 649.9 pg/mL 和 577.2 pg/mL。此外，与循环甲基丙二酸（MMA，钴胺素缺乏标志物）的第二四分位相比，第四四分位与心血管和全因死亡率的关联更为明显，心血管和全因死亡率的增长率分别为 111%（HR=2.11，1.71-2.61）和 73%（HR=1.73，1.55-1.93）。研究结果表明，在高血压成年人中，较低和较高的血清钴胺素浓度均与心血管和全因死亡率的风险增加相关。本研究是一项前瞻性队列研究，纳入了 1999-2006 年和 2011-2014 年 NHANES 中 9934 例高血压成年人的血清钴胺素数据。研究结果表明，在高血压成年人中，较低和较高的血清钴胺素浓度均与心血管和全因死亡率的风险增加相关。
