Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Inspire, Arlington, VA, USA.
J Integr Complement Med. 2023 Aug;29(8):492-500. doi: 10.1089/jicm.2022.0783. Epub 2023 Mar 27.
Glucosamine and chondroitin are supplements that are often, but not always, used in combination for arthritis and joint pain. Multiple studies have suggested that glucosamine and chondroitin may be associated with reduced risk of several diseases, as well as all-cause, cancer- and respiratory disease-specific mortality. Nationally representative data from the National Health and Nutrition Examination Survey (NHANES) were used to further evaluate the association between glucosamine and chondroitin with mortality. Participants include 38,021 adults, ages 20+ years and older, who completed the detailed NHANES between 1999 and 2014. Participants were followed for death through linkage with the National Death Index through the end of 2015, over which time 4905 deaths occurred. Adjusted hazard ratios (HRs) for overall and cause-specific mortality were estimated using Cox regression models. Despite glucosamine and chondroitin use appearing to be inversely associated with mortality in the minimally adjusted models, no association was observed in multivariable models (glucosamine: HR = 1.02; 95% confidence interval [CI]: 0.86-1.21, chondroitin: HR = 1.04, 95% CI: 0.87-1.25). No association with cancer mortality or other mortality rate was observed after multivariable adjustment. There was a suggestive, nonsignificant inverse association for cardiovascular-specific mortality (glucosamine HR = 0.72; 95% CI: 0.46-1.15, chondroitin: HR = 0.76; 95% CI: 0.47-1.21). The lack of significant relationship between glucosamine and chondroitin use and all-cause or cause-specific mortality after adjusting extensively for multiple covariates in this nationally representative adult population was in contrast to prior literature. Given the limited power to explore the cause-specific mortality, future well-powered studies will be needed to better understand the potential association with cardiovascular-specific mortality.
氨基葡萄糖和软骨素是常用于关节炎和关节疼痛的补充剂,但并非总是如此。多项研究表明,氨基葡萄糖和软骨素可能与降低多种疾病的风险以及全因、癌症和呼吸道疾病死亡率相关。本研究使用来自国家健康和营养检查调查(NHANES)的全国代表性数据,进一步评估氨基葡萄糖和软骨素与死亡率之间的关联。参与者包括 38021 名年龄在 20 岁及以上的成年人,他们在 1999 年至 2014 年期间完成了详细的 NHANES 调查。通过与国家死亡指数的链接,参与者在 2015 年底前被追踪死亡情况,在此期间有 4905 人死亡。使用 Cox 回归模型估计总体和病因特异性死亡率的调整后危害比(HRs)。尽管在最小调整模型中,氨基葡萄糖和软骨素的使用似乎与死亡率呈负相关,但在多变量模型中没有观察到关联(氨基葡萄糖:HR=1.02;95%置信区间[CI]:0.86-1.21,软骨素:HR=1.04,95%CI:0.87-1.25)。多变量调整后,与癌症死亡率或其他死亡率没有关联。心血管特异性死亡率有一个提示性的、无统计学意义的负相关(氨基葡萄糖 HR=0.72;95%CI:0.46-1.15,软骨素 HR=0.76;95%CI:0.47-1.21)。
在这个具有全国代表性的成年人群体中,广泛调整多种协变量后,氨基葡萄糖和软骨素的使用与全因或病因特异性死亡率之间没有显著关系,这与之前的文献结果相反。考虑到探索病因特异性死亡率的能力有限,未来需要进行更有力的研究,以更好地了解与心血管特异性死亡率的潜在关联。