School of Public Health, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou, Zhejiang, 310053, China.
School of Basic Medicine, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou, Zhejiang, 310053, China.
Nutr J. 2024 Aug 9;23(1):89. doi: 10.1186/s12937-024-00992-8.
We aimed to probe the association of serum 25-hydroxyvitamin D [25(OH)D] concentrations with all-cause and cause-specific mortality among patients with gout and hyperuricemia (HUA).
The study included 1169 gout patients and 7029 HUA patients from the National Health and Nutrition Examination Survey (NHANES) 2007-2018 and 2001-2018, respectively. The association between serum 25(OH)D and mortality was evaluated by Cox proportional hazard and restricted cubic spline models.
Among participants with gout and HUA, the weighted mean concentrations of serum 25(OH)D were 71.49 ± 30.09 nmol/L and 64.81 ± 26.92 nmol/L, respectively. Vitamin D deficiency occurred in 29.68% of gout patients and 37.83% of HUA patients. During 6783 person-years of follow-up among gout patients, 248 all-cause deaths occurred, among which 76 died from cardiovascular disease (CVD) and 49 died from cancer. 1375 HUA patients were recorded for all-cause mortality during 59,859 person-years of follow-up, including 427 CVD deaths and 232 cancer deaths. After multifactorial adjustment, per one-unit increment in natural log-transformed 25(OH)D was associated with lower risk of 55% all-cause mortality and 61% CVD mortality among gout patients, and a 45% reduced risk of cancer mortality among HUA patients. Restricted cubic splines showed a U-shaped relationship with all-cause and CVD mortality among HUA patients, with inflection points of 72.7 nmol/L and 38.0 nmol/L, respectively. The results were robust in subgroup and sensitivity analyses.
Serum 25(OH)D was negatively linearly correlated with mortality among gout patients, whereas U-shaped correlated with mortality in HUA patients. These results indicate that adequate vitamin D status could prevent premature death.
本研究旨在探讨血清 25-羟维生素 D [25(OH)D] 浓度与痛风和高尿酸血症（HUA）患者全因和特定原因死亡率之间的关系。
本研究纳入了分别来自 2007-2018 年和 2001-2018 年国家健康与营养调查（NHANES）的 1169 例痛风患者和 7029 例 HUA 患者。采用 Cox 比例风险和限制三次样条模型评估血清 25(OH)D 与死亡率之间的关系。
在痛风和 HUA 患者中，血清 25(OH)D 的加权平均浓度分别为 71.49±30.09 nmol/L 和 64.81±26.92 nmol/L。29.68%的痛风患者和 37.83%的 HUA 患者存在维生素 D 缺乏。在痛风患者的 6783 人年随访期间，发生了 248 例全因死亡，其中 76 例死于心血管疾病（CVD），49 例死于癌症。在 59859 人年的随访期间，1375 例 HUA 患者发生了全因死亡，其中包括 427 例 CVD 死亡和 232 例癌症死亡。经多因素校正后，血清 25(OH)D 的自然对数值每增加 1 个单位，痛风患者全因死亡率和 CVD 死亡率的风险分别降低 55%和 61%，HUA 患者的癌症死亡率降低 45%。限制三次样条模型显示，HUA 患者的全因死亡率和 CVD 死亡率与 25(OH)D 呈 U 型关系，拐点分别为 72.7 nmol/L 和 38.0 nmol/L。亚组和敏感性分析结果稳健。
血清 25(OH)D 与痛风患者的死亡率呈负线性相关，而与 HUA 患者的死亡率呈 U 型相关。这些结果表明，充足的维生素 D 状态可以预防过早死亡。
