血清25-羟维生素D浓度及其对帕金森病全因死亡率的影响：来自1999 - 2020年美国国家健康与营养检查调查数据的见解

Serum 25-hydroxyvitamin D concentrations and their impact on all-cause mortality in Parkinson's disease: insights from National Health and Nutrition Examination Survey 1999-2020 data.

作者信息

Yong Yufei, Dong Hui, Zhou Zhen, Zhu Yan, Gu Meiling, Li Wenxiao

机构信息

Department of Health Management Center, The Affiliated Hospital of Qingdao University, Qingdao, China.

出版信息

Front Nutr. 2024 Aug 9;11:1423651. doi: 10.3389/fnut.2024.1423651. eCollection 2024.

DOI:10.3389/fnut.2024.1423651

PMID:39183989

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11341485/

Abstract

BACKGROUND AND PURPOSE

This study explores the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and mortality among Parkinson's disease (PD) patients, providing evidence for the potential benefits of vitamin D (VD) supplementation.

METHODS

PD patients were collected from the National Health and Nutrition Examination Survey (NHANES) database from 1999 to 2020. These patients were categorized based on their serum 25(OH)D levels: deficiency, insufficiency, and sufficiency. We compared demographic information and analyzed mortality data from the National Death Index. A restricted cubic spline model assessed the nonlinear association between 25(OH)D levels and mortality, complemented by multivariable Cox regression analysis. Consistency of results was checked through subgroup analysis.

RESULTS

The study included 364 PD patients: 87 (23.9%) with VD deficiency, 121 (33.2%) with insufficiency, and 156 (42.9%) with sufficiency. Demographically, 46.4% were male, and 56% were over 65 years. The deficiency group predominantly consisted of Mexican Americans (53.1%), had lower income levels, a higher unmarried rate, and increased liver disease incidence. The analysis showed a U-shaped curve between 25(OH)D levels and mortality risk, with the lowest risk at 78.68 nmol/L (-non-linear = 0.007, -overall = 0.008). Kaplan-Meier analysis found the highest survival rates in patients with 25(OH)D levels between 75-100 nmol/L ( = 0.039). Compared to this group, patients with levels below 50 nmol/L had a 3.52-fold increased mortality risk (95% CI = 1.58-7.86, = 0.002), and those above 100 nmol/L had a 2.92-fold increase (95% CI = 1.06-8.05, = 0.038). Age-specific subgroup analysis ( = 0.009) revealed that both very low (<50 nmol/L) and high (>100 nmol/L) levels increased mortality risk in patients under 65, while levels below 75 nmol/L raised mortality risk in older patients.

CONCLUSION

Serum 25(OH)D levels are nonlinearly linked to mortality in PD patients, with optimal survival rates occurring at 75-100 nmol/L. Deviations from this range increase the risk of death.

摘要

背景与目的

本研究探讨帕金森病（PD）患者血清25-羟基维生素D[25(OH)D]水平与死亡率之间的关系，为补充维生素D（VD）的潜在益处提供证据。

方法

从1999年至2020年的美国国家健康与营养检查调查（NHANES）数据库中收集PD患者。这些患者根据其血清25(OH)D水平进行分类：缺乏、不足和充足。我们比较了人口统计学信息，并分析了来自国家死亡指数的死亡率数据。一个受限立方样条模型评估了25(OH)D水平与死亡率之间的非线性关联，并辅以多变量Cox回归分析。通过亚组分析检查结果的一致性。

结果

该研究纳入了364例PD患者：87例（23.9%）VD缺乏，121例（33.2%）不足，156例（42.9%）充足。在人口统计学方面，46.4%为男性，56%年龄超过65岁。缺乏组主要由墨西哥裔美国人组成（53.1%），收入水平较低，未婚率较高，肝病发病率增加。分析显示25(OH)D水平与死亡风险之间呈U形曲线，最低风险出现在78.68 nmol/L时（-非线性=0.007，-总体=0.008）。Kaplan-Meier分析发现25(OH)D水平在75-100 nmol/L之间的患者生存率最高（=0.039）。与该组相比，水平低于50 nmol/L的患者死亡风险增加3.52倍（95%CI=1.58-7.86，=0.002），高于100 nmol/L的患者增加2.92倍（95%CI=1.06-8.05，=0.038）。年龄特异性亚组分析（=0.009）显示，极低（<50 nmol/L）和极高（>100 nmol/L）水平均增加65岁以下患者的死亡风险，而低于75 nmol/L的水平则增加老年患者的死亡风险。