The Center of Obesity and Metabolic Diseases, Department of General Surgery, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiao Tong University, Chengdu, Sichuan, China; College of Medicine, Southwest Jiao Tong University, Chengdu, China; Research Center for Obesity and Metabolic Health, College of Medicine, Southwest Jiao Tong University, Chengdu, China.
Department of Cardiology, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiao Tong University, Chengdu, Sichuan, China.
Nutrition. 2024 Nov;127:112556. doi: 10.1016/j.nut.2024.112556. Epub 2024 Aug 11.
Flavonoids exhibit antioxidative, anti-inflammatory, and anticancer properties, yet the relationship between flavonoid intake and all-cause mortality in the obese population remains unclear.
This study included NHANES participants from 2007 to 2010 and 2017 to 2018. Cox regression analysis evaluated the impact of total flavonoid intake on all-cause mortality among participants with varying comorbidity profiles. Subgroup analysis was conducted by separately analyzing the six sub-classes of total flavonoids (anthocyanidins, flavan-3-ols, flavanones, flavones, flavonols, and isoflavones). Sensitivity analysis was used to investigate the impact of total flavonoid intake on all-cause mortality among patients with different comorbidities.
During a median follow-up period of 9.92 years (interquartile range (IQR), 5.54-14.29 years), a total of 639 participants died. COX regression analysis revealed a positive impact of flavonoid intake on all-cause mortality among participants with chronic kidney disease, with greater benefits observed in obese participants [hazard ratio (HR): 0.22, 95% CI: 0.11-0.44). In metabolically healthy obese participants (HR: 0.15, 95% CI: 0.07-0.35), obese individuals with diabetes (HR: 0.51, 95% CI: 0.29-0.88), and obese individuals with comorbid cardiovascular disease (HR: 0.37, 95% CI: 0.17-0.83), flavonoid intake was associated with a reduced risk of all-cause mortality. Restricted cubic spline (RCS) analysis indicated a non-linear relationship in obese participants, with optimal intake levels ranging from 319.4978 to 448.6907 mg/day, varying based on different comorbidity profiles. Subgroup analysis revealed varying effects of total flavonoid components in different health conditions, with hazard ratios ranging from 0.06 for higher levels of flavonol to 0.59 for higher levels of anthocyanidins in the Cox model. Sensitivity analyses further indicated that individuals with obesity and comorbid diabetes or CKD see the greatest benefit from flavonoid intake.
The consumption of flavonoids may be associated with a decreased risk of all-cause mortality. Consumption of flavonoids is particularly beneficial for individuals with obesity and comorbidities.
黄酮类化合物具有抗氧化、抗炎和抗癌作用，但黄酮类化合物的摄入量与肥胖人群的全因死亡率之间的关系尚不清楚。
本研究纳入了 2007 年至 2010 年和 2017 年至 2018 年的 NHANES 参与者。Cox 回归分析评估了总黄酮摄入量对不同合并症患者全因死亡率的影响。通过分别分析总黄酮的六个亚类（花色苷、黄烷-3-醇、黄烷酮、黄酮、黄酮醇和异黄酮），进行了亚组分析。敏感性分析用于研究总黄酮摄入量对不同合并症患者全因死亡率的影响。
在中位数为 9.92 年（四分位距（IQR），5.54-14.29 年）的随访期间，共有 639 名参与者死亡。Cox 回归分析显示，黄酮类化合物的摄入量与慢性肾脏病患者的全因死亡率呈正相关，肥胖患者的获益更大[风险比（HR）：0.22，95%置信区间（CI）：0.11-0.44）。在代谢健康肥胖参与者（HR：0.15，95%CI：0.07-0.35）、肥胖合并糖尿病患者（HR：0.51，95%CI：0.29-0.88）和肥胖合并心血管疾病患者（HR：0.37，95%CI：0.17-0.83）中，黄酮类化合物的摄入与全因死亡率降低相关。受限立方样条（RCS）分析表明，肥胖患者存在非线性关系，最佳摄入量范围为 319.4978 至 448.6907mg/天，具体摄入量因不同的合并症谱而异。亚组分析显示，在不同健康状况下，总黄酮成分的作用不同，Cox 模型中的风险比范围从更高水平的黄酮醇的 0.06 到更高水平的花色苷的 0.59。敏感性分析进一步表明，肥胖且合并糖尿病或 CKD 的个体从黄酮类化合物的摄入中获益最大。
黄酮类化合物的摄入可能与全因死亡率降低相关。黄酮类化合物的摄入对肥胖且合并症患者尤其有益。
