Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, 110001, Liaoning, China.
Department of Endocrinology and Metabolism, Institute of Endocrinology, The First Affiliated Hospital of China Medical University, Shenyang, 110001, Liaoning, China.
Food Funct. 2024 Sep 30;15(19):10037-10050. doi: 10.1039/d4fo02893g.
: Prediabetes has become a global health issue, and currently, the relationship between vitamin levels and mortality in prediabetes remains unclear. This study aims to investigate the association between the levels of eleven vitamins and all-cause and cardiovascular disease (CVD) mortality in prediabetes patients. : This cross-sectional study included 14 634 prediabetes patients from 10 cycles of the National Health and Nutrition Examination Survey between 1999 and 2018. Mortality and underlying causes of death were determined by linking records from the National Death Index until December 31, 2019. Multivariable Cox proportional hazards regression models were established to assess hazard ratios and 95% confidence intervals for all-cause, CVD, cancer, and other mortalities. Restricted cubic splines were used to visualize non-linear associations between various vitamins and mortality risk. : During the follow-up period, 2316/14 634 prediabetes patients died (12.55%), with 722 deaths (3.68%) attributed to CVD. After multivariable adjustment, vitamin B1, niacin, folate, vitamin C, vitamin E, and vitamin K levels exhibited non-linear associations with all-cause mortality (all < 0.05). Vitamin B1, niacin, and vitamin E levels showed non-linear associations with CVD mortality ( < 0.05). Vitamin B6 exhibited a linear negative association with all-cause, CVD, and other mortalities ( > 0.05). However, vitamins A and B2 levels were not significantly associated with mortality rates (all > 0.05). Consistent results were observed in the subgroup analyses after complete adjustment for variables. : Higher levels of dietary vitamins B1, B6, niacin, folate, vitamin C, vitamin E, and vitamin K were significantly associated with lower risk of all-cause mortality and CVD mortality in patients with prediabetes. There was no association between vitamin A and B2 levels and all-cause and CVD mortality among individuals with prediabetes. These findings suggest the importance of correcting vitamin deficiencies to prevent mortality in prediabetes patients.
糖尿病前期已成为全球性健康问题，目前，糖尿病前期患者维生素水平与死亡率之间的关系尚不清楚。本研究旨在探讨 11 种维生素水平与糖尿病前期患者全因和心血管疾病（CVD）死亡率之间的关系。
这项横断面研究纳入了 1999 年至 2018 年期间 10 个周期的国家健康和营养检查调查中的 14634 例糖尿病前期患者。通过链接国家死亡指数的记录，确定死亡率和死亡原因，截至 2019 年 12 月 31 日。采用多变量 Cox 比例风险回归模型评估全因、CVD、癌症和其他死亡率的危险比和 95%置信区间。采用受限立方样条来可视化各种维生素与死亡率风险之间的非线性关联。
在随访期间，14634 例糖尿病前期患者中有 2316/例（12.55%）死亡，其中 722 例（3.68%）死亡归因于 CVD。在多变量调整后，维生素 B1、烟酸、叶酸、维生素 C、维生素 E 和维生素 K 水平与全因死亡率呈非线性关联（均<0.05）。维生素 B1、烟酸和维生素 E 水平与 CVD 死亡率呈非线性关联（均<0.05）。维生素 B6 与全因、CVD 和其他死亡率呈线性负相关（均>0.05）。然而，维生素 A 和 B2 水平与死亡率无显著相关性（均>0.05）。在对变量进行完全调整后的亚组分析中观察到了一致的结果。
较高的膳食维生素 B1、B6、烟酸、叶酸、维生素 C、维生素 E 和维生素 K 水平与糖尿病前期患者全因死亡率和 CVD 死亡率降低显著相关。在糖尿病前期患者中，维生素 A 和 B2 水平与全因和 CVD 死亡率无关联。这些发现提示纠正维生素缺乏以预防糖尿病前期患者的死亡率的重要性。
