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探讨烟酸摄入量对心血管结局的影响:使用美国国家健康与营养检查调查(NHANES)数据(2003 - 2018年)的综合分析

Exploring the Impact of Niacin Intake on Cardiovascular Outcomes: A Comprehensive Analysis Using NHANES Data (2003-2018).

作者信息

Shao Lishi, Zhi Aihua, Li Manning, Zhang Yang, Jiang Shaohui, Zhang Jun, Yang Ke, Yang Enze, Zhu Xiankang, Cheng Yuanou, Sun Yi

机构信息

Department of Radiology, Fuwai Yunnan Cardiovascular Hospital, 650102 Kunming, Yunnan, China.

Department of Cardiac Surgery, Fuwai Yunnan Cardiovascular Hospital, 650102 Kunming, Yunnan, China.

出版信息

Rev Cardiovasc Med. 2024 Nov 20;25(11):410. doi: 10.31083/j.rcm2511410. eCollection 2024 Nov.

Abstract

BACKGROUND

The relationship between cardiovascular outcomes and niacin consumption levels remains unclear. This study aimed to examine the correlation between niacin intake and the incidence of cardiovascular disease, as well as the mortality rates associated with cardiovascular disease and other causes.

METHODS

From 2003 to 2018, we continually investigated updated information from the National Health and Nutrition Examination Survey. Based on the quartiles of niacin intake levels, four distinct categories of participants were established: Q1 (<14.646 mg), Q2 (14.646-21.302 mg), Q3 (21.302-30.401 mg), and Q4 (>30.401 mg). Baseline variable differences were assessed employing the Chi-Square and Student's -tests. A weighted logistic regression with multiple variables was used to determine the association between niacin intake and cardiovascular disease prevalence. Hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause death and cardiovascular disease were determined utilising hazard regression models. Kaplan-Meier curves were used to compare survival probability between the high and low niacin intake groups, and dose-response linear relationships were evaluated with restricted cubic splines.

RESULTS

The cohort analysis included 80,312 participants for the assessment of niacin intake. Comparing the Q1 dataset to the Q4 dataset in the overall population, weighted Cox regression analysis showed a negative association with all-cause mortality (95% CI: 0.71-0.96, HR: 0.82) and mortality owing to cardiovascular disease (95% CI: 0.67-0.96, odds ratio (OR): 0.80). Sex-based subgroup analysis revealed a detrimental correlation between niacin use and overall mortality in females (Q4 cohort: 95% CI: 0.62-0.97, HR: 0.78) but not in males. Additionally, the Q3 (95% CI: 0.59-0.94, HR: 0.75) and Q4 (95% CI: 0.51-0.97, HR: 0.7) groups exhibited a negative association with female cardiovascular disease mortality compared to the Q1 group. Niacin intake was not significantly correlated with prevalence, all-cause mortality, or death from cardiovascular disease in males.

CONCLUSIONS

Higher niacin consumption was correlated with a decreased risk of cardiovascular disease and death from all causes across the entire study population. Nevertheless, only females, and not males, exhibited a beneficial effect on mortality.

摘要

背景

心血管疾病转归与烟酸摄入量之间的关系仍不明确。本研究旨在探讨烟酸摄入量与心血管疾病发病率之间的相关性,以及与心血管疾病和其他病因相关的死亡率。

方法

2003年至2018年,我们持续调查了美国国家健康与营养检查调查的更新信息。根据烟酸摄入量的四分位数,将参与者分为四个不同类别:Q1(<14.646毫克)、Q2(14.646 - 21.302毫克)、Q3(21.302 - 30.401毫克)和Q4(>30.401毫克)。采用卡方检验和t检验评估基线变量差异。使用多变量加权逻辑回归确定烟酸摄入量与心血管疾病患病率之间的关联。利用风险回归模型确定全因死亡和心血管疾病的风险比(HR)和95%置信区间(CI)。采用Kaplan-Meier曲线比较高烟酸摄入量组和低烟酸摄入量组之间的生存概率,并使用受限立方样条评估剂量反应线性关系。

结果

队列分析纳入了80312名参与者以评估烟酸摄入量。在总体人群中,将Q1数据集与Q4数据集进行比较,加权Cox回归分析显示与全因死亡率(95%CI:0.71 - 0.96,HR:0.82)和心血管疾病导致的死亡率(95%CI:0.67 - 0.96,比值比(OR):0.80)呈负相关。基于性别的亚组分析显示,烟酸使用与女性总体死亡率之间存在有害相关性(Q4队列:95%CI:0.62 - 0.97,HR:0.78),而男性则不然。此外,与Q1组相比,Q3组(95%CI:0.59 - 0.94,HR:0.75)和Q4组(95%CI:0.51 - 0.97,HR:0.7)与女性心血管疾病死亡率呈负相关。烟酸摄入量与男性的患病率、全因死亡率或心血管疾病死亡无显著相关性。

结论

在整个研究人群中,较高的烟酸摄入量与心血管疾病风险和全因死亡风险降低相关。然而,只有女性而非男性在死亡率方面表现出有益影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4886/11607498/976a8fcc2e94/2153-8174-25-11-410-g1.jpg

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