Chen Hongxi, He Xu, Fan Junming, Mi Yongjie, Li Feiyan
School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan, PR China; Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, PR China.
School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan, PR China; Department of Experiment Teaching Center of Clinical Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, , PR China.
Am J Med Sci. 2025 Apr;369(4):460-466. doi: 10.1016/j.amjms.2024.11.004. Epub 2024 Dec 10.
Chronic kidney disease (CKD) is a major cause of human mortality and cardiovascular disease (CVD)-related death. Niacin can treat dyslipidemia and can lower overall cardiovascular event incidence and mortality rates. The present study was designed to clarify the link between dietary consumption of niacin and cardiovascular mortality.
This study enrolled subjects ≥18 years of age from the National Health and Nutrition Examination Survey 2009-2014 and excluded any individuals for whom data regarding their CKD status, dietary niacin intake, or other covariate information was unavailable. Relationships between dietary niacin intake levels and overall or CVD-related mortality among these CKD patients were assessed using univariate and multivariate Cox regression analyses.
The study included 1,798 subjects and recorded 514 and 186 instances of all-cause and cardiovascular death, respectively. Males comprised 51.8 % of the study cohort, and the mean age of these subjects was 65. Cox proportional hazard model analyses revealed no relationship between dietary niacin intake and all-cause or cardiovascular death risk among the overall CKD patient population (P > 0.05). However, in age-stratified analyses, those subjects <60 years of age exhibiting the highest levels of dietary niacin consumption (≥ 38 mg/day) were found to face a significantly higher risk of all-cause mortality, and this association remained intact in sensitivity analyses.
These results do not support any link between the dietary intake of niacin and all-cause or cardiovascular mortality risk among patients with CKD. Age and niacin intake exhibited a significant interaction related to all-cause mortality.
慢性肾脏病（CKD）是人类死亡及心血管疾病（CVD）相关死亡的主要原因。烟酸可治疗血脂异常，并可降低总体心血管事件发生率和死亡率。本研究旨在阐明膳食中烟酸摄入量与心血管死亡率之间的联系。
本研究纳入了2009 - 2014年美国国家健康与营养检查调查中年龄≥18岁的受试者，并排除了任何无法获取其CKD状态、膳食烟酸摄入量或其他协变量信息的数据个体。使用单因素和多因素Cox回归分析评估这些CKD患者膳食烟酸摄入量水平与总体或CVD相关死亡率之间的关系。
该研究纳入了1798名受试者，分别记录了514例全因死亡和186例心血管死亡病例。男性占研究队列的51.8%，这些受试者的平均年龄为65岁。Cox比例风险模型分析显示，在总体CKD患者人群中，膳食烟酸摄入量与全因或心血管死亡风险之间无相关性（P>0.05）。然而，在按年龄分层的分析中，发现年龄<60岁且膳食烟酸摄入量最高（≥38毫克/天）的受试者面临显著更高的全因死亡风险，并且这种关联在敏感性分析中仍然存在。
这些结果不支持CKD患者膳食烟酸摄入量与全因或心血管死亡风险之间存在任何联系。年龄和烟酸摄入量在全因死亡率方面表现出显著的相互作用。
