慢性肾脏病患者膳食维生素摄入量与心血管疾病患病率的联合及独立关联：一项横断面分析
Joint and independent associations of dietary vitamin intake and prevalence of cardiovascular disease in chronic kidney disease subjects: a cross-sectional analysis.
作者信息
Wang Guoqing, Huang Luojun, Yue Wenwen, Feng Jun
机构信息
Department of Cardiology, Hefei Hospital Affiliated to Anhui Medical University, Hefei, China.
Department of Cardiology, The Fifth Clinical College of Anhui Medical University, Hefei, China.
出版信息
Front Nutr. 2025 Apr 28;12:1579313. doi: 10.3389/fnut.2025.1579313. eCollection 2025.
BACKGROUND
Currently, the joint and independent effects of intake of multiple dietary vitamins (including vitamin A, B1, B2, B6, B12, C, D, E, and K) on the prevalence of cardiovascular disease (CVD) in the chronic kidney disease (CKD) population are unclear, so this study was conducted to investigate mainly this point.
METHODS
We collected National Health and Nutrition Examination Survey (NHANES) data from 2011 to 2016. We performed weighted multivariate logistic regression models to analyze the association of single dietary vitamins intake with CVD. Additionally, we examined the co-exposure of nine dietary vitamins, defined as their concurrent intake, and evaluated the potential additive or interactive effects of co-exposure of nine dietary vitamins on CVD risk in CKD patients using Bayesian kernel machine regression (BKMR) and weighted quantile sum (WQS) regression.
RESULTS
Finally, 2,203 CKD participants (weighted = 27,120,429) were included, and 622 had CVD, with a CVD prevalence of 28.2%. In the fully adjusted model, by comparing the third tertile with the first tertile, the adjusted OR [T3 vs. T1] for the effect of vitamin B6 on CVD prevalence was 0.67 (95% CI, 0.51-0.89, -value = 0.01), while that of vitamin E was 0.61 (95% CI, 0.42-0.87, -value = 0.01). In the WQS model, the intake of nine dietary vitamins was negatively correlated with CVD prevalence (OR: 0.81, 95% CI: 0.70-0.93, -value = 0.004). In the BKMR model, when the concentration was between the 25th and 75th percentiles, there was an overall negative correlation between the total intake of nine dietary vitamins and CVD prevalence.
CONCLUSION
High intakes of vitamin B6 and vitamin E were associated with low CVD risk in CKD patients, respectively. Additionally, nine dietary vitamins (vitamins A, B1, B2, B6, B12, C, D, E, and K) co-exposure were inversely correlated with the CVD prevalence in the CKD populations.
背景
目前，多种膳食维生素（包括维生素A、B1、B2、B6、B12、C、D、E和K）的摄入对慢性肾脏病（CKD）人群心血管疾病（CVD）患病率的联合及独立影响尚不清楚，因此本研究主要针对这一点展开调查。
方法
我们收集了2011年至2016年的美国国家健康与营养检查调查（NHANES）数据。我们进行了加权多变量逻辑回归模型分析单一膳食维生素摄入与CVD的关联。此外，我们研究了九种膳食维生素的共同暴露情况，即它们的同时摄入，并使用贝叶斯核机器回归（BKMR）和加权分位数和（WQS）回归评估九种膳食维生素共同暴露对CKD患者CVD风险的潜在相加或交互作用。
结果
最终，纳入了2203名CKD参与者（加权后=27120429），其中622人患有CVD，CVD患病率为28.2%。在完全调整模型中，将第三个三分位数与第一个三分位数进行比较，维生素B6对CVD患病率影响的调整后OR [T3 vs. T1]为0.67（95%CI，0.51 - 0.89，P值=0.01），而维生素E的为0.61（95%CI，0.42 - 0.87，P值=0.01）。在WQS模型中，九种膳食维生素的摄入与CVD患病率呈负相关（OR：0.81，95%CI：0.70 - 0.93，P值=0.004）。在BKMR模型中，当浓度处于第25百分位数和第75百分位数之间时，九种膳食维生素的总摄入量与CVD患病率总体呈负相关。
结论
高剂量的维生素B6和维生素E分别与CKD患者的低CVD风险相关。此外，九种膳食维生素（维生素A、B1、B2、B6、B12、C D、E和K）的共同暴露与CKD人群的CVD患病率呈负相关。
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