Fu Chen, Zhu Zhongxin, Mao Yijie, Wei Wenjuan
Department of Cardiology, The First People's Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, China.
Department of Scientific Research, The First People's Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, China.
Front Nutr. 2025 May 16;12:1562897. doi: 10.3389/fnut.2025.1562897. eCollection 2025.
Sarcopenia, defined as the progressive decline in muscular mass and physical power, poses significant health risks, particularly among aging populations.
Utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning 2001-2006, we employed multivariable Cox proportional hazards models to evaluate the relationship between serum 25-hydroxyvitamin D [25(OH)D] concentration and mortality outcomes, adjusting for multiple covariates. We additionally performed restricted cubic spline and threshold analyses using both linear and non-linear regression models to assess dose-response relationships and to explore the continuous effects of 25(OH)D on mortality outcomes. Stratified and sensitivity analyses were conducted to strengthen the reliability of our findings.
A total of 1,666 participants diagnosed with sarcopenia were included in the analysis. Our results indicated a significant non-linear association between 25(OH)D concentration and both all-cause mortality and cardiovascular (CVD) mortality. Notably, threshold analyses revealed inflection points at 62.563 nmol/L for all-cause mortality and 47.367 nmol/L for CVD mortality, suggesting a plateau in protective effects at higher vitamin D levels. Both stratified and sensitivity analyses revealed no significant interactions across different subgroups.
These findings emphasize the importance of maintaining adequate serum 25(OH)D concentration to mitigate mortality risk among sarcopenic individuals. Further research is needed to clarify the underlying mechanisms and to establish optimal vitamin D concentration for health benefits.
肌肉减少症被定义为肌肉质量和体力的逐渐下降，会带来重大健康风险，在老年人群体中尤为如此。
利用2001 - 2006年美国国家健康与营养检查调查（NHANES）的数据，我们采用多变量Cox比例风险模型来评估血清25 - 羟基维生素D [25(OH)D]浓度与死亡率之间的关系，并对多个协变量进行了调整。我们还使用线性和非线性回归模型进行了受限立方样条分析和阈值分析，以评估剂量反应关系，并探讨25(OH)D对死亡率的连续影响。进行了分层分析和敏感性分析以加强我们研究结果的可靠性。
共有1666名被诊断为肌肉减少症的参与者纳入分析。我们的结果表明，25(OH)D浓度与全因死亡率和心血管疾病（CVD）死亡率之间存在显著的非线性关联。值得注意的是，阈值分析显示全因死亡率的拐点为62.563 nmol/L，CVD死亡率的拐点为47.367 nmol/L，这表明在较高维生素D水平下保护作用趋于平稳。分层分析和敏感性分析均显示不同亚组之间无显著交互作用。
这些发现强调了维持足够的血清25(OH)D浓度以降低肌肉减少症患者死亡风险的重要性。需要进一步研究以阐明潜在机制，并确定有益于健康的最佳维生素D浓度。
