METHODS: We included participants from the National Health and Nutrition Examination Survey (NHANES) study. The latent class analysis (LCA) was applied to uncover specific malnutrition profiles within the sample. Risk of the end points across the phenogroups was compared using Kaplan-Meier analysis and Cox proportional hazard regression model. Multinomial logistic regression was used to determine the influencing factors of specific malnutrition profiles.
RESULTS: A total of 6924 participants aged 60 years or older with hypertension from NHANES 2003-2014 was followed until December 31, 2019 with a median follow-up of 8.7 years. Various nutrients included vitamin A, vitamin B1, vitamin B12, vitamin C, vitamin D, vitamin E, vitamin K, fiber, folate, calcium, magnesium, zinc, copper, iron, and selenium, and LCA revealed 4 classes of malnutrition. Regarding all-cause mortality, \"Nutrient Deprived\" group showed the strongest hazard ratio (1.42 from 1.19 to 1.70) compared with \"Adequate Nutrient\" group, followed by \"Inadequate Nutrient\" group (1.29 from 1.10 to 1.50), and \"Low Fiber, Magnesium, and Vit E\" group (1.17 from 1.02 to 1.35). For cardiovascular mortality, \"Nutrient Deprived\" group showed the strongest hazard ratio (1.61 from 1.19 to 2.16) compared with \"Adequate Nutrient\" group, followed by \"Low Fiber, Magnesium, and Vit E\" group (1.51 from 1.04 to 2.20), and \"Inadequate Nutrient\" group (1.37 from 1.03 to 1.83).
CONCLUSIONS: The study revealed a significant association between nutrients deficiency patterns and the risk of all-cause and cardiovascular mortality in older adults with hypertension. The findings suggested that nutrients deficiency pattern may be an important risk factor for mortality in older adults with hypertension.
方法:我们纳入了国家健康和营养调查(NHANES)研究的参与者。潜在类别分析(LCA)用于发现样本中特定的营养不良特征。使用Kaplan-Meier分析和Cox比例风险回归模型比较整个表型群终点的风险。多元logistic回归用于确定特定营养不良状况的影响因素。
结果:从NHANES2003-2014年,共有6924名年龄在60岁或以上的高血压患者随访至2019年12月31日,中位随访时间为8.7年。各种营养素包括维生素A,维生素B1,维生素B12,维生素C,维生素D,维生素E,维生素K,纤维,叶酸,钙,镁,锌,铜,铁,还有硒,LCA揭示了4类营养不良。关于全因死亡率,与“充足营养素”组相比,“营养素剥夺”组的危害比最强(从1.19到1.70为1.42),其次是“营养不足”组(1.29从1.10到1.50),和“低光纤,镁,和维生素E组(1.17从1.02到1.35)。对于心血管死亡率,与“充足营养素”组相比,“营养素剥夺”组的危害比最强(从1.19到2.16的1.61),其次是“低光纤,镁,和VitE“组(1.51从1.04到2.20),和“营养不足”组(1.37从1.03到1.83)。
结论:该研究揭示了营养缺乏模式与老年高血压患者全因死亡和心血管死亡风险之间的显著关联。研究结果表明,营养素缺乏模式可能是高血压老年人死亡的重要危险因素。