我们旨在评估维生素B5与全因死亡率的前瞻性关联,并探讨其在中国成人高血压患者中的潜在调节剂。嵌套的,病例对照研究在中国卒中一级预防试验中进行,包括505例各种原因的死亡和505例匹配的对照。中位随访时间为4.5年。这项调查的主要结果指标是全因死亡率,其中包括任何原因的死亡。病例的平均血浆维生素B5浓度(43.7ng/mL)高于对照组(40.9ng/mL)(p=.001)。当维生素B5被进一步评估为五分之一时,与参照组相比(Q1:<33.0ng/mL),全因死亡率风险在第二季度增加29%(OR=1.29,95%CI:0.83-2.01),在第三季度增加22%(OR=1.22,95%CI:0.77-1.94),在第四季度增加62%(OR=1.62,95%CI:1.00-2.62),在第四季度增加77%(OR=1.77,95%CI:1.06-2.95).趋势检验显著(p=0.022)。当Q4-Q5合并时,与Q1-Q3相比,全因死亡风险显著增加41%(OR=1.41,95%CI:1.03-1.95).在叶酸水平正常的人群(p-交互作用=0.019)和老年人(p-交互作用=0.037)中,不良反应更为明显。这项研究表明,较高的血浆维生素B5基线水平是中国高血压患者全因死亡的危险因素,尤其是老年人和那些有足够的叶酸水平。调查结果,如果确认,可能会提供新的临床和营养指南和干预措施,以优化维生素B5水平。
We aimed to evaluate the prospective association of vitamin B5 with all-cause mortality and explore its potential modifiers in Chinese adults with hypertension. A nested, case-control
study was conducted in the China Stroke Primary Prevention
Trial, including 505 deaths of all causes and 505 matched controls. The median follow-up duration was 4.5 years. The primary outcome measure in this investigation was all-cause mortality, which encompassed deaths for any reason. The mean plasma vitamin B5 concentration for cases (43.7 ng/mL) was higher than that in controls (40.9 ng/mL) (p = .001). When vitamin B5 was further assessed as quintiles, compared with the reference group (Q1: < 33.0 ng/mL), the risk of all-cause mortality increased by 29% (OR = 1.29, 95% CI: 0.83-2.01) in Q2, 22% (OR = 1.22, 95% CI: 0.77-1.94) in Q3, 62% (OR = 1.62, 95% CI: 1.00-2.62) in Q4, and 77% (OR = 1.77, 95% CI: 1.06-2.95) in Q5. The trend test was significant (p = .022). When Q4-Q5 were combined, a significant 41% increment (OR = 1.41, 95% CI: 1.03-1.95) in all-cause death risk was found compared with Q1-Q3. The adverse effects were more pronounced in those with normal folate levels (p-interaction = .019) and older people (p-interaction = .037). This
study suggests that higher baseline levels of plasma vitamin B5 are a risk factor for all-cause mortality among Chinese patients with hypertension, especially among older adults and those with adequate folate levels. The findings, if confirmed, may inform novel clinical and nutritional guidelines and interventions to optimize vitamin B5 levels.