Vitamin D Status and Risk of All-Cause and Cause-Specific Mortality in Osteoarthritis Patients: Results from NHANES III and NHANES 2001-2018

The unexpected role of B vitamins in osteoarthritis: a call for caution

Background: The purpose of this study was to investigate the single and mixed effects of B vitamins on OA. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) database, from 2003 to 2018, were extracted. A weighted multiple logistic regression model was used to assess the association between B vitamin intake alone and OA. In addition, Bayesian kernel machine regression (BKMR), weighted quantile sum (WQS) regression and quantile g-calculation (qgcomp) models were used to evaluate the combined effects of six B vitamins on OA. Additionally, restricted cubic spline (RCS) was used to assess possible nonlinear associations between individual B vitamins and OA. Results: The study found that vitamin B1 (OR = 1.17, 95%CI = 1.05-1.30), vitamin B2 (OR = 1.12, 95%CI = 1.02-1.22), vitamin B12 (OR = 1.01, 95%CI = 1.00-1.01) and total folate (OR = 1.001, 95%CI = 1.000-1.001) increased the risk of OA. Subgroup analysis showed that the association was more significant in people older than 65 and in women. In addition, the mixed effect model also suggested that the mixed effect of six B vitamin mixtures on OA risk was greater. Among them, vitamin B2 and vitamin B12 contributed the most to the promotion of OA disease by B-complex vitamins. Folic acid, however, showed a protective effect on the bone and joints in the mixed effect model. Conclusion: The data show that the intake of B vitamins accelerates the occurrence and progression of OA. People with OA disease and those at high risk should be cautious about using vitamin B as a dietary supplement.

Associations of Serum Vitamin D with Sarcopenia in Patients with Chronic Liver Disease: A Population-Based Cross-Sectional Study

The association between vitamin D and sarcopenia in patients with chronic liver disease (CLD) has yet to be conclusively established, particularly in Western populations. We investigated the association between serum 25(OH)D levels and sarcopenia in adult CLD patients in the USA. We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey III. Weighted logistic regression was used to determine the association between sarcopenia and serum 25(OH)D in participants with CLD. CLD was defined as chronic hepatitis B or C, non-alcoholic fatty liver disease, alcohol-related liver disease, and other liver diseases. A serum 25(OH)D level of less than 75 nmol/L was defined as vitamin D insufficiency. This study included 1402 participants with CLD. The serum 25(OH)D concentration was significantly lower in the sarcopenia group (45.3 nmol/l) compared to the non-sarcopenia group (50.6 nmol/l). The prevalence of vitamin D insufficiency was as high as 91.3% in participants with CLD, and the proportion of vitamin D insufficiency was higher in those with sarcopenia. In the full multivariate model, each 10-nmol/L increase in 25(OH)D concentration was significantly associated with a decreased risk of sarcopenia (OR 0.89; 95%CI 0.79-0.99). Conversely, participants with insufficient vitamin D levels had a significantly increased risk of sarcopenia (OR, 2.07; 95% CI 1.08-4.00). Subgroup analyses suggested a sex difference in the association between vitamin D levels and sarcopenia, with a significant association only observed in females. Restricted cubic spline curves indicated a linear inverse association between serum 25(OH)D concentration and risk of sarcopenia in all participants and in females. Low serum 25(OH)D levels were significantly associated with an increased risk of sarcopenia in individuals with CLD, with the observed gender differences in this association warranting further validation in future studies.

Association of cardiovascular health with morbidity and mortality among U.S. adults with osteoarthritis: a population-based study

BACKGROUND

Osteoarthritis (OA) is recognized as the most common joint disease with serious public health implications. Cardiovascular health (CVH) is also an issue that is frequently emphasized in public health and has an impact on a variety of diseases and mortality rates. This study aims to investigate the association of CVH with the morbidity of OA. And explore the association of CVH with both all-cause and cardiovascular disease (CVD) mortality among US adults with OA.

METHODS

This study utilized data from the National Health and Nutrition Examination Survey 2005-2018, which included 21,289 adults aged ≥ 20, representing 137,912,968 Americans. CVH was assessed by Life's Essential 8 (LE8) includes 4 behavior and 4 factor metrics. Total LE8 scores were calculated from the unweighted average on a 0-100 scale and were categorized as high (80-100), moderate (50-79), and low (0-49) CVH. Multivariable logistic regression explored the association of OA with CVH. Cox proportional hazards regression examined LE8 associations with mortality.

RESULTS

Adjusting for confounding variables, per 10 points LE8 increase, the OR was 0.82 in association with OA, while OA morbidity were decreased by 30% (OR 0.70, 95%CI 0.57, 0.87) and 54% (OR 0.46, 95%CI 0.36, 0.60) in moderate and high CVH compared to low CVH. During a median follow-up of 7.58 years in OA participants, per 10 points LE8 increase were decreased 23% mortality of all-cause (HR 0.77, 95%CI 0.70, 0.85) and 29% mortality of CVD (HR 0.71, 95% 0.60, 0.84). Moderate and high CVH demonstrated a decreased mortality of both all-cause and CVD compared with low CVH.

CONCLUSIONS

Higher CVH is associated with a lower morbidity of OA and lower mortality in OA participants. Our results suggest that adherence to CVH could reduce the morbidity of OA and improve survival outcomes for those affected.

Association between lean body mass and osteoarthritis: a cross-sectional study from the NHANES 2007-2018

The prevention of osteoarthritis through controlling body measurements has received increasing attention in recent years, but the relationship between lean body mass (LBM) and osteoarthritis remains unclear. Hence, we explored this association through the data from the National Health and Nutrition Examination Survey (2007-2018). The present study enrolled 31,172 participants. To explore the correlation between LBM and osteoarthritis, we utilized logistic regression equations to explore associations between covariates, exposures, and outcomes. We used multivariate regression models to further control confounding factors. Restricted cubic splines were employed to investigate non-linear relationships. And the inflection point was identified by recursive algorithm. Furthermore, stratified analyses of gender and age were conducted. Osteoarthritis was negatively correlated with LBM [0.74 (0.67, 0.80)] in the model adjusting for all confounders. Based on the restricted cubic spline curve, an inflection point of 52.26 kg was found to confirm the non-linear relationship. LBM was negatively correlated with osteoarthritis at 0.56 (0.48, 0.64) before the inflection point, and the association was not statistically significant afterward. This large-scale study revealed that LBM was non-linearly correlated with osteoarthritis in the general American population. Differences in age and gender were further identified.

A prospective cohort study on the joint associations of abdominal aortic calcification and systemic inflammation response index with mortality risk

Abdominal aortic calcification (AAC) and the systemic inflammation response index (SIRI) have been linked to both all-cause and cardiovascular disease (CVD)-related mortality. Whether combining AAC and SIRI improves the predictive ability for adverse outcomes remains poorly unexplored. The present study aims to investigate the joint associations of AAC and SIRI with the risk of all-cause and CVD-related mortality in the general population. This prospective cohort study included participants with AAC and SIRI data from the 2013-2014 National Health and Nutrition Examination Survey (NHANES). Primary outcomes were death from any cause (all-cause mortality) and heart or cerebrovascular diseases (CVD-related mortality). AAC was categorized into three groups based on the AAC score: non-AAC (score = 0), low- moderate AAC (score > 0 and < 5), and severe AAC (score ≥ 5). SIRI ( x 109/L) was stratified by tertiles. Multivariable Cox regression analyses and competing risk models were employed to examine the individual associations of AAC and SIRI with the risk of all-cause and CVD-related mortality. Participants were further divided into four groups according to AAC (presence or absence) and SIRI (≤ or > median) to explore their joint association. A total of 2159 participants with a median age of 55 years were included in this study. 1031 (47.8%) were males and 1128 (52.2%) were females. For race, 317 (14.7%) were mexican american, 226 (10.5%) were other hispanic, 878 (40.7%) were white, 431 (20.0%) were black, and 307 (14.2%) were other race. During a median of 73 months follow-up, 119 deaths were recorded, 41 of which were CVD-related cases. AAC was presented in 553 participants (355 with low-moderate AAC and 198 with severe AAC), and the median SIRI was 1.05 × 109/L. After adjusting for potential confounding factors, AAC and SIRI were significantly associated with the risks of all-cause (AAC: HRsevere AAC vs. non-AAC = 2.903, 95% CI: 1.855 ~ 4.543, p for trend < 0.001; SIRI: HRtertile 3 vs. tertile 1 = 2.077, 95% CI: 1.264 ~ 3.411, p for trend = 0.001) and CVD-related death (AAC: HRsevere AAC vs. non-AAC = 4.579, 95% CI: 2.019 ~ 10.381, p for trend < 0.001; SIRI: HRtertile 3 vs. tertile 1 = 3.215, 95% CI: 1.253 ~ 8.246, p for trend = 0.006). These associations remained statistically significant even after mutual adjustment. Participants with both AAC presence and elevated SIRI had higher risk of adverse outcomes. Severe AAC and elevated SIRI were independently associated with an increased risk of all-cause and CVD-related mortality in the general population. Notably, individuals with both AAC presence and increased SIRI exhibited the greatest mortality risk. The combined assessment of AAC and SIRI may provide novel predictive value, offering a more comprehensive approach to identifying high-risk individuals and refining risk stratification strategies.

The association between sedentary lifestyle and the prevalence of sarcopenia with the mediation role of systematic inflammation index, 25-hydroxyvitamin D, and testosterone: A nationwide cross-sectional study

BACKGROUND

While there is some evidence of the association between sedentary behavior and sarcopenia risk, it remains unclear whether systematic inflammation index (SII), 25(OH)D, and testosterone can mediate this association. This study aims to investigate whether sedentary behavior is associated with the prevalence of sarcopenia in the US population and further examine its potential mediators which have not been thoroughly explored, thereby presenting a novel approach to understanding the mechanism between sedentary behavior and sarcopenia.

METHODS

We conducted a cross-sectional study involving a representative sample of the US national population of 9902 adults aged 18 years or older from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. The participants with sarcopenia were identified by Dual-energy X-ray (DXA) absorptiometry. Weighted multivariable logistic regressions based on the complex survey designs were used to explore the associations between a sedentary lifestyle and the risk of sarcopenia and restricted cubic spline (RCS) regression was used to examine the non-linear association. Causal mediation analysis using the quasi-Bayesian Monte Carlo method was applied to identify the mediating role of SII, 25(OH)D, and testosterone as potential mediators.

RESULTS

A total of 358 participants (3.6 %) had sarcopenia. Compared to those in the lowest quartile of sedentary time, participants in the highest quartile had a hazard ratio of 1.631 (95 % CI: 1.162 to 2.289) for the prevalence of sarcopenia. A non-linear relationship (P for non-linearity <0.001) between sedentary time and the risk of sarcopenia was observed using the RCS method. The odds ratio for sarcopenia was highest (OR = 3.427) when the sedentary time was 1080 min daily. Furthermore, SII, 25(OH)D, and testosterone showed a significant mediation in the association between sedentary time and sarcopenia risk, with a mediation effect of 3.39 %, 10.3 %, and 8.56 %, respectively.

CONCLUSIONS

This study demonstrated novel findings of the association between sedentary behavior and sarcopenia in the US population. Our study found that sedentary time was associated with the prevalence of sarcopenia. Vitamin D, SII, and testosterone served as mediating factors in the association of sedentary time with the risk of sarcopenia.

Association between the composite dietary antioxidant index and all-cause mortality in individuals with osteoarthritis via NHANES data

The impact of antioxidant intake on the prognosis of osteoarthritis (OA) patients remains unclear. The aim of this study was to investigate the relationship between the composite dietary antioxidant index (CDAI) and all-cause mortality in OA patients. A total of 35,590 participants with OA from the National Health and Nutrition Examination Survey (1999-2020) were included in this study. We analysed the associations between the CDAI and the risk of all-cause mortality in OA patients via a multivariate Cox regression model. Restricted cubic spline regression was used to investigate the dose-response associations between the CDAI and mortality. We also conducted stratified analyses and interaction tests to explore underlying effect modification. After multivariable adjustment, each one-unit increase in the CDAI was associated with a 2.1% reduction in the risk of mortality. Compared with those in the low CDAI group, the multivariate-adjusted hazard ratios (HRs) for mortality for patients in the high CDAI group were lower [Model 1 (HR 0.648, 95% CI 0.557-0.754), Model 2 (HR 0.739, 95% CI 0.627-0.871), and Model 3 (HR 0.788, 95% CI 0.661-0.941)]. We observed a negative nonlinear relationship between the CDAI and all-cause mortality (P < 0.05). Stratification analyses and interaction tests confirmed the robustness of the results. We found a negative nonlinear relationship between the CDAI and all-cause mortality in OA patients. A higher CDAI was significantly associated with a lower risk of mortality. These results highlight the potential advantages of monitoring and evaluating the CDAI status in preventing mortality among patients with OA.

Associations of Urinary Cadmium with Body Composition and Fat Distribution in US Adults: Findings from NHANES 2011-2018

The effects of cadmium (Cd) on metabolic physiology remain controversial. Given the varying metabolic impacts associated with different body compositions, investigating the relationship between Cd exposure and body composition may facilitate further research. Here, the associations of body composition and fat distribution with urine Cd (UCd) were evaluated. This analysis included 2979 adult participants from the 2011-2018 National Health and Demographic Survey (NHANES). UCd was measured using inductively coupled plasma mass spectrometry and adjusted for urinary creatinine. Body composition and fat distribution were estimated using dual-energy x-ray absorptiometry (DXA). The study results show that UCd was negatively associated with fat mass index (FMI) and percent fat mass (p for trend < 0.001), and the negative correlation between UCd and FMI was stronger in males and smokers (all p for interaction < 0.05). In terms of abdominal fat distribution, UCd was negatively associated with abdominal subcutaneous adipose tissue (SAT) mass (p for trend < 0.001), but with abdominal visceral adipose tissue (VAT) mass only in those with low percent fat mass (< 32.3%) (p for trend = 0.026 and p for interaction < 0.05). UCd was positively related to percent VAT (p for trend < 0.001) and visceral-to-subcutaneous (VAT/SAT) ratio (p for trend = 0.003). And there was a significant negative association between UCd and android-to-gynoid (A/G) ratio (p for trend = 0.001). Meanwhile, UCd was negatively correlated with fat-free mass index (FFMI) (p for trend < 0.001). And the negative correlation between UCd and FFMI was stronger in males, smokers, and individuals with < 32.3 percent fat mass (all p for interaction < 0.05). We found the association of UCd with body composition and fat distribution, with distinct patterns observed in different demographic groups. These findings underscore the importance of considering UCd exposure in the context of body composition and fat distribution.

Higher Vitamin E Intake Reduces Risk of All-Cause Mortality and Chronic Lower Respiratory Disease Mortality in Chronic Obstructive Pulmonary Disease: NHANES (2008-2018)

Background

In human health, vitamins play a vital role in various metabolic and regulatory processes and in the proper functioning of cells. Currently, the effect of Vitamin E (VE) intake on multiple causes of death in Chronic obstructive pulmonary disease (COPD) patients is unclear. Therefore, this paper aims to investigate the relationship between VE and multiple causes of death in COPD patients, to guide the rationalization of dietary structure and reduce the risk of COPD death.

Methods

This study screened patients with COPD aged ≥40 years from the National Health and Nutrition Examination Survey (NHANES) database 2008-2018. Weighted COX regression was used to analyze the association between VE intake and multiple causes of death in COPD. The restricted cubic spline(RCS) is drawn to show their relationship. Finally, we conducted a subgroup analysis for further verification.

Results

A total of 1261 participants were included in this study. After adjustment for multiple covariates, VE intake was associated with all-cause death in COPD patients, and chronic lower respiratory disease (CLRD) deaths were linearly associated with cardiovascular disease (CVD) deaths there was no such correlation. Subgroup analyses showed no interaction between subgroups, further validating the robustness of the relationship.

Conclusion

In COPD patients, VE intake was negatively associated with all-cause mortality and CLRD death. Higher VE intake reduces the risk of all-cause mortality and CLRD death in COPD patients.

Inflammatory burden index: associations between osteoarthritis and all-cause mortality among individuals with osteoarthritis

BACKGROUND

The newly described inflammatory burden index (IBI) reflects a patient's inflammatory burden. This study aimed to estimate the association between IBI, osteoarthritis (OA), and all-cause mortality in patients with OA.

METHODS

We extracted the data of adults from the National Health and Nutrition Examination Survey database between 1999 and 2018. After using appropriate survey weights to correct for sample bias, we conducted multivariate logistic regression analyses to explore the association between IBI and OA across three models: in the unadjusted model, partially adjusted model (adjusting age, sex, race, education level, marital status, PIR, BMI, smoking status, drinking status, stroke, CVD, DM, and hypertension) and fully adjusted model (which included additional variables: HBA1C, ALT, AST, BUN, TC, and HDL). And the odds ratios (OR) and 95% confidence intervals (CI) were calculated. Similarly, using comparable survey weights and covariates adjustments, we employed Cox proportional hazards regression analysis to investigate the association between IBI and all-cause mortality in the other 3 models. The Cox proportional hazards regression models were fitted to calculate the hazard ratios (HR) and 95% CI of the association between IBI and all-cause mortality. A restricted cubic spline (RCS) was used to explore the nonlinear relationships between association effects. Subgroup analysis was performed to validate the reliability of their effects.

RESULTS

In total, 22,343 eligible participants were included. Multiple logistic regression models revealed that participants with the highest IBI had 2.54 times (95%CI, 2.23, 2.90)) higher risk of OA than those with the lowest IBI in Model 1, whereas the OR was 1.21 (95%CI, 1.03, 1.42) in Model 2 and 1.23 (95%CI,1.05, 1.45) in Model 3. Multiple Cox regression models showed participants with the highest IBI had 186% (95%CI, 1.50, 2.31) times risk of developing all-cause death than those with the lowest IBI in Model 1. This trend remained stable in Models 2 (HR,1.54; 95%CI,1.22, 1.95) and 3 (HR, 1.41; 95%CI, 1.10, 1.80). The RCS revealed a significant positive association between IBI and OA risk. With respect to the association between IBI and all-cause mortality, a slight decrease in mortality was observed from the lowest quartile to the second quartile of IBI, and the mortality risk increased with increasing IBI. Subgroup analyses showed that age, cardiovascular disease, and hypertension were pivotal in the association of IBI with all-cause mortality, whereas the association of IBI with OA remained stable after stratification by other factors such as sex, race, education level, marital, smoking, and drinking status, hypertension, and most serological indices.

CONCLUSIONS

This study provides evidence of a positive association between IBI, OA, and all-cause mortality. IBI may be a promising signature for assessing the inflammatory burden in patients with OA, which, in turn, is conducive to precise references for high-risk population recognition, anti-inflammatory guidance, and reducing mortality intervention.

Confronting the global obesity epidemic: investigating the role and underlying mechanisms of vitamin D in metabolic syndrome management

The escalating prevalence of MetS, driven by global obesity trends, underscores the urgent need for innovative therapeutic strategies. To gain a deeper understanding of the therapeutic potential of vitamin D in addressing MetS, we embarked on a targeted literature review that thoroughly examines the scientific underpinnings and pivotal discoveries derived from pertinent studies, aiming to unravel the intricate mechanisms through which vitamin D exerts its effects on MetS and its components. This article explores the multifunctional role of vitamin D in the management of MetS, focusing on its regulatory effects on insulin sensitivity, lipid metabolism, inflammation, and immune response. Through an extensive review of current research, we unveil the complex mechanisms by which vitamin D influences MetS components, highlighting its potential as a therapeutic agent. Our analysis reveals that vitamin D's efficacy extends beyond bone health to include significant impacts on cellular and molecular pathways critical to MetS. We advocate for further research to optimize vitamin D supplementation as a component of precision medicine for MetS, considering the safety concerns related to dosage and long-term use.

Association of serum 25-hydroxyvitamin D concentrations with all-cause and cause-specific mortality among individuals with gout and hyperuricemia

BACKGROUND

We aimed to probe the association of serum 25-hydroxyvitamin D [25(OH)D] concentrations with all-cause and cause-specific mortality among patients with gout and hyperuricemia (HUA).

METHODS

The study included 1169 gout patients and 7029 HUA patients from the National Health and Nutrition Examination Survey (NHANES) 2007-2018 and 2001-2018, respectively. The association between serum 25(OH)D and mortality was evaluated by Cox proportional hazard and restricted cubic spline models.

RESULTS

Among participants with gout and HUA, the weighted mean concentrations of serum 25(OH)D were 71.49 ± 30.09 nmol/L and 64.81 ± 26.92 nmol/L, respectively. Vitamin D deficiency occurred in 29.68% of gout patients and 37.83% of HUA patients. During 6783 person-years of follow-up among gout patients, 248 all-cause deaths occurred, among which 76 died from cardiovascular disease (CVD) and 49 died from cancer. 1375 HUA patients were recorded for all-cause mortality during 59,859 person-years of follow-up, including 427 CVD deaths and 232 cancer deaths. After multifactorial adjustment, per one-unit increment in natural log-transformed 25(OH)D was associated with lower risk of 55% all-cause mortality and 61% CVD mortality among gout patients, and a 45% reduced risk of cancer mortality among HUA patients. Restricted cubic splines showed a U-shaped relationship with all-cause and CVD mortality among HUA patients, with inflection points of 72.7 nmol/L and 38.0 nmol/L, respectively. The results were robust in subgroup and sensitivity analyses.

CONCLUSIONS

Serum 25(OH)D was negatively linearly correlated with mortality among gout patients, whereas U-shaped correlated with mortality in HUA patients. These results indicate that adequate vitamin D status could prevent premature death.

Association of waist circumference and BMI with premature death in young and middle-aged population

Introduction

Premature death is a global health indicator, significantly impacted by obesity, especially in young and middle-aged population. Both body mass index (BMI) and waist circumference (WC) assess obesity, with WC specifically indicating central obesity and showing a stronger relationship with mortality. However, despite known associations between BMI and premature death, as well as the well-recognized correlation between WC and adverse health outcomes, the specific relationship between WC and premature death remains unclear. Therefore, focusing on young and middle-aged individuals, this study aimed to reliably estimate independent and combined associations between WC, BMI and premature death, thereby providing causal evidence to support strategies for obesity management.

Methods

This study involved 49,217 subjects aged 18-50 years in the United States from 1999 to 2018 National Health and Nutrition Examination Survey (NHANES). Independent and combined associations between WC and BMI with premature death across sex and age stratum were examined by Cox regression. Survey weighting and inverse probability weighting (IPW) were further considered to control selection and confounding bias. Robustness assessment has been conducted on both NHANES and China Health and Retirement Longitudinal Study (CHARLS) data.

Results

A linear and positive relationship between WC and all-cause premature death was found in both males and females, with adjusted HRs of 1.019 (95%CI = 1.004-1.034) and 1.065 (95%CI = 1.039-1.091), respectively. Nonlinear relationships were found with respect to BMI and all-cause premature death. For females aged 36-50 with a BMI below 28.6 kg/m2, the risk of premature death decreased as BMI increased, indicated by adjusted HRs of 0.856 (95%CI = 0.790-0.927). Joint analysis showed among people living with obesity, a larger WC increased premature death risk (HR = 1.924, 95%CI = 1.444-2.564).

Discussion

WC and BMI exhibited prominent associations with premature death in young and middle-aged population. Maintaining an appropriate WC and BMI bears significant implications for preventing premature death.

Serum klotho levels and mortality patterns in frail individuals: unraveling the u-shaped association

BACKGROUND

Frailty, a clinical syndrome intricately linked with the aging process, stands as a harbinger of numerous adverse outcomes, most notably mortality. This study aimed to elucidate the association between serum α-klotho concentration and mortality patterns, including all-cause and cause-specific mortality, in patients with frailty.

METHODS

The study employed Cox proportional hazard models, smoothed curve fitting, and supplementary analyses, encompassing threshold effect analysis, subgroup and sensitivity analyses, to explore the relationship between α-klotho levels and mortality, including all-cause, CVD, and cancer-related mortality.

RESULTS

Among the 2,608 frail individuals (mean age: 60.78 [SD 10.48] years; 59.89% female), the mortality stood at 25.35% during a median follow-up period of 6.95 years. Both unadjusted and adjusted models revealed a significant inverse association between higher serum α-klotho levels and the risk of all-cause and CVD-related mortality ([mean(95% CI) 0.68 (0.55, 0.83)] for all-cause mortality; [mean(95% CI) 0.48 (0.32, 0.74)] for CVD-related mortality, all P for trend < 0.001). Notably, log2-klotho displayed a U-shaped correlation with all-cause mortality and cancer mortality, characterized by thresholds of 9.48 and 9.55, respectively. The robustness of these findings was consistently supported by subgroup and sensitivity analyses.

CONCLUSION

This study unveils a U shaped association between serum α-klotho levels and both all-cause and cancer-related mortality among middle-aged and elderly individuals with frailty in the United States. The identified serum α-klotho thresholds, at 714.8 pg/ml for all-cause mortality and 750.6 pg/ml for cancer-related mortality, hold promise as potential targets for interventions aimed at mitigating the risks of premature death and cancer within this vulnerable population.

Association of serum 25-hydroxyvitamin D concentrations with all-cause and cardiovascular mortality among US adults with prehypertension: a prospective cohort study

BACKGROUND

Prehypertension affects 25-50% of adults worldwide and no prior study has examined the relationship between serum 25-hydroxyvitamin D [25(OH)D] concentrations and mortality risk in individuals with prehypertension. This study aims to investigate the association of serum 25(OH)D concentrations with all-cause and CVD mortality among prehypertensive adults by utilizing data from the US National Health and Nutrition Examination Survey (NHANES) 2007-2014 and linked 2019 mortality file.

METHODS

We included 4345 prehypertensive adults who participated in the NHANES between 2007 and 2014 and were followed up until 31 December 2019. Weighted Cox proportional hazards models were used with adjustments for multiple covariates to calculate the hazard ratio (HR) and 95% confidence interval (CI) for the risks of dying from any cause and CVD.

RESULTS

During a median follow-up of 8.8 years, 335 deaths from any causes were documented, of which 88 participants died from CVD. Compared with participants with sufficient 25(OH)D (≥ 75 nmol/L), the multivariate-adjusted HRs and 95% CIs for participants with severe deficiency (< 25 nmol/L), moderate deficiency (25-49.9 nmol/L), and insufficient concentrations (50-74.9 nmol/L) of serum 25(OH)D for all-cause death were 2.83 (1.46-5.52), 1.17 (0.74-1.86), and 1.36 (0.93-1.98), respectively. Similarly, the multivariable-adjusted HRs and 95%CIs for CVD death were 4.14 (1.10-15.51), 1.23 (0.46-3.28), and 1.73 (0.96-3.14), respectively. We found that there was a 9% reduction in the risk of death from all causes and a 14% reduction in the risk of death from CVD for every 10 nmol/L increase in serum 25(OH)D concentrations.

CONCLUSION

Severe serum 25(OH)D deficiency among prehypertensive adults was associated with increased risk of mortality from all causes as well as from CVD. Our work suggests that supplementing with vitamin D may prevent premature death in severely deficient individuals with prehypertension.

Association between the Serum Vitamin D Concentration and All-Cause and Cancer-Specific Mortality in Individuals with Cancer

We aimed to explore the association between the serum 25-hydroxyvitamin D concentration and all-cause and cancer-specific mortality in 2,463 adult patients with cancer from the National Health and Nutrition Examination Survey 2007-2018. We linked mortality data from the survey to the National Death Index records up to December 31, 2019. During a median follow-up period of 70 months, 567 patients died, of whom 194 died due to cancer. Multivariate adjustment was performed for demographic characteristics, lifestyle, dietary factors, 25-hydroxyvitamin D testing period, and cancer site. Higher serum 25-hydroxyvitamin D concentrations up to 75 nmol/L significantly reduced the risk of all-cause and cancer-specific mortality. When 25-hydroxyvitamin D quartiles were compared, the multivariable-adjusted hazard ratios were 0.59 (95% confidence interval: 0.42, 0.84) for all-cause mortality (P for trend <0.001) and 0.48 (95% confidence interval: 0.29, 0.79) for cancer-specific mortality (P for trend = 0.037) in quartile 3 (79.3-99.2 nmol/L). A threshold of 75 nmol/L for serum 25-hydroxyvitamin D may represent an intervention target to reduce mortalities in patients with cancer, and maintaining 25(OH)D concentrations within range (79.3-99.2 nmol/L) is beneficial for reducing all-cause and cancer-specific mortality.

Exploring GPR109A Receptor Interaction with Hippuric Acid Using MD Simulations and CD Spectroscopy

Previous research has indicated that various metabolites belonging to phenolic acids (PAs), produced by gut microflora through the breakdown of polyphenols, help in promoting bone development and protecting bone from degeneration. Results have also suggested that G-protein-coupled receptor 109A (GPR109A) functions as a receptor for those specific PAs such as hippuric acid (HA) and 3-(3-hydroxyphenyl) propionic acid (3-3-PPA). Indeed, HA has a molecular structural similarity with nicotinic acid (niacin) which has been shown previously to bind to GPR109A receptor and to mediate antilipolytic effects; however, the binding pocket and the structural nature of the interaction remain to be recognized. In the present study, we employed a computational strategy to elucidate the molecular structural determinants of HA binding to GPR109A and GPR109B homology models in understanding the regulation of osteoclastogenesis. Based on the docking and molecular dynamics simulation studies, HA binds to GPR109A similarly to niacin. Specifically, the transmembrane helices 3, 4 and 6 (TMH3, TMH4 and TMH6) and Extracellular loop 1 and 2 (ECL1 and ECL2) residues of GRP109A; R111 (TMH3), K166 (TMH4), ECL2 residues; S178 and S179, and R251 (TMH6), and residues of GPR109B; Y87, Y86, S91 (ECL1) and C177 (ECL2) contribute for HA binding. Simulations and Molecular Mechanics Poisson-Boltzmann solvent accessible area (MM-PBSA) calculations reveal that HA has higher affinity for GPR109A than for GPR109B. Additionally, in silico mutation analysis of key residues have disrupted the binding and HA exited out from the GPR109A protein. Furthermore, measurements of time-resolved circular dichroism spectra revealed that there are no major conformational changes in the protein secondary structure on HA binding. Taken together, our findings suggest a mechanism of interaction of HA with both GPR109A and GPR109B receptors.