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Clin Nutrition:维生素B6转换增加与美国普通人群的死亡风险增加相关

2022-05-18 xuiyhan MedSci原创

维生素B6是一种B族维生素,维生素B6主要的功效有抑制呕吐、营养神经、促进代谢、预防血栓、治疗贫血、防治异烟肼中毒等。

维生素 B6 在人体内以六种可相互转换的维生素的形式存在。PLP是维生素 B6 的活性辅酶形式,具有140多种酶活性,PLP 去磷酸化为吡哆醛 (PL),即运输形式,允许通过膜脂双层。然后,PL 被分解代谢成 4-吡哆酸 (4-PA),并在尿液中排泄。炎症期间维生素 B6 的更新和细胞摄取增加,并且有人提出维生素 B6 代谢在全身炎症和主要慢性疾病(即 2 型糖尿病)发展之间的界面中起重要作用。因此,有人认为维生素B6状态与炎症和慢性病风险之间的关联。

鉴于目前缺乏关于维生素 B6 和普通人群死亡风险的大型前瞻性生物标志物研究,本项研究旨在在全国健康和营养调查 (NHANES) 中检查了维生素 B6 状态生物标志物与死亡率之间的关联。特别是评估 PLP及其降解产物4-PA,单独和组合为 4-PA/PLP 比率,表明维生素 B6转化率,是否与全因死亡率以及心血管疾病和癌症死亡率的风险相关,

研究人员在 2005 年至 2010 年的全国健康和营养调查 (NHANES) 中筛选了合格患者,采用高效液相色谱法测定患者维生素 B6 维生素 5'-磷酸吡哆醛 (PLP) 和 4-吡哆酸 (4-PA)的水平直至患者死亡。然后进行多变量 Cox 回归分析以估计 PLP、4-PA 五分位数死亡率的危险比 (HR) 和 95% 置信区间 (CI) 以及 4- PA和PLP。

 

在基线年龄在 20 至 85 岁之间的 15,304 名研究参与者中,1666 名(7.7%)在中位随访时间 7.8 年期间死亡。在一个多变量模型中发现了 PLP 与死亡率之间的负相关关系,该模型根据社会经济和生活方式因素进行了调整,但在调整了常规生物标志物(C 反应蛋白、肌酐、白蛋白和碱性磷酸酶)后变得无统计学意义。在完全调整的回归模型中,4-PA 水平与死亡风险之间存在显着的线性趋势(p= 0.02)。在多变量模型中观察到 4-PA/PLP 比率与全因死亡率之间呈正相关,HRs Q5vs.Q1为 1.45(95% CI:1.14, 1.85;p<0.0001)。生物标志物与心血管或癌症死亡率之间没有显着关联。4-PA/PLP 与死亡风险之间的关联在不同年龄组之间存在异质性,并且仅在基线时 65 岁以上的参与者中具有统计学意义(HR Q5vs.Q1 (95% CI): 1.72 (1.29, 2.29), p<0.0001)。

本项研究证实如果4-PA/PLP 比率较高即维生素 B6转化率增加与美国老年人群的全因和癌症死亡率相关。

原始出处:

PaulaSchorgg. Et al. Increased vitamin B6 turnover is associated with greater mortality risk in the general US population: A prospective biomarker study. Clinical Nutrition.2022.

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    2022-05-20 马龙
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