医学
类风湿性关节炎
危险系数
维生素D与神经学
内科学
维生素D缺乏
比例危险模型
队列
人口
置信区间
维生素
人口学
胃肠病学
环境卫生
社会学
作者
Siyu Chen,Shiqi Chen,Zhijian Zhao,Xueqing Cao,Zhangling Chen,Jin Lin
出处
期刊:Maturitas
[Elsevier]
日期:2023-12-01
卷期号:178: 107848-107848
标识
DOI:10.1016/j.maturitas.2023.107848
摘要
To assess the associations of both the level of circulating vitamin D and the ratio of omega-3 fatty acids to total fatty acids (omega-3 %) with mortality among participants with rheumatoid arthritis.This study included 4,293 and 1,157 adults with rheumatoid arthritis identified by self-report from the UK Biobank for the analysis of vitamin D and omega-3 %, respectively.Death outcomes were obtained from the National Health Service Information Centre (England and Wales) and the National Health Service Central Register Scotland (Scotland). Cox proportional hazards models were used to estimate hazard ratios and 95 % confidence intervals for mortality.The medians (25th-75th percentiles) of serum 25(OH)D and omega-3 % were 45.8 (31.4-62.9) nmol/L and 4.1 % (3.3 %-5.1 %), respectively. During 52,612 person-years of follow-up in the 25(OH)D group, 502 all-cause deaths occurred; and during 14,192 person-years of follow-up in the omega-3 % group, 122 all-cause deaths occurred. Rheumatoid arthritis patients with vitamin D levels of at least 20 nmol/L had an approximately 40-50 % lower risk of all-cause mortality than those with severe vitamin D deficiency (hazard ratio ranging from 0.51 to 0.62, all P values < 0.05). Each unit increase in natural log-transformed 25(OH)D was associated with a 22 % reduction in the risk of all-cause mortality, and a U-shaped association between serum 25(OH)D and all-cause mortality was found. However, the association between omega-3 % and mortality was not significant.Lower serum 25(OH)D concentration, but not omega-3 %, was significantly associated with higher all-cause mortality in patients with rheumatoid arthritis. Optimizing serum vitamin D levels may be an important factor in reducing mortality risk in this population.
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