医学
全国健康与营养检查调查
内科学
类风湿性关节炎
维生素D与神经学
比例危险模型
危险系数
胃肠病学
死因
队列
维生素D缺乏
死亡率
疾病
人口
置信区间
环境卫生
作者
Bin Cai,Mengmeng Zhou,Qingqing Xiao,Hejian Zou,Xiaoxia Zhu
出处
期刊:Rheumatology
[Oxford University Press]
日期:2022-06-11
卷期号:62 (2): 575-582
被引量:4
标识
DOI:10.1093/rheumatology/keac341
摘要
Abstract Objective We aimed to examine the relationship between serum 25-hydroxyvitamin D and all-cause, cause-specific mortality of patients with RA. Methods This cohort study included 1466 patients with RA from The National Health and Nutrition Examination Survey (NHANES) 2001–14. Mortality status was obtained according to death certificate records from the National Death Index. Cox proportional risk models were used to estimate hazard ratios (HR) and 95% CI for mortality. A generalized additive model, smooth curve fitting and 2-piecewise Cox proportional hazards models were established to address the nonlinearity between serum 25-hydroxyvitamin D and mortality. Results A total of 1466 patients [mean (s.d.) 59.89 (14.14) years old; 58.94% female] were enrolled. The weighted mean level of 25-hydroxyvitamin D was 59.26 (24.99) nmol/l and 38.95% were found with deficient (or severe deficient) vitamin D (<50.00 nmol/l). During 10453 person-years of follow-up, 268 patients were documented for all-cause death, including 52 cardiovascular disease (CVD)deaths and 48 cancer deaths. Compared with patients with serum 25-hydroxyvitamin D <25.00 nmol/l, patients with higher serum 25-hydroxyvitamin D were more likely to have lower rate of all-cause mortality. Nonlinear and L-shaped association between serum 25-hydroxyvitamin D and all-cause mortality was found, and decreased serum 25-hydroxyvitamin D was significantly associated with increased risk of all-cause mortality in patients with serum 25-hydroxyvitamin D <37.30 nmol/l [HR 0.95 (0.92, 0.98); P < 0.01]. Conclusion An L-shaped association between serum 25-hydroxyvitamin D and all-cause mortality was found among patients with RA, indicating that serum 25-hydroxyvitamin D should be improved to a certain level for the prevention of premature death.
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