PMID- 36771258
OWN - NLM
STAT- MEDLINE
DCOM- 20230214
LR  - 20230214
IS  - 2072-6643 (Electronic)
IS  - 2072-6643 (Linking)
VI  - 15
IP  - 3
DP  - 2023 Jan 20
TI  - Serum Nutritional Biomarkers and All-Cause and Cause-Specific Mortality in U.S. 
      Adults with Metabolic Syndrome: The Results from National Health and Nutrition 
      Examination Survey 2001-2006.
LID - 10.3390/nu15030553 [doi]
LID - 553
AB  - BACKGROUND: There is limited research on the associations between serum 
      nutritional biomarkers and mortality risk in patients with metabolic syndrome 
      (MetS). Existing studies merely investigated the single-biomarker effect. Thus, 
      this study aimed to investigate the combined effect of nutritional biomarker 
      mixtures and mortality risk using the Bayesian kernel machine regression (BKMR) 
      model in patients with MetS. METHODS: We included the MetS patients, defined 
      according to the 2018 Guideline on the Management of Blood Cholesterol from the 
      National Health and Nutrition Examination Survey (NHANES) 2001-2006. A total of 
      20 serum nutritional biomarkers were measured and evaluated in this study. The 
      Cox proportional hazard model and restricted cubic spline models were used to 
      evaluate the individual linear and non-linear association of 20 nutritional 
      biomarkers with mortality risk. Bayesian kernel machine regression (BKMR) was 
      used to assess the associations between mixture of nutritional biomarkers and 
      mortality risk. RESULTS: A total of 1455 MetS patients had a median age of 50 
      years (range: 20-85). During a median of 17.1-year follow-up, 453 (24.72%) died: 
      146 (7.20%) caused by CVD and 87 (5.26%) by cancer. Non-linear and linear 
      analyses indicated that, in total, eight individual biomarkers (alpha-carotene, 
      beta-carotene, bicarbonate, lutein/zeaxanthin, lycopene, potassium, protein, and 
      vitamin A) were significantly associated with all-cause mortality (all p-values < 
      0.05). Results from BKMR showed an association between the low levels of the 
      mixture of nutritional biomarkers and high risk of all-cause mortality with the 
      estimated effects ranging from 0.04 to 0.14 (referent: medians). alpha-Carotene (PIP 
      = 0.971) and potassium (PIP = 0.796) were the primary contributors to the 
      combined effect of the biomarker mixture. The nutritional mixture levels were 
      found to be negatively associated with the risk of cardiovascular disease (CVD) 
      mortality and positively associated with the risk of cancer mortality. After it 
      was stratified by nutrients, the mixture of vitamins showed a negative 
      association with all-cause and CVD mortality, whereas the mixture of 
      mineral-related biomarkers was positively associated with all-cause and cancer 
      mortality. CONCLUSION: Our findings support the evidence that nutritional status 
      was associated with long-term health outcomes in MetS patients. It is necessary 
      for MetS patients to be concerned with certain nutritional status (i.e., vitamins 
      and mineral elements).
FAU - Peng, Xinwei
AU  - Peng X
AUID- ORCID: 0000-0001-9868-0136
AD  - Department of Biostatistics, Key Laboratory on Public Health Safety, School of 
      Public Health, Fudan University, Ministry of Education, Shanghai 200032, China.
FAU - Zhu, Jingjing
AU  - Zhu J
AD  - Clinical Research Unit, Shanghai Ninth People's Hospital Affiliated to Shanghai 
      Jiao Tong University School of Medicine, Shanghai 200011, China.
FAU - Lynn, Henry S
AU  - Lynn HS
AUID- ORCID: 0000-0002-8078-5690
AD  - Department of Biostatistics, Key Laboratory on Public Health Safety, School of 
      Public Health, Fudan University, Ministry of Education, Shanghai 200032, China.
FAU - Zhang, Xi
AU  - Zhang X
AD  - Clinical Research Unit, Xinhua Hospital, Shanghai Jiao Tong University School of 
      Medicine, Shanghai 200092, China.
LA  - eng
GR  - CHDI-2021-B-09/Hospital Management Project 2021, China Institute of Hospital 
      Development, Shanghai Jiao Tong University/
GR  - 81703238/National Natural Science Foundation of China/
PT  - Journal Article
DEP - 20230120
PL  - Switzerland
TA  - Nutrients
JT  - Nutrients
JID - 101521595
RN  - 45XWE1Z69V (alpha-carotene)
RN  - 0 (Biomarkers)
RN  - 0 (Vitamins)
SB  - IM
MH  - Humans
MH  - Adult
MH  - Young Adult
MH  - Middle Aged
MH  - Aged
MH  - Aged, 80 and over
MH  - *Metabolic Syndrome
MH  - Nutrition Surveys
MH  - Cause of Death
MH  - Bayes Theorem
MH  - Biomarkers
MH  - Vitamins
MH  - *Cardiovascular Diseases/etiology
PMC - PMC9918903
OTO - NOTNLM
OT  - Bayesian analysis
OT  - NHANES
OT  - biomarkers
OT  - carotenoid
OT  - metabolic syndrome
OT  - mortality
OT  - potassium
COIS- The authors declare no conflict of interest.
EDAT- 2023/02/12 06:00
MHDA- 2023/02/15 06:00
PMCR- 2023/01/20
CRDT- 2023/02/11 01:37
PHST- 2022/11/22 00:00 [received]
PHST- 2023/01/06 00:00 [revised]
PHST- 2023/01/12 00:00 [accepted]
PHST- 2023/02/11 01:37 [entrez]
PHST- 2023/02/12 06:00 [pubmed]
PHST- 2023/02/15 06:00 [medline]
PHST- 2023/01/20 00:00 [pmc-release]
AID - nu15030553 [pii]
AID - nutrients-15-00553 [pii]
AID - 10.3390/nu15030553 [doi]
PST - epublish
SO  - Nutrients. 2023 Jan 20;15(3):553. doi: 10.3390/nu15030553.