Biochemical risk indices, including plasma homocysteine, that prospectively predict mortality in older British people: the National Diet and Nutrition Survey of People Aged 65 Years and Over.
Biochemical risk indices, including plasma homocysteine, that prospectively predict mortality in older British people: the National Diet and Nutrition Survey of People Aged 65 Years and Over.
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DOI：
10.1017/s0007114510001236
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发表时间：
2010-09
影响因子：
3.6
通讯作者：
Mishra, Gita D.
中科院分区：
文献类型：
--
作者：
Bates, Christopher J.;Mansoor, Mohammed A.;Pentieva, Kristina D.;Hamer, Mark;Mishra, Gita D.
关键词：
对英国国家饮食和营养调查（社区生活子集）中65岁及以上人群基线测量的选定指数的总死亡率和血管死亡率的预测能力进行了测试。从1994- 1995年基线调查至2008年9月，记录了1100名受访者（平均年龄76.7（SD 7.5）岁，50.2%为女性）的死亡状况及其主要和根本原因。随访数据分析特别关注已知的血管疾病风险预测因子，以及已知影响或受这些预测因子影响的选定营养素的摄入量和状态指数。总同型半胱氨酸（tHcy）基线血浆浓度（每SD）的风险比显著预测总死亡率（95% CI）1·19（1·11，1·27），磷酸吡哆醛0·90（0·81，1·00），吡哆酸1·10（1·03，1·19），α1-抗糜蛋白酶1·21（1·13，1·29），纤维蛋白原1·14（1·05，1·23），肌酐1·20（1·10，1·31）和糖化血红蛋白（Hb）（1·14，1·32），能量（0·80，0·96）和蛋白质（0·86，0·77，0·97）摄入量。主要原因血管死亡率的预测模式和重要性相似。传统的风险预测因子血浆总胆固醇和HDL胆固醇在这个年龄组中不是显著的死亡率预测因子，已知的tHcy调节营养素、叶酸和维生素B12（摄入量和状态指数）也不是。已知风险预测因子的模型调整导致上述一些指标的显著性丧失;然而，tHcy 1·34（1·04，1·73）仍然是血管性死亡的显著预测因子。因此，总的和主要的血管死亡率预测的能量和蛋白质的摄入量，并通过生化指标，包括tHcy，独立的血清叶酸或维生素B12。
Predictive power, for total and vascular mortality, of selected indices measured at baseline in the British National Diet and Nutrition Survey (community-living subset) of People Aged 65 Years and Over was tested. Mortality status and its primary and underlying causes were recorded for 1100 (mean age 76·7 (SD 7·5) years, 50·2 % females) respondents from the baseline survey in 1994–5 until September 2008. Follow-up data analyses focussed especially on known predictors of vascular disease risk, together with intakes and status indices of selected nutrients known to affect, or to be affected by, these predictors. Total mortality was significantly predicted by hazard ratios of baseline plasma concentrations (per SD) of total homocysteine (tHcy) (95 % CI) 1·19 (1·11, 1·27), pyridoxal phosphate 0·90 (0·81, 1·00), pyridoxic acid 1·10 (1·03, 1·19), α1-antichymotrypsin 1·21 (1·13, 1·29), fibrinogen 1·14 (1·05, 1·23), creatinine 1·20 (1·10, 1·31) and glycosylated Hb 1·23 (1·14, 1·32), and by dietary intakes of energy 0·87 (0·80, 0·96) and protein 0·86 (0·77, 0·97). Prediction patterns and significance were similar for primary-cause vascular mortality. The traditional risk predictors plasma total and HDL cholesterol were not significant mortality predictors in this age group, nor were the known tHcy-regulating nutrients, folate and vitamin B12 (intakes and status indices). Model adjustment for known risk predictors resulted in the loss of significance for some of the afore-mentioned indices; however, tHcy 1·34 (1·04, 1·73) remained a significant predictor for vascular mortality. Thus, total and primary vascular mortality is predicted by energy and protein intakes, and by biochemical indices including tHcy, independent of serum folate or vitamin B12.