The Journal of nutrition · 2025
Serum Vitamin A Is Associated with Variations in the Relationship between Plasma B6 Vitamers and Cardiovascular Disease Risk.
Клиническое исследование III фазыСтатьяМногоцентровое исследованиеРандомизированное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Dhar Indu, Svingen Gard Ft, Ulvik Arve, Bjørnestad Espen Ø, Sagen Jørn V, Nygård Ottar K
Аннотация
BACKGROUND: Low concentrations of biologically active B6 vitamer, pyridoxal 5'-phosphate (PLP) are associated with an increased risk of cardiovascular disease (CVD). Vitamin A (Vit-A) promotes lipid homeostasis and the transport cholesterol. Vit-A may also stimulate the intracellular transport of PLP.
OBJECTIVES: This study aimed to investigate whether Vit-A is associated with variations in the relationship of systemic B6-vitamers with incident acute myocardial infarctions (AMIs).
METHODS: A total of 4091 patients undergoing elective coronary angiography for suspected stable angina pectoris were studied. Associations of different plasma B6 vitamers, including PLP, pyridoxal (PL), 4-pyridoxic acid (PA), and PA/PL ratio with the risk of AMI according to median concentrations of Vit-A, were explored in Cox regression models.
RESULTS: Serum Vit-A demonstrated positive associations with PLP and PA/PL ratio at baseline (P < 0.001 for both). During a median follow-up of 7.5 y, 521 (12.7%) patients suffered an AMI. In age and sex-adjusted analyses, plasma PLP, PA, and PA/PL ratio showed an overall association with incident AMI {hazard ratio (HR) [95% confidence interval (CI)] per SD: 0.90 [0.82, 0.99; P = 0.02], 1.14 [1.05, 1.23; P < 0.001], and 1.28 [1.18, 1.39; P < 0.001], respectively}. However, low plasma PLP and high PA/PL ratio were associated with an increased risk of AMI primarily among patients with high compared with low Vit-A concentrations [HR (95% CI) per SD: 0.77 (0.68, 0.88; P < 0.001, P-interaction = 0.002) and 1.36 (1.23, 1.49; P < 0.001, P-interaction = 0.05), respectively]. The interactions persisted after multivariable adjustment (both P-interactions ≤ 0.04).
CONCLUSIONS: The relationship between vitamin B6 indexes and AMI risk varied according to serum Vit-A concentrations. Additional research is needed to clarify the importance of Vit-A and B6 bioavailability in atherosclerotic CVD. This trial was registered at clinicaltrials.gov as NCT00354081.
OBJECTIVES: This study aimed to investigate whether Vit-A is associated with variations in the relationship of systemic B6-vitamers with incident acute myocardial infarctions (AMIs).
METHODS: A total of 4091 patients undergoing elective coronary angiography for suspected stable angina pectoris were studied. Associations of different plasma B6 vitamers, including PLP, pyridoxal (PL), 4-pyridoxic acid (PA), and PA/PL ratio with the risk of AMI according to median concentrations of Vit-A, were explored in Cox regression models.
RESULTS: Serum Vit-A demonstrated positive associations with PLP and PA/PL ratio at baseline (P < 0.001 for both). During a median follow-up of 7.5 y, 521 (12.7%) patients suffered an AMI. In age and sex-adjusted analyses, plasma PLP, PA, and PA/PL ratio showed an overall association with incident AMI {hazard ratio (HR) [95% confidence interval (CI)] per SD: 0.90 [0.82, 0.99; P = 0.02], 1.14 [1.05, 1.23; P < 0.001], and 1.28 [1.18, 1.39; P < 0.001], respectively}. However, low plasma PLP and high PA/PL ratio were associated with an increased risk of AMI primarily among patients with high compared with low Vit-A concentrations [HR (95% CI) per SD: 0.77 (0.68, 0.88; P < 0.001, P-interaction = 0.002) and 1.36 (1.23, 1.49; P < 0.001, P-interaction = 0.05), respectively]. The interactions persisted after multivariable adjustment (both P-interactions ≤ 0.04).
CONCLUSIONS: The relationship between vitamin B6 indexes and AMI risk varied according to serum Vit-A concentrations. Additional research is needed to clarify the importance of Vit-A and B6 bioavailability in atherosclerotic CVD. This trial was registered at clinicaltrials.gov as NCT00354081.