Association between serum pyridoxal 5'-phosphate levels and all-cause, cardiovascular mortality, and cardiovascular disease in adults: a population-based cohort study

Chao Xuan; Ru-Hua Liu; Cong Zhao; Jing Li; Ting-Ting Zhou; Qing-Wu Tian; Guo-Wei He

doi:10.1177/20406223241290411

Association between serum pyridoxal 5'-phosphate levels and all-cause, cardiovascular mortality, and cardiovascular disease in adults: a population-based cohort study

Ther Adv Chronic Dis. 2024 Oct 18:15:20406223241290411. doi: 10.1177/20406223241290411. eCollection 2024.

Authors

Chao Xuan¹, Ru-Hua Liu², Cong Zhao³, Jing Li², Ting-Ting Zhou², Qing-Wu Tian², Guo-Wei He^{4

5}

Affiliations

¹ Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, No. 1677, Wutai Mountain Road, Qingdao 266500, China.
² Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China.
³ Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, China.
⁴ Department of Cardiovascular Surgery, TEDA International Cardiovascular Hospital; Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.
⁵ Department of Surgery, Oregon Health and Science University, Portland, OR, USA.

Abstract

Background: The association between pyridoxal 5'-phosphate (PLP) and cardiovascular disease (CVD) remains a topic of discussion.

Objectives: This study aimed to explore the relationship between serum PLP levels and the incidence of all-cause mortality, cardiovascular mortality, and the risk of CVD among the US population.

Design: A population-based cohort study.

Methods: This study analyzed data from the National Health and Nutrition Examination Survey. Adjusted hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) were calculated using weighted Cox proportional hazards regression models to assess the risk associated with all-cause and cardiovascular mortality. Weighted binary logistic regression was utilized to assess the relationship between serum PLP levels and the risk of CVD. Nonlinear associations were evaluated using multivariable-adjusted restricted cubic splines.

Results: There were 2546 cases of all-cause mortality and 867 cases of cardiovascular mortality over a mean follow-up of 11.36 years. In the fully adjusted model, the adjusted HRs with 95% CIs for all-cause mortality associated with increases in serum PLP levels corresponding to the interquartile ranges were 0.83 (0.74-0.93), 0.71 (0.63-0.80), and 0.64 (0.56-0.74), respectively. Similarly, cardiovascular mortality decreased by 0.78 (0.62-0.97), 0.63 (0.49-0.81), and 0.62 (0.50-0.77) with each quartile increase in serum PLP levels. Higher serum PLP levels confer protection against CVD risk (odds ratio: 0.87, 95% CI: 0.79-0.96). Serum PLP levels showed nonlinear relationships with risk of all-cause mortality, cardiovascular mortality, and CVD.

Conclusion: The results of this study provide evidence that serum PLP serves as a protective factor against all-cause mortality, cardiovascular mortality, and CVD in US adults, with dose-response relationships.

Keywords: all-cause mortality; cardiovascular disease; cardiovascular mortality; prospective cohort study; pyridoxal phosphate.

Plain language summary

Association between serum pyridoxal 5′-phosphate levels and all-cause, cardiovascular mortality, and cardiovascular disease in US adults Why was the study done? The association between pyridoxal 5′-phosphate (PLP) and cardiovascular disease (CVD) remains a topic of discussion. This study aimed to explore the relationship between serum PLP levels and the incidence of all-cause mortality, cardiovascular mortality, and the risk of CVD among the US population. What did the researchers do? This study used data from National Health and Nutrition Examination Survey (NHANES), applying statistical methods to see if there’s a connection between the amount of PLP in the blood and health outcomes. What did the researchers find? The findings showed that over an average of 11 years, people with higher levels of PLP in their blood were less likely to die for any reason. They were also less likely to die from heart-related problems or to develop heart disease. The protection seemed to increase as PLP levels got higher. What do the findings mean? The results of this study provide evidence that serum PLP serves as a protective factor against all-cause mortality, cardiovascular mortality, and cardiovascular disease in US adults, with dose–response relationships.