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Additive effects of obesity and vitamin D insufficiency on all-cause and cause-specific mortality
Obesity and vitamin D deficiency are both considered risk factors for mortality, but the potential additive effects of vitamin D status and obesity on mortality has not been well-studied. We aimed to examine the possible additive effects of obesity and vitamin D status on all-cause and cause-specifi...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9634746/ https://www.ncbi.nlm.nih.gov/pubmed/36337642 http://dx.doi.org/10.3389/fnut.2022.999489 |
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author | Song, Shuaihua Yuan, Yuan Wu, Xiaolong Zhang, Di Qi, Qianjin Wang, Haoran Feng, Li |
author_facet | Song, Shuaihua Yuan, Yuan Wu, Xiaolong Zhang, Di Qi, Qianjin Wang, Haoran Feng, Li |
author_sort | Song, Shuaihua |
collection | PubMed |
description | Obesity and vitamin D deficiency are both considered risk factors for mortality, but the potential additive effects of vitamin D status and obesity on mortality has not been well-studied. We aimed to examine the possible additive effects of obesity and vitamin D status on all-cause and cause-specific mortality. The data from the NHANES III (1988–1994) and NHANES 2001–2014 surveys were used, and multivariate Cox regression models were performed to assess the additive effects of vitamin D status and overweight/obesity/abdominal obesity on the all-cause, cardiovascular and cancer mortality, by stratifying Cox Hazard Ratios (HRs) across different categories of vitamin D status and body mass index (BMI) and waist circumference (WC) categories. The models were adjusted for age, race/ethnicity, gender, educational level, family income to poverty ratio, leisure-time physical activity, smoking, and drinking. Across all BMI/WC categories, there was an additive effect of the vitamin D both insufficiency and deficiency on all mortality rates, with deficiency having much stronger effect than insufficiency. Interestingly, the effect of vitamin D deficiency overcame the effect of obesity on all mortality rates. The highest HRs for overall and cardiovascular mortality were observed among vitamin D deficient obese/abdominally obese subjects, while for cancer mortality among vitamin D deficient normal weight/non-abdominally obese subjects. In stratified analyses, regarding all-cause mortality, there was an additive effect of the vitamin D both insufficiency and deficiency in all BMI/WC categories. Regarding cardiovascular mortality, there was an additive effect of vitamin D deficiency in all BMI/WC categories, but the additive effect of vitamin D insufficiency reached significance only in normal weight subjects. Regarding cancer mortality, the effect did not reach significance among obese subjects for vitamin D deficiency, while for insufficiency, significance was reached only among non-abdominally obese subjects. Interestingly, vitamin D surplus was associated with increased risk for cancer mortality in obese subjects, but there was an inadequate number of subjects in this category to make proper judgment. In conclusion, vitamin D insufficiency and deficiency gradually increase risk for mortality across all BMI/WC categories. In our analyses, vitamin D deficiency overcame the effect of obesity on mortality rates. |
format | Online Article Text |
id | pubmed-9634746 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-96347462022-11-05 Additive effects of obesity and vitamin D insufficiency on all-cause and cause-specific mortality Song, Shuaihua Yuan, Yuan Wu, Xiaolong Zhang, Di Qi, Qianjin Wang, Haoran Feng, Li Front Nutr Nutrition Obesity and vitamin D deficiency are both considered risk factors for mortality, but the potential additive effects of vitamin D status and obesity on mortality has not been well-studied. We aimed to examine the possible additive effects of obesity and vitamin D status on all-cause and cause-specific mortality. The data from the NHANES III (1988–1994) and NHANES 2001–2014 surveys were used, and multivariate Cox regression models were performed to assess the additive effects of vitamin D status and overweight/obesity/abdominal obesity on the all-cause, cardiovascular and cancer mortality, by stratifying Cox Hazard Ratios (HRs) across different categories of vitamin D status and body mass index (BMI) and waist circumference (WC) categories. The models were adjusted for age, race/ethnicity, gender, educational level, family income to poverty ratio, leisure-time physical activity, smoking, and drinking. Across all BMI/WC categories, there was an additive effect of the vitamin D both insufficiency and deficiency on all mortality rates, with deficiency having much stronger effect than insufficiency. Interestingly, the effect of vitamin D deficiency overcame the effect of obesity on all mortality rates. The highest HRs for overall and cardiovascular mortality were observed among vitamin D deficient obese/abdominally obese subjects, while for cancer mortality among vitamin D deficient normal weight/non-abdominally obese subjects. In stratified analyses, regarding all-cause mortality, there was an additive effect of the vitamin D both insufficiency and deficiency in all BMI/WC categories. Regarding cardiovascular mortality, there was an additive effect of vitamin D deficiency in all BMI/WC categories, but the additive effect of vitamin D insufficiency reached significance only in normal weight subjects. Regarding cancer mortality, the effect did not reach significance among obese subjects for vitamin D deficiency, while for insufficiency, significance was reached only among non-abdominally obese subjects. Interestingly, vitamin D surplus was associated with increased risk for cancer mortality in obese subjects, but there was an inadequate number of subjects in this category to make proper judgment. In conclusion, vitamin D insufficiency and deficiency gradually increase risk for mortality across all BMI/WC categories. In our analyses, vitamin D deficiency overcame the effect of obesity on mortality rates. Frontiers Media S.A. 2022-10-21 /pmc/articles/PMC9634746/ /pubmed/36337642 http://dx.doi.org/10.3389/fnut.2022.999489 Text en Copyright © 2022 Song, Yuan, Wu, Zhang, Qi, Wang and Feng. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Nutrition Song, Shuaihua Yuan, Yuan Wu, Xiaolong Zhang, Di Qi, Qianjin Wang, Haoran Feng, Li Additive effects of obesity and vitamin D insufficiency on all-cause and cause-specific mortality |
title | Additive effects of obesity and vitamin D insufficiency on all-cause and cause-specific mortality |
title_full | Additive effects of obesity and vitamin D insufficiency on all-cause and cause-specific mortality |
title_fullStr | Additive effects of obesity and vitamin D insufficiency on all-cause and cause-specific mortality |
title_full_unstemmed | Additive effects of obesity and vitamin D insufficiency on all-cause and cause-specific mortality |
title_short | Additive effects of obesity and vitamin D insufficiency on all-cause and cause-specific mortality |
title_sort | additive effects of obesity and vitamin d insufficiency on all-cause and cause-specific mortality |
topic | Nutrition |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9634746/ https://www.ncbi.nlm.nih.gov/pubmed/36337642 http://dx.doi.org/10.3389/fnut.2022.999489 |
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