Abstract

There is little evidence regarding the association between serum vitamin B6 concentration and subsequent mortality. We aimed to evaluate the association of serum vitamin B6 concentration with all-cause, cardiovascular disease (CVD), and cancer mortality in the general population using data from the National Health and Nutrition Examination Survey (NHANES). Our study examined 12,190 adults participating in NHANES from 2005 to 2010 in the United States. The mortality status was linked to National Death Index (NDI) records up to 31 December 2015. Pyridoxal 5′-phosphate (PLP) is the biologically active form of vitamin B6. Vitamin B6 status was defined as deficient (PLP < 20 nmol/L), insufficient (PLP ≥ 20.0 and <30.0 nmol/L), and sufficient (PLP ≥ 30.0 nmol/L). We established Cox proportional-hazards models to estimate the associations of categorized vitamin B6 concentration and log-transformed PLP concentration with all-cause and cause-specific mortality by calculating hazard ratios (HRs) and 95% confidence intervals (95%CIs). In our study, serum vitamin B6 was sufficient in 70.6% of participants, while 12.8% of the subjects were deficient in vitamin B6. During follow-up, a total of 1244 deaths were recorded, including 294 cancer deaths and 235 CVD deaths. After multivariate adjustment in Cox regression, participants with higher serum vitamin B6 had a 15% (HR = 0.85, 95%CI = 0.77, 0.93) reduced risk of all-cause mortality and a 19% (HR = 0.81, 95%CI = 0.68, 0.98) reduced risk for CVD mortality for each unit increment in natural log-transformed PLP. A higher log-transformed PLP was not significantly associated with a lower risk for cancer mortality. Compared with sufficient vitamin B6, deficient (HR = 1.37, 95%CI = 1.17, 1.60) and insufficient (HR = 1.19, 95%CI = 1.02, 1.38) vitamin B6 level were significantly associated with a higher risk for all-cause mortality. There was no significant association for cause-specific mortality. Participants with higher levels of vitamin B6 had a lower risk for all-cause mortality. These findings suggest that maintaining a sufficient level of serum vitamin B6 may lower the all-cause mortality risk in the general population.

Highlights

  • Micronutrients, including minerals and vitamins, are important components of our bodies

  • Vitamin B6 was sufficient in the majority of participants (70.6%), and only 12.8% of the participants were deficient in vitamin B6

  • In the analysis of this nationally representative prospective cohort study of U.S adults, we found that deficient and insufficient serum vitamin B6 were significantly associated with a higher risk for all-cause mortality

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Summary

Introduction

Micronutrients, including minerals and vitamins, are important components of our bodies. Micronutrient deficiency can result in slow growth, high anemia prevalence, increased infection rates, and even death [2]. The 2017 Global Nutrition Report showed that one million premature deaths attributable to micronutrient deficiency have occurred annually [1]. As one of the important micronutrients, the prevalence of vitamin B6 deficiency was about 11% according to the second national report of the Centers for Disease Control and Prevention (CDC) [3]. Vitamin B6 plays a role as an essential coenzyme that regulates catabolic and anabolic processes [4]. It is involved in many enzyme activities as a cofactor, including molecule synthesis, interconversion, and degradation [5]. Researchers have found that suboptimal levels of vitamin B6 were associated with increased risk of chronic diseases such as diabetes [6], cancer [7], and cardiovascular disease (CVD) [8]

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