Serum Nutritional Biomarkers and All-Cause and Cause-Specific Mortality in U.S. Adults with Metabolic Syndrome: The Results from National Health and Nutrition Examination Survey 2001–2006

Abstract

Background: There is limited research on the associations between serum nutritional biomarkers and mortality risk in patients with metabolic syndrome (MetS). Existing studies merely investigated the single-biomarker effect. Thus, this study aimed to investigate the combined effect of nutritional biomarker mixtures and mortality risk using the Bayesian kernel machine regression (BKMR) model in patients with MetS. Methods: We included the MetS patients, defined according to the 2018 Guideline on the Management of Blood Cholesterol from the National Health and Nutrition Examination Survey (NHANES) 2001–2006. A total of 20 serum nutritional biomarkers were measured and evaluated in this study. The Cox proportional hazard model and restricted cubic spline models were used to evaluate the individual linear and non-linear association of 20 nutritional biomarkers with mortality risk. Bayesian kernel machine regression (BKMR) was used to assess the associations between mixture of nutritional biomarkers and mortality risk. Results: A total of 1455 MetS patients had a median age of 50 years (range: 20–85). During a median of 17.1-year follow-up, 453 (24.72%) died: 146 (7.20%) caused by CVD and 87 (5.26%) by cancer. Non-linear and linear analyses indicated that, in total, eight individual biomarkers (α-carotene, β-carotene, bicarbonate, lutein/zeaxanthin, lycopene, potassium, protein, and vitamin A) were significantly associated with all-cause mortality (all p-values < 0.05). Results from BKMR showed an association between the low levels of the mixture of nutritional biomarkers and high risk of all-cause mortality with the estimated effects ranging from 0.04 to 0.14 (referent: medians). α-Carotene (PIP = 0.971) and potassium (PIP = 0.796) were the primary contributors to the combined effect of the biomarker mixture. The nutritional mixture levels were found to be negatively associated with the risk of cardiovascular disease (CVD) mortality and positively associated with the risk of cancer mortality. After it was stratified by nutrients, the mixture of vitamins showed a negative association with all-cause and CVD mortality, whereas the mixture of mineral-related biomarkers was positively associated with all-cause and cancer mortality. Conclusion: Our findings support the evidence that nutritional status was associated with long-term health outcomes in MetS patients. It is necessary for MetS patients to be concerned with certain nutritional status (i.e., vitamins and mineral elements).

The Colombo Twin and Singleton Study (COTASS): Piloting the Feasibility of Collecting Nutritional Data and Extension of the Sample to Include Children of Twins

“…Nitrogen serves as an indicator of protein consumption. The intake of proteins holds paramount importance for the human body, as they serve numerous essential functions that greatly contribute to maintaining overall health and well-being (Peng et al 2023 ). These roles encompass a wide array of physiological processes that are vital for optimal functioning.…”

Association of Serum Beta-Carotene with Metabolic Risk Factors among a Work Cohort in Malaysia

“…The reported positive effects of beta-carotene have the ability to prevent and control the oxidative stress that found in diseases such as T2DM (5). In addition, abnormalities of micronutrients with antioxidant properties such as beta-carotene may be associated with MetS and the progression of MetS (33). A systematic review and meta-analysis (2) reported a strong inverse association of serum total carotenoids and beta-carotene with MetS occurrence.…”

Co-exposure to multiple vitamins and the risk of all-cause mortality in patients with diabetes

“…Qiu et al (12) examined the association between serum carotenoid levels and the risk of cardiovascular disease mortality in patients with type 2 diabetes and found that higher serum b-carotene concentrations were significantly correlated with increased risk of cardiovascular mortality in diabetic patients. However, Peng et al (13) investigated the relationship between serum nutritional biomarkers and the risk of all-cause mortality and cause-specific mortality in individuals with metabolic syndrome and the results indicated that a-carotene may be the primary protective biomarker against mortality risk in individuals with metabolic syndrome, while folate and vitamin B12 were not associated with mortality risk in metabolic syndrome population.…”

“…However, Peng et al. ( 13 ) investigated the relationship between serum nutritional biomarkers and the risk of all-cause mortality and cause-specific mortality in individuals with metabolic syndrome and the results indicated that α-carotene may be the primary protective biomarker against mortality risk in individuals with metabolic syndrome, while folate and vitamin B12 were not associated with mortality risk in metabolic syndrome population.…”