Serum 25-Hydroxyvitamin D and Risk of Disability in Activities of Daily Living among the Oldest-Old: An Observational and Mendelian Randomization Study

被引:0
|
作者
Li, Xinwei [1 ,2 ]
Chen, Chen [2 ]
Zhang, Yue [3 ]
Wang, Jun [2 ]
Cui, Xingyao [1 ,2 ]
Xu, Lanjing [2 ,4 ]
Zhou, Jinhui [2 ]
Deng, Luojia [3 ]
Zhang, Min [1 ,2 ]
Lv, Yuebin [2 ]
Yu, Qiong [1 ]
Shi, Xiaoming [2 ]
机构
[1] Jilin Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Changchun, Jilin, Peoples R China
[2] Chinese CDC, China Ctr Dis Control & Prevent CDC, Natl Inst Environm Hlth, Key Lab Environm & Populat Hlth, Beijing, Peoples R China
[3] Shanghai Jiao Tong Univ, Sch Life Sci & Biotechnol, Dept Bioinformat & Biostat, Shanghai, Peoples R China
[4] Zhejiang Univ, Sch Publ Hlth, Dept Big Data Hlth Sci, Hangzhou, Zhejiang, Peoples R China
来源
JOURNAL OF NUTRITION | 2024年 / 154卷 / 03期
基金
中国国家自然科学基金;
关键词
vitamin D deficiency; physical disability; genetic risk score; Mendelian randomization; healthy aging; VITAMIN-D DEFICIENCY; PHYSICAL PERFORMANCE; D SUPPLEMENTATION; MUSCLE FUNCTION; SECONDARY HYPERPARATHYROIDISM; INSTRUMENTAL VARIABLES; SKELETAL-MUSCLE; ASSOCIATION; PREVALENCE; STRENGTH;
D O I
10.1016/j.tjnut.2024.01.016
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background: Vitamin D deficiency and disability are both prevalent among older adults. However, the association between them has rarely been investigated in the oldest-old subjects (aged >= 80 y), and the causality remains unclear. Objective: This study aimed to elucidate the causal effect of vitamin D on the incident risk of disability in activities of daily living (ADL) among Chinese oldest-old based on the 2012-2018 Chinese Healthy Ageing and Biomarkers Cohort Study. Methods: Serum 25-hydroxyvitamin D [25(OH)D] concentrations and ADL status at baseline and follow-up interviews were documented. Cox regression models were applied among 1427 oldest-old (mean age, 91.2 y) with normal baseline ADL status. One sample Mendelian randomization (MR) analyses were performed on a subset of 941 participants with qualified genetic data, using a 25(OH)D-associated genetic risk score as the genetic instrument. Results: During a median follow-up of 3.4 y, 231 participants developed disability in ADL. Serum 25(OH)D concentration was inversely associated with the risk of disability in ADL [per 10 nmol/L increase hazard ratio (HR) 0.85; 95% CI: 0.75, 0.96]. Consistent results from MR analyses showed that a 10 nmol/L increment in genetically predicted 25(OH)D concentration corresponded to a 20% reduced risk of ADL disability (HR 0.80; 95% CI: 0.68, 0.94). Nonlinear MR demonstrated a monotonic declining curve, with the HRs exhibiting a more pronounced reduction among individuals with 25(OH)D concentrations below 50 nmol/L. Subgroup analyses showed that the associations were more distinct among females and those with poorer health conditions. Conclusions: Our study supports an inverse causal relationship between serum 25(OH)D concentration and the risk of disability in ADL among Chinese oldest-old. This protective effect was more distinct, especially for participants with vitamin D deficiency. Appropriate measures for improving vitamin D might help reduce the incidence of physical disability in this specific age group.
引用
收藏
页码:1004 / 1013
页数:10
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