Association of Serum Vitamin B6 with All-Cause and Cause-Specific Mortality in a Prospective Study

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.

Associations of serum vitamin B6 status with the risks of cardiovascular, cancer, and all-cause mortality in the elderly

“…However, a study from Caerphilly showed that vitamin B6 levels were associated with non-cardiovascular disease mortality in men, but not with cardiovascular or cancer mortality ( 29 ). Another study conducted on the general population also observed a negative association between PLP and all-cause mortality, but found no association with cardiovascular or cancer mortality ( 24 ). These discrepancies may be due to the different study populations.…”

“…Based on reviewing relevant literature ( 17 , 24 ), we selected the following covariates in the model: age (<70, 70-80 or ≥80 years), sex (male or female), drink (yes or no), smoke (never or former or current), education (Less than high school, High school or equivalent, and College or above), race ethnicity (Hispanic, non-Hispanic white, non-Hispanic black, and Race-including multi-racial), physical activity (low, moderate, or vigorous), cholesterol (≥6.2 mmol/L or <6.2 mmol/L), and self-reported physician diagnosed cardiovascular disease (yes or no), cancer (yes or no), hypertension (yes or no) and type 2 diabetes (yes or no). Body mass index (BMI) was calculated as weight (kg) divided by height (meters squared).…”

There is no association of serum vitamin B levels with all‐cause and cardiovascular mortality in hemodialysis patients

“…There is little evidence regarding the association between serum vitamin B1, B3, B5, and B6 and mortality in either general population or dialysis patients. Some research suggested higher levels of vitamin B6 were associated with a lower risk for all‐cause mortality in the general population [14]. But meta‐analyses showed that supplement B‐complex or niacin did not reduce all‐cause mortality or CV mortality [15].…”

Relationship of Low Vitamin B6 Status with Sarcopenia, Frailty, and Mortality: A Narrative Review

“…A summary of findings from seven studies [ 22 , 23 , 24 , 25 , 26 , 27 , 28 ] examining the relationship between B6 status and all-cause mortality in the general population is presented in Table 3 . Among these seven studies, six [ 23 , 24 , 25 , 26 , 27 , 28 ] indicated a significant inverse association between B6 status and all-cause mortality.…”