Nutrition Journal (Jan 2025)

Combined 25-hydroxyvitamin D concentrations and physical activity on mortality in US stroke survivors: findings from the NHANES

  • Junqi Liao,
  • Jingyi Chen,
  • Huimin Wu,
  • Qing Zhu,
  • Xiaogang Tang,
  • Li Li,
  • Aimei Zhang,
  • Peiyi Mo,
  • Yan Liu,
  • Xinyi Yang,
  • Yang Han,
  • Zhaoyao Chen,
  • Wenlei Li,
  • Yuan Zhu,
  • Minghua Wu

DOI
https://doi.org/10.1186/s12937-025-01076-x
Journal volume & issue
Vol. 24, no. 1
pp. 1 – 10

Abstract

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Abstract Background 25-hydroxyvitamin D [25(OH)D] concentrations and physical activity (PA) are linked and both are associated with changes in mortality. We examined the association of 25(OH)D and PA with all-cause or cause-specific mortality risk in stroke survivors. Methods The analysis included 677 stroke survivors from National Health and Nutrition Examination Survey (NHANES) 2007–2008 to 2017–2018. Independent and joint associations of 25(OH)D, PA and mortality among stroke survivors were analyzed using weighted Cox regression. Results We identified 133 all-cause deaths [major adverse cardiovascular events (MACE), 34; non-MACE, 79] with a median follow-up of 5.8 years (interquartile, 2.8–8.9 years). In a range of adjusted models, high 25(OH)D was observed with lower all-cause mortality compared to low 25(OH)D (HR, 0.376; 95% CI, 0.233–0.607) and non-MACE (HR, 0.265; 95% CI, 0.143–0.490) mortality was consistently associated. At the same time, compared with no PA, PA was associated with a lower all-cause (HR, 0.280; 95%CI, 0.107–0.733) and non-MACE (HR, 0.266; 95%CI, 0.087–0.810) was associated with a lower risk of death. In addition, pooled analyses showed that stroke survivors with high 25(OH)D and PA had the lowest risk of all-cause death (HR, 0.132; 95%CI, 0.038–0.460) and non-MACE (HR, 0.092; 95%CI, 0.023–0.363), there is an additive interaction between 25(OH)D and PA in non-MACE. Conclusion In conclusion, this study found that combining high 25(OH)D levels and PA showed an enhanced protective effect which demonstrated a synergistic effect between them in reducing mortality among stroke survivors. These findings provide new ideas and possibilities for the prevention and treatment of cardiovascular and cerebrovascular diseases, offering a reference for development of clinical practice guidelines in the future.

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