Association between serum pyridoxal 5′-phosphate levels and all-cause, cardiovascular mortality, and cardiovascular disease in adults: a population-based cohort study

Abstract

Background: The association between pyridoxal 5′-phosphate (PLP) and cardiovascular disease (CVD) remains a topic of discussion. Objectives: This study aimed to explore the relationship between serum PLP levels and the incidence of all-cause mortality, cardiovascular mortality, and the risk of CVD among the US population. Design: A population-based cohort study. Methods: This study analyzed data from the National Health and Nutrition Examination Survey. Adjusted hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) were calculated using weighted Cox proportional hazards regression models to assess the risk associated with all-cause and cardiovascular mortality. Weighted binary logistic regression was utilized to assess the relationship between serum PLP levels and the risk of CVD. Nonlinear associations were evaluated using multivariable-adjusted restricted cubic splines. Results: There were 2546 cases of all-cause mortality and 867 cases of cardiovascular mortality over a mean follow-up of 11.36 years. In the fully adjusted model, the adjusted HRs with 95% CIs for all-cause mortality associated with increases in serum PLP levels corresponding to the interquartile ranges were 0.83 (0.74–0.93), 0.71 (0.63–0.80), and 0.64 (0.56–0.74), respectively. Similarly, cardiovascular mortality decreased by 0.78 (0.62–0.97), 0.63 (0.49–0.81), and 0.62 (0.50–0.77) with each quartile increase in serum PLP levels. Higher serum PLP levels confer protection against CVD risk (odds ratio: 0.87, 95% CI: 0.79–0.96). Serum PLP levels showed nonlinear relationships with risk of all-cause mortality, cardiovascular mortality, and CVD. Conclusion: The results of this study provide evidence that serum PLP serves as a protective factor against all-cause mortality, cardiovascular mortality, and CVD in US adults, with dose–response relationships.