Association of vitamin B6 intake with the risk and prognosis of diabetic retinopathy: a NHANES-based study

Investigating the role of dietary vitamin B6 intake in the risk and prognosis of diabetic retinopathy (DR) could facilitate the management of DR. This study aimed to assess the association between dietary vitamin B6 intake and the risk of DR and further explore the association between vitamin B6 intake and mortality in patients with DR. This retrospective cohort study gained data from the National Health and Nutrition Examination Survey (NHANES) 2005–2006 and 2007–2008. The intake of dietary vitamin B6 was assessed by two 24-h dietary recall interviews. Mortality information in the National Death Index was recorded from the date of survey participation through 31 December 2019. Multivariate regression analyses were employed to assess the association between vitamin B6 intake and the risk of DR, and the association between vitamin B6 intake and the risk of mortality in patients with DR. A total of 5559 subjects were included, of which 693 (12.47%) had DR. Among these patients with DR, 429 (61.90%) were survivors. Multivariate analyses showed that the intake of vitamin B6 was negatively associated with the risk of DR (odds ratio = 0.81, 95% confidence level: 0.69–0.95, <i>p</i> = 0.012), and patients with DR with an increased intake of vitamin B6 had a significantly decreased risk of all-cause death (hazard ratio = 0.81, 95% confidence level: 0.66–0.99, <i>p</i> = 0.041) or cardiovascular disease-related death (hazard ratio = 0.76, 95% confidence level: 0.58–0.98, <i>p</i> = 0.037). The intake of vitamin B6 was negatively associated with the risk of DR, and in patients with DR, a higher intake of vitamin B6 was associated with a lower risk of all-cause death and cardiovascular disease-related death, indicating the possible protective role of increased vitamin B6 intake.

探讨膳食维生素B6摄入在糖尿病视网膜病变（diabetic retinopathy, DR）发生风险与预后中的作用，有助于优化糖尿病视网膜病变的临床管理。本研究旨在评估膳食维生素B6摄入与糖尿病视网膜病变发生风险的关联，并进一步探讨糖尿病视网膜病变患者的膳食维生素B6摄入与死亡率的关联。本回顾性队列研究的数据来源于2005-2006年及2007-2008年的国家健康与营养检查调查（National Health and Nutrition Examination Survey, NHANES）。膳食维生素B6摄入情况通过两次24小时膳食回顾访谈进行评估。国家死亡索引（National Death Index）中的死亡信息从研究对象参与调查之日起记录至2019年12月31日。本研究采用多因素回归分析，评估维生素B6摄入与糖尿病视网膜病变发生风险的关联，以及维生素B6摄入与糖尿病视网膜病变患者死亡率的关联。最终共纳入5559名研究对象，其中693名（12.47%）患有糖尿病视网膜病变。在这693名糖尿病视网膜病变患者中，429名（61.90%）为存活者。多因素分析结果显示，维生素B6摄入与糖尿病视网膜病变发生风险呈负相关（优势比=0.81，95%置信水平：0.69~0.95，*p*=0.012）；糖尿病视网膜病变患者的维生素B6摄入水平越高，其全因死亡风险显著降低（风险比=0.81，95%置信水平：0.66~0.99，*p*=0.041）或心血管疾病相关死亡风险显著降低（风险比=0.76，95%置信水平：0.58~0.98，*p*=0.037）。综上可见，维生素B6摄入与糖尿病视网膜病变发生风险呈负相关；在糖尿病视网膜病变患者中，更高的维生素B6摄入水平与更低的全因死亡及心血管疾病相关死亡风险相关，提示增加维生素B6摄入或可发挥保护性作用。