Table_2_Trends of serum 25(OH) vitamin D and association with cardiovascular disease and all-cause mortality: from NHANES survey cycles 2001–2018.docx

BackgroundThe focus of this survey is on survey data for adults aged 20 and above, covering nine survey cycles from 2001 to 2018. Additionally, the present study explored the correlation between vitamin D concentrations and both cardiovascular disease (CVD) and all-cause mortality.
ObjectiveThe objectives of this study were to evaluate the trend of changes in the serum 25(OH)D concentration changes in US adults during the survey period, the prevalence of vitamin D deficiency, and the current status of vitamin D dietary intake and supplementation.
MethodsIn-home health interviews were performed using meticulously designed questionnaires that gathered information on demographic details, socioeconomic conditions, dietary patterns, and overall health status. Health assessments were conducted in specially designed mobile centers.1
ResultsSurvey data from 2001 to 2018 revealed a rise in serum 25(OH)D levels, from a weighted mean (95% CI) of 65.6 (63.8–67.4) nmol/L during 2001–2002 to 73.5 (70.4–76.5) nmol/L during 2017–2018, among US adults, while overall vitamin D deficiency rates remained stable (p = 0.152). Notably, in adults aged 20–39, 25(OH)D levels decreased (p = 0.002 for trend), and 25(OH)D deficiency increased (p = 0.003 for trend), especially among those with low incomes (deficiency >30%). Upon multivariable adjustment, an L-shaped relationship was found between serum 25(OH)D concentrations and both CVD and all-cause mortality (p < 0.001 for nonlinearity), as corroborated by sensitivity analyses.
ConclusionFrom 2001 to 2018, US adults experienced a significant increase in their serum 25(OH) D concentration. However, subgroups of individuals, including young adults and individuals with lower socioeconomic status, exhibited a heightened risk of 25(OH)D deficiency. Furthermore, an L-shaped relationship was found between 25(OH)D concentration and both all-cause and CVD mortality among US adults.

背景：本综述的研究对象为20岁及以上成年人的调查数据，涵盖2001年至2018年共计9个调查周期。此外，本研究还探讨了维生素D浓度与心血管疾病（Cardiovascular Disease, CVD）及全因死亡率之间的关联。
目标：本研究的目标为评估调查周期内美国成年人血清25(OH)D（25-羟维生素D）浓度的变化趋势、维生素D缺乏的患病率，以及当前维生素D膳食摄入与补充剂使用现状。
方法：研究采用精心设计的问卷开展居家健康访谈，收集人口统计学特征、社会经济状况、膳食模式及整体健康状况相关信息；健康评估则在专门设置的移动体检中心完成[1]。
结果：2001年至2018年的调查数据显示，美国成年人的血清25(OH)D水平呈上升趋势，加权均值（95%置信区间，Confidence Interval, CI）从2001-2002年的65.6（63.8~67.4）nmol/L升至2017-2018年的73.5（70.4~76.5）nmol/L，而整体维生素D缺乏率保持稳定（p=0.152）。值得注意的是，20~39岁成年人的血清25(OH)D水平出现下降（趋势检验p=0.002），维生素D缺乏率亦随之升高（趋势检验p=0.003），其中低收入群体的缺乏率尤为突出（>30%）。经多变量校正后，研究发现血清25(OH)D浓度与心血管疾病（CVD）及全因死亡率之间呈L型关联（非线性检验p<0.001），该结果经敏感性分析得以验证。
结论：2001年至2018年间，美国成年人的血清25(OH)D浓度显著升高。然而，包括年轻成年人及社会经济地位较低群体在内的亚人群，其25(OH)D缺乏风险均有所上升。此外，美国成年人的血清25(OH)D浓度与全因死亡率及心血管疾病（CVD）死亡率之间均存在L型关联。