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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Vitamin d deficiency and metabolic syndrome: The joint effect on cardiovascular and all-cause mortality in the United States adults
Longjian Liu, Saishi Cui, Stella L Volpe, Nathalie S May, Deeptha Sukumar, Rose Ann DiMaria-Ghalili, Howard J Eisen
Longjian Liu, Saishi Cui, Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, United States
Stella L Volpe, Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, United States
Nathalie S May, Department of Medicine, College of Medicine, Drexel University, Philadelphia, PA 19102, United States
Deeptha Sukumar, Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA 19102, United States
Rose Ann DiMaria-Ghalili, Department of Graduate Nursing, College of Nursing and Health Professions, Drexel University, Philadelphia, PA 19102, United States
Howard J Eisen, Division of Cardiology, Heart and Vascular Institute, Pennsylvania State University, Hershey, PA 17033, United States
Author contributions: Liu L conceptualized the study and analysis designs, and performed the data analysis and drafted the manuscript; Cui S performed the machine learning analysis. Volpe SL, May NS, Sukumar D, DiMaria-Ghalili RA, Cui S, and Eisen H critically reviewed the study design and analysis methods, and carefully reviewed the results and edited the manuscript. All authors contributed to the study and approved the submission.
Institutional review board statement: The study was reviewed and approved by Drexel University Institutional Review Board (Approval No. 2105008546).
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Longjian Liu, MD, MSc, PhD, Doctor, Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, 3215 Market Street, Philadelphia, PA 19104, United States. ll85@drexel.edu
Received: August 30, 2021
Peer-review started: August 30, 2021
First decision: April 7, 2022
Revised: April 25, 2022
Accepted: June 17, 2022
Article in press: June 17, 2022
Published online: July 26, 2022
ARTICLE HIGHLIGHTS
Research background
Studies that tested whether there is a significant joint effect of vitamin D intake and metabolic syndrome (MetS) on the risk of cardiovascular disease (CVD) and all-cause mortality are sparse.
Research motivation
The third National Health and Nutrition Examination Survey provides us an unique opportunity to test the research questions using a large-scale population sample size, with an average of 18 years follow-up. An integrated analysis approach of standard statistics methods and Machine Learning may provide new insights into the study field and add new evidence of clustering risk factors to control CVD and all-cause mortality.
Research objectives
To test the hypotheses that lower serum 25 hydroxyvitamin D [25(OH)D] concentrations (a marker of decreased vitamin D intake) and MetS have a long-term impact on the risk of CVD and all-cause mortality, and individuals with vitamin D deficiency can be detected by key covariates.
Research methods
A prospective analysis of 9094 adults who participated in the Third National Health and Nutrition Examination Survey in 1988 to 1994 and were followed for each participant's vital status by December 31, 2015, was conducted.
Research results
Findings from the study add new evidence to the body of research by highlighting the joint effects of vitamin D deficiency and MetS on the risk of CVD and all-cause mortality among the United States adults. A comprehensive intervention for both groups of risk factors are necessary to reduce the risk of CVD and all-cause mortality.
Research conclusions
There is a significant joint effect of vitamin D deficiency and MetS on the risk of CVD and all-cause mortality. The application of standard bio-statistics and Machine Learning techniques provides a new tool to test research hypothesis and provide new insights into health promotion for individuals who are at high risk of unhealthy exposures and risk of CVD and all-cause mortality.
Research perspectives
A high proportion of populations who have lower vitamin D levels and prevalent MetS poses a serious public health issue. Further studies are needed to examine the potential mechanisms by which that may cause vitamin D deficiency and MetS.
