Arve Ulvik1, Eva R Pedersen2, Gard Ft Svingen2, Adrian McCann3, Øivind Midttun3, Ottar Nygård4, Per M Ueland5. 1. Bevital AS, Bergen, Norway; arve.ulvik@farm.uib.no. 2. Department of Clinical Science, University of Bergen, Bergen, Norway; and. 3. Bevital AS, Bergen, Norway; 4. Department of Clinical Science, University of Bergen, Bergen, Norway; and Department of Heart Disease and. 5. Department of Clinical Science, University of Bergen, Bergen, Norway; and Laboratory of Ok Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway.
Abstract
BACKGROUND: Low vitamin B-6 status has been related to increased risk of coronary artery disease (CAD), which is a condition that is associated with inflammation. The most common status marker, plasma pyridoxal 5'-phosphate (PLP), decreases during inflammation; therefore, causal relations are uncertain. OBJECTIVE: We evaluated the vitamin B-6 biomarkers PLP, pyridoxal, and pyridoxic acid (PA) and the pyridoxic acid:(pyridoxal + PLP) ratio (PAr), a proposed marker of vitamin B-6 catabolism during activated cellular immunity, as predictors of mortality. DESIGN: Associations with risks of long-term all-cause mortality and cardiovascular mortality were evaluated with the use of Cox regression in patients who were undergoing elective coronary angiography for suspected stable angina pectoris (SAP) (n = 4131) and an independent cohort of patients who were hospitalized for acute myocardial infarction (AMI) (n = 3665). RESULTS: Plasma PLP (AMI patients only) and PA predicted all-cause mortality in models that were adjusted for established risk predictors, but associations were attenuated or nonsignificant after additional adjustment for inflammatory markers. PAr was correlated with biomarkers of inflammation (Pearson's r ≥ 0.37) and predicted all-cause mortality and cardiovascular mortality after adjustment for established risk predictors. In SAP patients, PAr had greater predictive strength than did current smoking, diabetes, hypertension, apolipoproteins, or C-reactive protein. PAr provided multiadjusted HRs per SD of 1.45 (95% CI: 1.30, 1.63) and 1.31 (95% CI: 1.21, 1.41) in SAP and AMI patients, respectively. In both cohorts, PAr was a particularly strong predictor of all-cause mortality for patients with no previous CAD history (P-interaction ≤ 0.04). CONCLUSION: PAr may capture unique aspects of inflammatory activation and thus provide new insights into disease mechanisms that may aid in identifying patients at increased risk of future fatal events.
BACKGROUND: Low vitamin B-6 status has been related to increased risk of coronary artery disease (CAD), which is a condition that is associated with inflammation. The most common status marker, plasma pyridoxal 5'-phosphate (PLP), decreases during inflammation; therefore, causal relations are uncertain. OBJECTIVE: We evaluated the vitamin B-6 biomarkers PLP, pyridoxal, and pyridoxic acid (PA) and the pyridoxic acid:(pyridoxal + PLP) ratio (PAr), a proposed marker of vitamin B-6 catabolism during activated cellular immunity, as predictors of mortality. DESIGN: Associations with risks of long-term all-cause mortality and cardiovascular mortality were evaluated with the use of Cox regression in patients who were undergoing elective coronary angiography for suspected stable angina pectoris (SAP) (n = 4131) and an independent cohort of patients who were hospitalized for acute myocardial infarction (AMI) (n = 3665). RESULTS: Plasma PLP (AMI patients only) and PA predicted all-cause mortality in models that were adjusted for established risk predictors, but associations were attenuated or nonsignificant after additional adjustment for inflammatory markers. PAr was correlated with biomarkers of inflammation (Pearson's r ≥ 0.37) and predicted all-cause mortality and cardiovascular mortality after adjustment for established risk predictors. In SAP patients, PAr had greater predictive strength than did current smoking, diabetes, hypertension, apolipoproteins, or C-reactive protein. PAr provided multiadjusted HRs per SD of 1.45 (95% CI: 1.30, 1.63) and 1.31 (95% CI: 1.21, 1.41) in SAP and AMI patients, respectively. In both cohorts, PAr was a particularly strong predictor of all-cause mortality for patients with no previous CAD history (P-interaction ≤ 0.04). CONCLUSION:PAr may capture unique aspects of inflammatory activation and thus provide new insights into disease mechanisms that may aid in identifying patients at increased risk of future fatal events.
Authors: Cornelia M Ulrich; Mary Playdon; Rama Kiblawi; Andreana N Holowatyj; Biljana Gigic; Stefanie Brezina; Anne J M R Geijsen; Jennifer Ose; Tengda Lin; Sheetal Hardikar; Caroline Himbert; Christy A Warby; Jürgen Böhm; Martijn J L Bours; Fränzel J B van Duijnhoven; Tanja Gumpenberger; Dieuwertje E Kok; Janna L Koole; Eline H van Roekel; Petra Schrotz-King; Arve Ulvik; Andrea Gsur; Nina Habermann; Matty P Weijenberg; Per Magne Ueland; Martin Schneider; Alexis Ulrich Journal: Br J Nutr Date: 2020-02-05 Impact factor: 3.718
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Authors: Hui Zuo; Grethe S Tell; Per M Ueland; Ottar Nygård; Stein E Vollset; Øivind Midttun; Klaus Meyer; Arve Ulvik Journal: Am J Clin Nutr Date: 2018-01-01 Impact factor: 7.045