Associations of serum folate and vitamin B12 levels with all-cause mortality among patients with metabolic dysfunction associated steatotic liver disease: a prospective cohort study

作者：Jiaxin Zhu, Xinyi Liao, Du Lei, Pengju Lv, Jian Deng · 发表于：Frontiers in Endocrinology · 年份：2024 · DOI：10.3389/fendo.2024.1426103 · 被引用次数：10 · 研究领域：Liver Disease Diagnosis and Treatment、Folate and B Vitamins Research、Liver Disease and Transplantation

Introduction Serum folate and vitamin B 12 levels correlate with the prevalence of fatty liver disease, but it is not clear how they affect mortality. Therefore, this study aimed to investigate the association of serum folate and vitamin B 12 concentrations with all-cause mortality in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD). Methods MASLD subjects were from the Third National Health and Nutrition Examination Survey (NHANES III) in the United States, and mortality follow-up data were obtained by linkage to death records from the National Death Index. Multivariable Cox proportional regression models and restricted cubic spline (RCS) models were used to evaluate the association of serum folate/vitamin B 12 with all-cause mortality in the MASLD population. Results 3,636 and 2,125 MASLD individuals were included in the analyses related to serum folate and vitamin B 12 , respectively. During a follow-up period of more than 20 years, the RCS models demonstrated significant nonlinear associations of both serum folate ( P < 0.001) and vitamin B 12 ( P =0.016) with all-cause mortality in MASLD. When their serum concentrations were below the median level, the risk of all-cause mortality decreased with increasing concentration, reaching a lowest risk around the median level, and then leveled off. In the multivariable cox regression model, for vitamin B 12 , the risk of all-cause mortality was reduced by 42% and 28% in the third and fourth ...