中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (22): 5629-5638.doi: 10.12307/2026.140

• 骨组织构建 bone tissue construction •    下一篇

骨关节炎患者镁摄入量与全因和癌症死亡率的U型相关性分析

周海东1,卢姚宏1,范少勇2   

  1. 1江西中医药大学,江西省南昌市   330004;2江西中医药大学附属洪都中医院,江西省南昌市   330038
  • 收稿日期:2025-03-14 接受日期:2025-08-01 出版日期:2026-08-08 发布日期:2025-12-25
  • 通讯作者: 范少勇,医学博士,主任医师,江西中医药大学附属洪都中医院,江西省南昌市 330038
  • 作者简介:周海东,男,1995年生,重庆市人,土家族,江西中医药大学在读博士,中医师,主要从事关节相关疾病的研究。
  • 基金资助:
    江西省重点研发计划项目(20202BBG73028),项目负责人:范少勇;2024年江西省校级大学生创新创业训练计划项目(202410412281),项目负责人:周海东;2024年江西省研究生创新专项资金项目(YC2024-B239),项目负责人:周海东

U-shaped association between magnesium intake and all-cause and cancer mortality in patients with osteoarthritis

Zhou Haidong1, Lu Yaohong1, Fan Shaoyong2   

  1. 1Jiangxi University of Chinese Medicine, Nanchang 330004, Jiangxi Province, China; 2Hongdu Hospital of Traditional Chinese Medicine Affiliated to Jiangxi University of Chinese Medicine, Nanchang 330038, Jiangxi Province, China
  • Received:2025-03-14 Accepted:2025-08-01 Online:2026-08-08 Published:2025-12-25
  • Contact: Fan Shaoyong, MD, Chief physician, Hongdu Hospital of Traditional Chinese Medicine, Nanchang 330038, Jiangxi Province, China
  • About author:Zhou Haidong, PhD candidate, Physician, Jiangxi University of Chinese Medicine, Nanchang 330004, Jiangxi Province, China
  • Supported by:
    the Jiangxi Provincial Key Research and Development Program Project, No. 20202BBG73028 (to FSY); 2024 Jiangxi Provincial University-level Student Innovation and Entrepreneurship Training Program Project, No. 202410412281 (to ZHD); 2024 Jiangxi Provincial Postgraduate Innovation Special Funds Project, No. YC2024-B239 (to ZHD)

摘要:


文题释义:
全因死亡率:是指一定时期内各种原因导致的总死亡人数与该人群人口数之比,分母是某段时间内的人口总数,分子是在该段时间内所有死亡人数,不论任何原因导致的死亡,都算作死亡人数,作为分子。
膳食镁摄入量:指通过日常饮食摄入的镁元素含量,通常以g/d为单位进行测量。镁是人体必需的矿物质,参与多种生理功能,包括骨骼健康、神经和肌肉功能调节及心血管系统稳定。

背景:明确膳食镁摄入量与骨关节炎患者死亡风险之间的关系,可为优化膳食干预措施、降低全因死亡率及心血管疾病死亡率提供理论依据,为骨关节炎患者的营养管理提供参考价值。
目的:评估美国成年骨关节炎患者中膳食镁摄入量与全因及特定病因死亡率的关联。
方法:使用2003-2020年期间国家健康与营养检查调查数据库(由美国疾病控制与预防中心下属的国家健康统计中心负责,旨在评估美国平民的健康和营养状况)的数据,纳入骨关节炎成年参与者,通过Cox比例风险模型及两段式Cox模型评估膳食镁摄入量与骨关节炎患者死亡率之间的关系;为了评估膳食镁摄入量与全因死亡率的关联是否在人群中保持一致,并识别潜在的高风险人群,按年龄、性别、体质量指数、高血压、糖尿病、体力活动、吸烟状况、饮酒状态等分层的亚组进行分析和交互作用检验。
结果与结论:①共纳入2 868例骨关节炎患者,随访期间记录了699例全因死亡、281例心血管疾病死亡及143例癌症死亡。调整多变量后的结果显示,较高的膳食镁摄入量与心血管疾病死亡风险显著降低相关,膳食镁摄入量每增加1个单位心血管疾病死亡风险降低78%(P=0.022 2),膳食镁摄入量的四分位分析结果与此一致。膳食镁摄入量与全因死亡率及癌症死亡率呈现U型关联,最低死亡风险的镁摄入阈值分别为0.38 g/d和0.40 g/d,当镁摄入量低于阈值时,较高的摄入量与较低的全因死亡率[HR=0.17,95%CI(0.06,0.50)]和癌症死亡率[HR=0.16,95%CI(0.01,1.50)]显著相关;但高于阈值时,镁摄入量与全因死亡率[HR=2.94,95%CI(0.55,15.84)]及癌症死亡率[HR=26.30,95%CI(1.46,474.73)]增加显著相关。亚组分析进一步验证了结果的稳健性。②结果表明膳食镁摄入不足可能在心血管健康中发挥不利作用,同时膳食镁摄入量与全因死亡率和癌症死亡率之间呈现U型关系,镁摄入过低或过高均可能导致死亡风险增加。这一发现为膳食镁摄入量对心血管疾病、癌症及全因死亡率潜在影响提供了新的见解,为骨关节炎患者的营养干预提供了科学依据,为中国心血管疾病和癌症的预防及管理提供了理论支持,尤其是在心血管疾病高发的背景下,合理的镁摄入有助于降低相关死亡率。
https://orcid.org/0009-0000-2385-7144(周海东);https://orcid.org/0000-0001-7936-2642(范少勇)

中国组织工程研究杂志出版内容重点:干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程

关键词: 膳食镁, 骨关节炎, 横断面研究, 死亡率, 全因死亡, 癌症

Abstract: BACKGROUND: Clarifying the relationship between dietary magnesium intake and mortality risk in patients with osteoarthritis can provide theoretical basis for optimizing dietary interventions, reducing all-cause mortality and cardiovascular disease mortality, and provide reference value for nutritional management in patients with osteoarthritis.
OBJECTIVE: To assess the association between dietary magnesium intake and all-cause and etiological mortality in adults with osteoarthritis in the United States. 
METHODS: We enrolled data of adults with osteoarthritis from the National Health and Nutrition Examination Survey (conducted by the National Center for Health Statistics under the U.S. Centers for Disease Control and Prevention, it aims to assess the health and nutritional status of the civilian population in the United States) between 2003 and 2020. The association between dietary magnesium intake and mortality in patients with osteoarthritis was evaluated by Cox proportional hazard model and two-stage Cox model. To assess whether the association between dietary magnesium intake and all-cause mortality was consistent across the population and to identify potential high-risk groups, subgroup analyses in terms of age, sex, body mass index, hypertension, diabetes mellitus, physical activity, smoking status, and drinking status were performed and tested for interactions.
RESULTS AND CONCLUSION: (1) A total of 2 868 patients with osteoarthritis were included in this study. During the follow-up period, 699 all-cause deaths, 281 cardiovascular disease deaths and 143 cancer deaths were recorded. After multivariate adjustment, higher dietary magnesium intake was associated with a significantly lower risk of death from cardiovascular disease. Each 1-unit increase in dietary magnesium intake was associated with a 78% lower risk of death from cardiovascular disease (P=0.022 2). The results of quartile analysis of dietary magnesium intake were consistent with this. At the same time, dietary magnesium intake showed a U-shaped association with all-cause mortality and cancer mortality, with turning points at 0.38 g/d and 0.4 g/d, respectively. When magnesium intake was below the threshold, higher intake was significantly associated with lower all-cause mortality [hazard ratio (HR)=0.17, 95% confidence interval (CI)=0.06-0.50] and cancer mortality (HR=0.16, 95% CI=0.01-1.50). Above the threshold, however, magnesium intake was significantly associated with an increase in all-cause mortality (HR=2.94, 95% CI=0.55-15.84) and cancer mortality (HR=26.30, 95% CI=1.46-474.73). Subgroup analyses further verified the robustness of the results. (2) The results suggested that magnesium deficiency might play an adverse role in cardiovascular health. At the same time, there was a U-shaped relationship between dietary magnesium intake and all-cause mortality and cancer mortality, with either too low or too high magnesium intake associated with an increased risk of death. This finding provides new insights into the potential impacts of dietary magnesium intake on cardiovascular disease, cancer, and all-cause mortality, a scientific basis for nutritional interventions in patients with osteoarthritis, and theoretical support for the prevention and management of cardiovascular disease and cancer in China, especially in the context of the high prevalence of cardiovascular disease, where a rational magnesium intake can help to reduce the associated mortality.

Key words: dietary magnesium, osteoarthritis, cross-sectional study, mortality rate, all-cause death, cancer

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