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Background <p>The potential influence of dietary vitamin E in osteoarthritis (OA) progression has been explored; however, its association with mortality risk in patients with OA remains unclear. This study aimed to investigate the relationship between dietary vitamin E intake and all-cause mortality among US adults with OA.</p> Methods <p>This cross-sectional analysis included 2,974 adults with OA from the National Health and Nutrition Examination Survey cycles spanning 2003–2018. Mortality data were obtained by linking to the National Death Index, with follow-up until December 31, 2019. Cox proportional hazards models were used to evaluate the association between dietary vitamin E intake and all-cause mortality in patients with OA. Restricted cubic spline analyses investigated potential nonlinear dose–response relationships. Stratified analyses further explored mortality risk variations across subgroups to identify high-risk populations.</p> Results <p>After comprehensive multivariable adjustment, a higher dietary vitamin E intake was significantly inversely associated with all-cause mortality in patients with OA (<Emphasis Type="BoldItalic">P</Emphasis> for trend &lt; 0.001). Compared with the lowest quartile (Q1) of intake, the adjusted hazard ratios (HRs) for mortality in Q2, Q3, and Q4 were 0.86 [95% confidence interval (CI) 0.74–1.00], 0.76 (95% CI 0.64–0.90), and 0.61 (95% CI 0.50–0.74), respectively. Restricted cubic spline analysis revealed a nonlinear relationship (<Emphasis Type="BoldItalic">P</Emphasis> for nonlinearity = 0.025), with a threshold effect observed at 8.554&#xa0;mg/day vitamin E consumption. Below 8.55&#xa0;mg/day, each 1-mg increment in vitamin E intake reduced the mortality risk by 7.6% (HR: 0.92, 95% CI 0.89–0.96; <i>P</i> &lt; 0.001) without significant correlation above this threshold (HR: 0.98, 95% CI 0.95–1.01; <i>P</i> = 0.23).</p> Conclusions <p>This national cohort study revealed a nonlinear inverse association between dietary vitamin E intake and mortality in patients with OA, with a threshold of 8.55&#xa0;mg/day. Sub-threshold intake demonstrated a significant reduction in mortality, potentially informing OA nutritional management. Therefore, prospective studies are required to establish causality.</p>

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Dietary vitamin E intake and all-cause mortality in patients with osteoarthritis: a prospective cohort study using NHANES data

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月26日

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  • Fan Yang,
  • Yongqing Liu,
  • Weihua Sang,
  • Jun Wang

摘要

Background

The potential influence of dietary vitamin E in osteoarthritis (OA) progression has been explored; however, its association with mortality risk in patients with OA remains unclear. This study aimed to investigate the relationship between dietary vitamin E intake and all-cause mortality among US adults with OA.

Methods

This cross-sectional analysis included 2,974 adults with OA from the National Health and Nutrition Examination Survey cycles spanning 2003–2018. Mortality data were obtained by linking to the National Death Index, with follow-up until December 31, 2019. Cox proportional hazards models were used to evaluate the association between dietary vitamin E intake and all-cause mortality in patients with OA. Restricted cubic spline analyses investigated potential nonlinear dose–response relationships. Stratified analyses further explored mortality risk variations across subgroups to identify high-risk populations.

Results

After comprehensive multivariable adjustment, a higher dietary vitamin E intake was significantly inversely associated with all-cause mortality in patients with OA (P for trend < 0.001). Compared with the lowest quartile (Q1) of intake, the adjusted hazard ratios (HRs) for mortality in Q2, Q3, and Q4 were 0.86 [95% confidence interval (CI) 0.74–1.00], 0.76 (95% CI 0.64–0.90), and 0.61 (95% CI 0.50–0.74), respectively. Restricted cubic spline analysis revealed a nonlinear relationship (P for nonlinearity = 0.025), with a threshold effect observed at 8.554 mg/day vitamin E consumption. Below 8.55 mg/day, each 1-mg increment in vitamin E intake reduced the mortality risk by 7.6% (HR: 0.92, 95% CI 0.89–0.96; P < 0.001) without significant correlation above this threshold (HR: 0.98, 95% CI 0.95–1.01; P = 0.23).

Conclusions

This national cohort study revealed a nonlinear inverse association between dietary vitamin E intake and mortality in patients with OA, with a threshold of 8.55 mg/day. Sub-threshold intake demonstrated a significant reduction in mortality, potentially informing OA nutritional management. Therefore, prospective studies are required to establish causality.