Combined 25-hydroxyvitamin D concentrations and physical activity on mortality in US stroke survivors: findings from the NHANES

Abstract Background 25-hydroxyvitamin D [25(OH)D] concentrations and physical activity (PA) are linked and both are associated with changes in mortality. We examined the association of 25(OH)D and PA with all-cause or cause-specific mortality risk in stroke survivors. Methods The analysis included 6...

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Main Authors: Junqi Liao, Jingyi Chen, Huimin Wu, Qing Zhu, Xiaogang Tang, Li Li, Aimei Zhang, Peiyi Mo, Yan Liu, Xinyi Yang, Yang Han, Zhaoyao Chen, Wenlei Li, Yuan Zhu, Minghua Wu
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Language:English
Published: BMC 2025-01-01
Series:Nutrition Journal
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Online Access:https://doi.org/10.1186/s12937-025-01076-x
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author Junqi Liao
Jingyi Chen
Huimin Wu
Qing Zhu
Xiaogang Tang
Li Li
Aimei Zhang
Peiyi Mo
Yan Liu
Xinyi Yang
Yang Han
Zhaoyao Chen
Wenlei Li
Yuan Zhu
Minghua Wu
author_facet Junqi Liao
Jingyi Chen
Huimin Wu
Qing Zhu
Xiaogang Tang
Li Li
Aimei Zhang
Peiyi Mo
Yan Liu
Xinyi Yang
Yang Han
Zhaoyao Chen
Wenlei Li
Yuan Zhu
Minghua Wu
author_sort Junqi Liao
collection DOAJ
description Abstract Background 25-hydroxyvitamin D [25(OH)D] concentrations and physical activity (PA) are linked and both are associated with changes in mortality. We examined the association of 25(OH)D and PA with all-cause or cause-specific mortality risk in stroke survivors. Methods The analysis included 677 stroke survivors from National Health and Nutrition Examination Survey (NHANES) 2007–2008 to 2017–2018. Independent and joint associations of 25(OH)D, PA and mortality among stroke survivors were analyzed using weighted Cox regression. Results We identified 133 all-cause deaths [major adverse cardiovascular events (MACE), 34; non-MACE, 79] with a median follow-up of 5.8 years (interquartile, 2.8–8.9 years). In a range of adjusted models, high 25(OH)D was observed with lower all-cause mortality compared to low 25(OH)D (HR, 0.376; 95% CI, 0.233–0.607) and non-MACE (HR, 0.265; 95% CI, 0.143–0.490) mortality was consistently associated. At the same time, compared with no PA, PA was associated with a lower all-cause (HR, 0.280; 95%CI, 0.107–0.733) and non-MACE (HR, 0.266; 95%CI, 0.087–0.810) was associated with a lower risk of death. In addition, pooled analyses showed that stroke survivors with high 25(OH)D and PA had the lowest risk of all-cause death (HR, 0.132; 95%CI, 0.038–0.460) and non-MACE (HR, 0.092; 95%CI, 0.023–0.363), there is an additive interaction between 25(OH)D and PA in non-MACE. Conclusion In conclusion, this study found that combining high 25(OH)D levels and PA showed an enhanced protective effect which demonstrated a synergistic effect between them in reducing mortality among stroke survivors. These findings provide new ideas and possibilities for the prevention and treatment of cardiovascular and cerebrovascular diseases, offering a reference for development of clinical practice guidelines in the future.
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spelling doaj-art-935dc4fb4bde4154a12927ccc7afb74c2025-01-19T12:11:18ZengBMCNutrition Journal1475-28912025-01-0124111010.1186/s12937-025-01076-xCombined 25-hydroxyvitamin D concentrations and physical activity on mortality in US stroke survivors: findings from the NHANESJunqi Liao0Jingyi Chen1Huimin Wu2Qing Zhu3Xiaogang Tang4Li Li5Aimei Zhang6Peiyi Mo7Yan Liu8Xinyi Yang9Yang Han10Zhaoyao Chen11Wenlei Li12Yuan Zhu13Minghua Wu14Department of Neurology, Affiliated Hospital of Nanjing University of Chinese MedicineDepartment of Neurology, Affiliated Hospital of Nanjing University of Chinese MedicineDepartment of Neurology, Affiliated Hospital of Nanjing University of Chinese MedicineDepartment of Neurology, Affiliated Hospital of Nanjing University of Chinese MedicineDepartment of Neurology, Affiliated Hospital of Nanjing University of Chinese MedicineDepartment of Neurology, Affiliated Hospital of Nanjing University of Chinese MedicineDepartment of Neurology, Affiliated Hospital of Nanjing University of Chinese MedicineDepartment of Neurology, Affiliated Hospital of Nanjing University of Chinese MedicineDepartment of Neurology, Affiliated Hospital of Nanjing University of Chinese MedicineDepartment of Neurology, Affiliated Hospital of Nanjing University of Chinese MedicineDepartment of Neurology, Changshu Hospital, Nanjing University of Chinese MedicineDepartment of Neurology, Affiliated Hospital of Nanjing University of Chinese MedicineDepartment of Neurology, Affiliated Hospital of Nanjing University of Chinese MedicineDepartment of Neurology, Affiliated Hospital of Nanjing University of Chinese MedicineDepartment of Neurology, Affiliated Hospital of Nanjing University of Chinese MedicineAbstract Background 25-hydroxyvitamin D [25(OH)D] concentrations and physical activity (PA) are linked and both are associated with changes in mortality. We examined the association of 25(OH)D and PA with all-cause or cause-specific mortality risk in stroke survivors. Methods The analysis included 677 stroke survivors from National Health and Nutrition Examination Survey (NHANES) 2007–2008 to 2017–2018. Independent and joint associations of 25(OH)D, PA and mortality among stroke survivors were analyzed using weighted Cox regression. Results We identified 133 all-cause deaths [major adverse cardiovascular events (MACE), 34; non-MACE, 79] with a median follow-up of 5.8 years (interquartile, 2.8–8.9 years). In a range of adjusted models, high 25(OH)D was observed with lower all-cause mortality compared to low 25(OH)D (HR, 0.376; 95% CI, 0.233–0.607) and non-MACE (HR, 0.265; 95% CI, 0.143–0.490) mortality was consistently associated. At the same time, compared with no PA, PA was associated with a lower all-cause (HR, 0.280; 95%CI, 0.107–0.733) and non-MACE (HR, 0.266; 95%CI, 0.087–0.810) was associated with a lower risk of death. In addition, pooled analyses showed that stroke survivors with high 25(OH)D and PA had the lowest risk of all-cause death (HR, 0.132; 95%CI, 0.038–0.460) and non-MACE (HR, 0.092; 95%CI, 0.023–0.363), there is an additive interaction between 25(OH)D and PA in non-MACE. Conclusion In conclusion, this study found that combining high 25(OH)D levels and PA showed an enhanced protective effect which demonstrated a synergistic effect between them in reducing mortality among stroke survivors. These findings provide new ideas and possibilities for the prevention and treatment of cardiovascular and cerebrovascular diseases, offering a reference for development of clinical practice guidelines in the future.https://doi.org/10.1186/s12937-025-01076-x25-hydroxyvitamin DPhysical activityMortalityStroke survivors
spellingShingle Junqi Liao
Jingyi Chen
Huimin Wu
Qing Zhu
Xiaogang Tang
Li Li
Aimei Zhang
Peiyi Mo
Yan Liu
Xinyi Yang
Yang Han
Zhaoyao Chen
Wenlei Li
Yuan Zhu
Minghua Wu
Combined 25-hydroxyvitamin D concentrations and physical activity on mortality in US stroke survivors: findings from the NHANES
Nutrition Journal
25-hydroxyvitamin D
Physical activity
Mortality
Stroke survivors
title Combined 25-hydroxyvitamin D concentrations and physical activity on mortality in US stroke survivors: findings from the NHANES
title_full Combined 25-hydroxyvitamin D concentrations and physical activity on mortality in US stroke survivors: findings from the NHANES
title_fullStr Combined 25-hydroxyvitamin D concentrations and physical activity on mortality in US stroke survivors: findings from the NHANES
title_full_unstemmed Combined 25-hydroxyvitamin D concentrations and physical activity on mortality in US stroke survivors: findings from the NHANES
title_short Combined 25-hydroxyvitamin D concentrations and physical activity on mortality in US stroke survivors: findings from the NHANES
title_sort combined 25 hydroxyvitamin d concentrations and physical activity on mortality in us stroke survivors findings from the nhanes
topic 25-hydroxyvitamin D
Physical activity
Mortality
Stroke survivors
url https://doi.org/10.1186/s12937-025-01076-x
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