Vitamin D as a mediator in the J-shaped association between serum uric acid and all-cause and cardiovascular mortality in patients with cardiovascular-kidney-metabolic syndrome: A prospective cohort study.
Y, Q., L, W., Z, L., L, L., & Y, S. (2026). Vitamin D as a mediator in the J-shaped association between serum uric acid and all-cause and cardiovascular mortality in patients with cardiovascular-kidney-metabolic syndrome: A prospective cohort study.. Medicine. https://doi.org/10.1097/MD.0000000000049346
Y Q, L W, Z L, L L, Y S. Vitamin D as a mediator in the J-shaped association between serum uric acid and all-cause and cardiovascular mortality in patients with cardiovascular-kidney-metabolic syndrome: A prospective cohort study.. Medicine. 2026; doi: 10.1097/MD.0000000000049346
Y Q, L W, Z L, et al. Vitamin D as a mediator in the J-shaped association between serum uric acid and all-cause and cardiovascular mortality in patients with cardiovascular-kidney-metabolic syndrome: A prospective cohort study.[J]. Medicine. 2026. DOI: 10.1097/MD.0000000000049346.
@article{y2026,
author = {Qu Y and Wang L and Li Z and Liu L and Sun Y},
title = {Vitamin D as a mediator in the J-shaped association between serum uric acid and all-cause and cardiovascular mortality in patients with cardiovascular-kidney-metabolic syndrome: A prospective cohort study.},
journal = {Medicine},
year = {2026},
doi = {10.1097/MD.0000000000049346},
note = {PMID: 42363472},
}
TY - JOUR AU - Qu Y AU - Wang L AU - Li Z AU - Liu L AU - Sun Y TI - Vitamin D as a mediator in the J-shaped association between serum uric acid and all-cause and cardiovascular mortality in patients with cardiovascular-kidney-metabolic syndrome: A prospective cohort study. T2 - Medicine PY - 2026 DO - 10.1097/MD.0000000000049346 AN - PMID:42363472 ER -
The relationship between serum uric acid (UA) and mortality in patients with cardiovascular-kidney-Metabolic (CKM) syndrome remains unclear. We hypothesized that elevated UA increases mortality nonlinearly and is partly mediated by vitamin D. Using NHANES data (2007-2016) from 25,979 adults with CKM stages 0 to 4, we performed Cox regression, threshold analysis, and causal mediation analysis. During a median follow-up of 93.0 months, 2264 all-cause and 689 cardiovascular deaths occurred. A J-shaped relationship existed between UA and mortality. Each 1 mg/dL increase in UA increased fully adjusted risks of all-cause (HR = 1.06, 95% CI: 1.02-1.09) and cardiovascular mortality (HR = 1.11, 95% CI: 1.04-1.18). Thresholds were identified at 6.6 mg/dL and 7.1 mg/dL. Participants aged ≤60 years showed higher all-cause mortality risk (HR = 1.15, 95% CI: 1.06-1.25). Serum 25(OH)D negatively correlated with UA (β = -0.064, P < .00001) and mediated 14.55% of its effect on all-cause mortality. High UA beyond specific thresholds predicts mortality in CKM syndrome, partially mediated by vitamin D. Interventions on UA and vitamin D may improve outcomes.