AbstractAnthocyanins, as a type of polyphenolic compound, have been discovered to offer multiple health benefits to humans, including anti-aging and anti-inflammatory properties. This prospective cohort study aims to examine the relationship of dietary intake of anthocyanin with all-cause mortality and cardiovascular diseases mortality in the US.

摘要花青素作为一种多酚化合物，已被发现可为人类提供多种健康益处，包括抗衰老和抗炎特性。这项前瞻性队列研究旨在研究美国饮食中花青素摄入量与全因死亡率和心血管疾病死亡率的关系。

The aim of this research was to explore the possible correlation between anthocyanin consumption and the mortality rate from all causes as well as from cardiovascular disease. Based on the Public Access NHANES-linked National Death Index files up to December 31, 2019, we identified mortality status and heart disease-specific causes of death.

这项研究的目的是探索花青素消耗与各种原因以及心血管疾病死亡率之间的可能相关性。根据截至2019年12月31日与NHANES相关的国家死亡指数文件，我们确定了死亡率状况和心脏病特定死亡原因。

A multivariate Cox regression analysis was employed to evaluate the effects of anthocyanin intake on mortality outcomes, generating hazard ratios and 95% confidence intervals, adjusting for various demographic characteristics, lifestyle factors, and comorbid conditions. Additionally, we utilized Kaplan-Meier survival curves, subgroup analyses.

采用多变量Cox回归分析来评估花青素摄入对死亡率结果的影响，产生危险比和95%置信区间，并根据各种人口统计学特征，生活方式因素和合并症进行调整。此外，我们利用Kaplan-Meier生存曲线，亚组分析。

In different scenarios, dietary anthocyanin intake was assessed using restricted cubic spline models. A total of 11,959 participants completed the final cohort, averaging 47.12 years of age (SD ± 0.35). Following adjustments for multiple variables, an inverse relationship was identified between anthocyanin intake in the highest quartile and all causes mortality, yielding a hazard ratio (HR) of 0.68 (95% CI: 0.52–0.89).

在不同的情况下，使用限制性三次样条模型评估膳食花青素摄入量。共有11959名参与者完成了最终队列研究，平均年龄为47.12岁（标准差±0.35）。在对多个变量进行调整后，发现最高四分位数的花青素摄入量与全因死亡率呈反比关系，风险比（HR）为0.68（95%CI:0.52-0.89）。

Similarly, elevated anthocyanin consumption was linked to a reduction in heart disease mortality, with HR of 0.61 (95% CI: 0.38–0.97). Additionally, dose–response curve revealed a consistent decrease in both all-cause and cardiovascular mortality with increasing anthocyanin intake. Further subgroup analyses revealed that elevated intake.

同样，花青素消耗量的增加与心脏病死亡率的降低有关，HR为0.61（95%CI:0.38-0.97）。此外，剂量-反应曲线显示，随着花青素摄入量的增加，全因死亡率和心血管死亡率均持续下降。进一步的亚组分析显示摄入量增加。

IntroductionAs a category of polyphenolic substances extensively distributed in berries and pigmented flora1,2, anthocyanins have garnered long-standing acknowledgment for their abilities in counteracting aging3, inflammation4, cancer5,6, and safeguarding neural tissues7,8. Amidst the prevalent accessibility of calorie-rich foods and the escalating consumption of processed foodstuffs, the weight of diet-related ailments like diabetes, hypertension, and cardiovascular disorders is amplifying9,10,11.

引言作为一类广泛分布于浆果和色素花中的多酚物质，花青素因其抵抗衰老3，炎症4，癌症5,6和保护神经组织7,8的能力而获得了长期的认可。随着高热量食物的普遍可及性和加工食品的消费量不断增加，与饮食相关的疾病（如糖尿病，高血压和心血管疾病）的重量正在增加9,10,11。

Anthocyanins, as non-essential elements inherent in fresh edibles, hold potential in diminishing the pervasiveness of chronic illnesses.In the realm of anthocyanin classification, six principal subtypes—cyanidin, delphinidin, pelargonidin, petunidin, malvidin, and peonidin—are recognized as representative of the majority of anthocyanins found in plants.

花青素是新鲜食物中固有的非必需元素，具有减少慢性疾病扩散的潜力。在花青素分类领域，六种主要亚型花青素，飞燕草素，天竺葵素，矮牵牛素，malvidin和芍药素被认为是植物中发现的大多数花青素的代表。

Numerous epidemiological investigations and clinical experiments have indicated that these anthocyanins and their subtypes possess significant efficacy in preventing malignant tumors12,13, diabetes mellitus14,15, cardiovascular disease16,17, and other critical illnesses. Fresh foods abundant in anthocyanins, such as blueberries18, mulberries19, and cherries20, have been shown to confer diverse health benefits across multiple human physiological systems.Although the consensus acknowledges the positive impact of anthocyanins on cardiac function and cardiovascular health, primarily through the stimulation of nitric oxide (NO) release or the neutralization of reactive oxygen species (ROS), there remains a lack of prospective studies on the long-term health effect pertaining to quantitative anthocyanin intake.

大量流行病学调查和临床实验表明，这些花青素及其亚型在预防恶性肿瘤12,13，糖尿病14,15，心血管疾病16,17和其他严重疾病方面具有显着功效。富含花青素的新鲜食物，如蓝莓18，桑椹19和樱桃20，已被证明可以在多种人体生理系统中赋予多种健康益处。虽然共识承认花青素对心脏功能和心血管健康的积极影响，主要是通过刺激一氧化氮（NO）释放或中和活性氧（ROS），但仍然缺乏关于长期健康的前瞻性研究与定量花青素摄入有关。

Prior investigations have put the spotlight on the outcomes of specific plant-based foods in mitigating cardiovascular dise.

先前的调查将重点放在特定植物性食品在缓解心血管疾病方面的结果上。

Data availability

数据可用性

Publicly available datasets were analyzed in this study. These data can be found here: https://www.cdc.gov/nchs/nhanes/index.htm. And the datasets have analysed during the current study are available from the corresponding author on reasonable request.

本研究分析了公开可用的数据集。这些数据可以在这里找到：https://www.cdc.gov/nchs/nhanes/index.htm.并且在当前研究期间分析的数据集可以根据合理的要求从通讯作者那里获得。

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Download referencesAcknowledgementsThanks to Zhang Jing (Second Department of Infectious Disease, Shanghai Fifth People’s Hospital, Fudan University) for his work on the NHANES database. His outstanding work, nhanesR package and webpage, makes it easier for us to explore NHANES database.FundingJ.L.

下载参考文献致谢感谢张静（复旦大学上海市第五人民医院传染病二科）在NHANES数据库上的工作。他出色的工作，nhanesR软件包和网页，使我们更容易探索NHANES数据库。基金J。L。

received support from the Guangdong Medical Science and Technology Research Fund, grant number: A2019319.Author informationAuthors and AffiliationsDepartment of Urology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, ChinaYifei Yan & Jianchang LiAuthorsYifei YanView author publicationsYou can also search for this author in.

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PubMed Google ScholarJianchang LiView author publicationsYou can also search for this author in

PubMed谷歌学者建昌LiView作者出版物您也可以在

PubMed Google ScholarContributionsJ.L. and Y.Y.; methodology, J.L. and Y.Y.; software, J.L. and Y.Y.; validation, J.L. and Y.Y.; formal analysis, Y.Y.; resources, Y.Y.; data curation, Y.Y.; original draft preparation, Y.Y.; paper review and editing, J.L. and Y.Y.; visualization, Y.Y.; supervision, J.L.; project administration, J.L.; funding acquisition, J.L.

PubMed谷歌学术贡献。五十、 和Y.Y。；方法论，J.L.和Y.Y。；软件，J.L.和Y.Y。；验证，J.L.和Y.Y。；形式分析，Y.Y。；。；数据管理，Y.Y。；原稿准备，Y.Y。；论文评论和编辑，J.L.和Y.Y。；可视化，Y.Y。；监督，J.L。；项目管理，J.L。；资金收购，J.L。

All authors have read and agreed to the published version of the manuscript.Corresponding authorCorrespondence to.

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This study was performed using public data from the National Center for Health Statistics and the National Health and Nutrition Examination Survey (NHANES). Prior to enrollment, all participants furnished informed consent. The study requires no further approval and follows ethical guidelines.

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Reprints and permissionsAbout this articleCite this articleYan, Y., Li, J. Association of dietary anthocyanidins intake with all-cause mortality and cardiovascular diseases mortality in USA adults: a prospective cohort study.

转载和许可本文引用本文Yan，Y.，Li，J。膳食花青素摄入量与美国成年人全因死亡率和心血管疾病死亡率的关系：一项前瞻性队列研究。

Sci Rep 14, 26595 (2024). https://doi.org/10.1038/s41598-024-76805-zDownload citationReceived: 05 June 2024Accepted: 16 October 2024Published: 04 November 2024DOI: https://doi.org/10.1038/s41598-024-76805-zShare this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

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KeywordsAnthocyanidinsMortalityDietary intakeNHANESCardiovascular diseases mortality

关键词Santhocyanidismortalitydietary intakeNHANESCardiovascular diseases死亡率