Full
Outline
To explore the association between serum 25-hydroxyvitamin D [25(OH)D] concentration and the risk of respiratory tract infections(RTIs) in obese populations, analyze the influence of obesity stratification on the relationship between the two, and provide a scientific basis for the infection prevention and control strategies of RTIs in obese populations.
Based on the data of the National Health and Nutrition Examination Survey（NHANES） of the United States from 2009 to 2018,participants over 20 years old were included as the research subjects. The relationship between serum 25(OH)D and the risk of RTIs in obese people was analyzed using multivariable logistic regression, subgroup analysis, restricted cubic spline analysis,and logistic inflection point model.
A total of 21 532 research subjects were finally included (12 989 cases in the non-obese group, 4 629 cases in the grade I obese group, 2 196 cases in the grade II obese group, and 1 718 cases in the grade III obese group), and there were significant differences in baseline characteristics among the groups (P<0.001). The overall prevalence rate of RTIs was 17.5%. Compared with the non-obese group, the serum 25(OH)D levels of obese people at all levels were significantly decreased, and the proportion of serum 25(OH)D deficiency increased with the aggravation of obesity (up to 16.9% in the grade III obese group). Serum 25(OH)D level was a protective factor for reducing the risk of RTIs. However, its protective effect showed a gradient decreasing trend with the increase of obesity degree. Among participants with adequate serum 25(OH)D, the protective effect persisted: grade I obesity group (OR=0.75, 95% CI: 0.62-0.88), grade II obesity group (OR=0.78, 95% CI: 0.70-0.86),and grade III obesity group (OR=0.82, 95% CI: 0.74-0.90). There was a clear threshold effect in the non-obese group (inflection point=29.96 nmol/L), the threshold in the grade I obese group shifted down to 25.97 nmol/L, while the grade II and grade III obese groups showed a linear relationship.
Obese individuals have a deficiency in serum 25(OH)D, which is closely associated with an increased risk of respiratory tract infections. Moreover, the higher the degree of obesity, the more limited the protective effect of serum 25(OH)D. Therefore, stratified joint intervention strategies need to be developed for obese individuals.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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