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The Serum Osmolality Was Nonlinearly Associated with the Risk of All-Cause and Cardiovascular Mortality

16 Pages Posted: 13 Sep 2022

See all articles by Yihai Liu

Yihai Liu

Nanjing University - Department of Cardiology

Mingyue Wu

Nanjing University - Department of Cardiology

Jiayi Si

Nanjing University - Department of Cardiology

Lina Kang

Nanjing University - Department of Cardiology

Biao Xu

Nanjing University - Department of Cardiology

More...

Abstract

Objective: This study aimed to evaluate the relationship between both low and high osmolarity and the risk of all-cause and cause-specific mortality in a large general population.

Methods: All participants were included from the National Health and Nutrition Examination Survey 1999-2014. Baseline serum osmolality was determined from laboratory tests and cause of death from national death records. Hazard ratios (HR) and 95% confidence intervals (CI) for all-cause mortality and cause-specific mortality were estimated using Cox proportional regression analysis. The nonlinear relationship was explored using restricted cubic splines regression.

Results: Among 40,679 individuals, 5029 (12.4%) died during a total of 3.26 thousand person-years of follow-up. Compared with the reference category (279~282 mmol/kg), the multivariable-adjusted HRs and 95% CIs for all-cause mortality were 1.27 (1.16-1.40; P<0.001) in the lowest osmolality category (<201 mmol/kg) and 1.18 (1.09-1.28; P<0.001) in the highest osmolality category (>323 mmol/kg). Restricted cubic splines results showed that serum levels of osmolality had a U-shaped association with the risk of all-cause mortality, L-shaped relation with the risk of cardiovascular death, while a reverse J-shaped relationship with the risk of cancer death.

Conclusions: Both low and high osmolality were predictive of increased all-cause mortality, supporting a U-shaped relationship. While serum osmolality was L-shaped related with the risk of cardiovascular death, and reverse J-shaped related with the risk of cancer death.

Funding Information: None.

Declaration of Interests: The authors have nothing to disclose regarding conflict of interest with respect to this manuscript.

Ethics Approval Statement: The protocol was approved by the Institutional Review Board of National Center for Health Statistics and no new data was added.

Keywords: osmolarity, all-cause mortality, cardiovascular mortality, cancer mortality, NHANES

Suggested Citation

Liu, Yihai and Wu, Mingyue and Si, Jiayi and Kang, Lina and Xu, Biao, The Serum Osmolality Was Nonlinearly Associated with the Risk of All-Cause and Cardiovascular Mortality. Available at SSRN: https://ssrn.com/abstract=4217730 or http://dx.doi.org/10.2139/ssrn.4217730

Yihai Liu

Nanjing University - Department of Cardiology

Mingyue Wu

Nanjing University - Department of Cardiology ( email )

Jiayi Si

Nanjing University - Department of Cardiology ( email )

Lina Kang

Nanjing University - Department of Cardiology ( email )

Nanjing
China

Biao Xu (Contact Author)

Nanjing University - Department of Cardiology ( email )

Nanjing
China