关于循环类胡萝卜素和死亡风险的流行病学证据仍然相互矛盾，大多数研究都集中在单个类胡萝卜素的影响上。本研究旨在阐明同时暴露于多种血清类胡萝卜素对死亡风险的影响。我们从国家健康和营养检查调查 (NHANES) III (1988-1994) 和 NHANES 2003-2006 中招募了 22,472 名年龄≥20 岁的参与者。测量了五种主要类胡萝卜素（α-胡萝卜素、β-胡萝卜素、番茄红素、β-隐黄质和叶黄素/玉米黄质）的基线血清水平，并对个体进行随访直至 2019 年 12 月 31 日。使用K-均值方法。 Cox 比例风险模型用于调查类胡萝卜素暴露与死亡风险之间的关联。在 16.7 年的中位随访期间，发生了 7,901 例死亡。 K 均值将参与者分为低水平、低番茄红素、高番茄红素和高水平暴露组。在完全调整的模型中，与低水平暴露组相比，低番茄红素、高番茄红素和高水平暴露组的全因死亡风险显着降低，风险比 (HR) 和 95% 置信区间 (CI) ）分别为 0.79（0.72，0.87）、0.75（0.67，0.84）和 0.67（0.61，0.74）。对于心血管疾病死亡率，高番茄红素暴露组的风险降低了 27%（HR：0.73，95% CI：0.61-0.86），高水平暴露组的风险降低了 21%（HR：0.79，95） % CI：0.67-0.93）。对于癌症死亡率，高番茄红素组和高水平暴露组的风险降低了 30% 和 35%，HR（95% CI）分别为 0.70（0.57，0.86）和 0.65（0.54，0.79）。这项研究显示共同暴露于多种血清类胡萝卜素与降低死亡风险相关，这凸显了增加类胡萝卜素摄入量对健康的潜在益处。需要进一步研究以阐明不同类胡萝卜素之间相互作用的潜在机制。版权所有 © 2024 He、Yuan、Liu 和 Wei。

Epidemiological evidence regarding circulating carotenoids and mortality risk remains conflicting, and most studies focus on the impact of individual carotenoids. This study aimed to elucidate the effects of co-exposure to multiple serum carotenoids on mortality risk.We enrolled 22,472 participants aged ≥20 from the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and NHANES 2003-2006. Baseline serum levels of five major carotenoids (α-carotene, β-carotene, lycopene, β-cryptoxanthin, and lutein/zeaxanthin) were measured, and individuals were followed up until December 31, 2019. Carotenoid co-exposure patterns were identified using the K-means method. Cox proportional hazard models were used to investigate the associations between carotenoid exposure and mortality risk.During a median follow-up of 16.7 years, 7,901 deaths occurred. K-means clustered participants into low-level, low-lycopene, high-lycopene, and high-level exposure groups. In the fully adjusted model, low-lycopene, high-lycopene, and high-level exposure groups had significantly lower all-cause mortality risks compared to the low-level exposure group, with hazard ratios (HRs) and 95% confidence intervals (CIs) of 0.79 (0.72, 0.87), 0.75 (0.67, 0.84), and 0.67 (0.61, 0.74), respectively. For cardiovascular disease mortality, the high-lycopene exposure group had a 27% reduced risk (HR: 0.73, 95% CI: 0.61-0.86), and the high-level exposure group had a 21% reduced risk (HR: 0.79, 95% CI: 0.67-0.93). For cancer mortality, the high-lycopene and high-level exposure groups had 30% and 35% lower risks, with HRs (95% CIs) of 0.70 (0.57, 0.86) and 0.65 (0.54, 0.79), respectively.This study revealed that co-exposure to multiple serum carotenoids was associated with reduced mortality risk, highlighting the potential health benefits of increased carotenoid intake. Further investigation is warranted to elucidate the underlying mechanisms of interactions among different carotenoids.Copyright © 2024 He, Yuan, Liu and Wei.