Abstract
BACKGROUND: The relationship between cardiovascular outcomes and niacin consumption levels remains unclear. This study aimed to examine the correlation between niacin intake and the incidence of cardiovascular disease, as well as the mortality rates associated with cardiovascular disease and other causes. METHODS: From 2003 to 2018, we continually investigated updated information from the National Health and Nutrition Examination Survey. Based on the quartiles of niacin intake levels, four distinct categories of participants were established: Q1 (<14.646 mg), Q2 (14.646-21.302 mg), Q3 (21.302-30.401 mg), and Q4 (>30.401 mg). Baseline variable differences were assessed employing the Chi-Square and Student's t-tests. A weighted logistic regression with multiple variables was used to determine the association between niacin intake and cardiovascular disease prevalence. Hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause death and cardiovascular disease were determined utilising hazard regression models. Kaplan-Meier curves were used to compare survival probability between the high and low niacin intake groups, and dose-response linear relationships were evaluated with restricted cubic splines. RESULTS: The cohort analysis included 80,312 participants for the assessment of niacin intake. Comparing the Q1 dataset to the Q4 dataset in the overall population, weighted Cox regression analysis showed a negative association with all-cause mortality (95% CI: 0.71-0.96, HR: 0.82) and mortality owing to cardiovascular disease (95% CI: 0.67-0.96, odds ratio (OR): 0.80). Sex-based subgroup analysis revealed a detrimental correlation between niacin use and overall mortality in females (Q4 cohort: 95% CI: 0.62-0.97, HR: 0.78) but not in males. Additionally, the Q3 (95% CI: 0.59-0.94, HR: 0.75) and Q4 (95% CI: 0.51-0.97, HR: 0.7) groups exhibited a negative association with female cardiovascular disease mortality compared to the Q1 group. Niacin intake was not significantly correlated with prevalence, all-cause mortality, or death from cardiovascular disease in males. CONCLUSIONS: Higher niacin consumption was correlated with a decreased risk of cardiovascular disease and death from all causes across the entire study population. Nevertheless, only females, and not males, exhibited a beneficial effect on mortality.