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Epidemiology
Associations of regular glucosamine use with all-cause and cause-specific mortality: a large prospective cohort study
  1. Zhi-Hao Li1,
  2. Xiang Gao2,
  3. Vincent CH Chung3,
  4. Wen-Fang Zhong1,
  5. Qi Fu3,
  6. Yue-Bin Lv4,
  7. Zheng-He Wang1,
  8. Dong Shen1,
  9. Xi-Ru Zhang1,
  10. Pei-Dong Zhang1,
  11. Fu-Rong Li1,
  12. Qing-Mei Huang1,
  13. Qing Chen1,
  14. Wei-Qi Song1,
  15. Xian-Bo Wu1,
  16. Xiao-Ming Shi4,
  17. Virginia Byers Kraus5,
  18. Xingfen Yang6,
  19. Chen Mao1
  1. 1 Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
  2. 2 Department of Nutritional Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA
  3. 3 Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
  4. 4 National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
  5. 5 Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
  6. 6 Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, China
  1. Correspondence to Professor Chen Mao, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China; maochen9{at}smu.edu.cn; Professor Xingfen Yang, Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, China; yangalice79{at}smu.edu.cn; Professor Virginia Byers Kraus, Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; vbk{at}duke.edu

Abstract

Objectives To evaluate the associations of regular glucosamine use with all-cause and cause-specific mortality in a large prospective cohort.

Methods This population-based prospective cohort study included 495 077 women and men (mean (SD) age, 56.6 (8.1) years) from the UK Biobank study. Participants were recruited from 2006 to 2010 and were followed up through 2018. We evaluated all-cause mortality and mortality due to cardiovascular disease (CVD), cancer, respiratory and digestive disease. HRs and 95% CIs for all-cause and cause-specific mortality were calculated using Cox proportional hazards models with adjustment for potential confounding variables.

Results At baseline, 19.1% of the participants reported regular use of glucosamine supplements. During a median follow-up of 8.9 years (IQR 8.3–9.7 years), 19 882 all-cause deaths were recorded, including 3802 CVD deaths, 8090 cancer deaths, 3380 respiratory disease deaths and 1061 digestive disease deaths. In multivariable adjusted analyses, the HRs associated with glucosamine use were 0.85 (95% CI 0.82 to 0.89) for all-cause mortality, 0.82 (95% CI 0.74 to 0.90) for CVD mortality, 0.94 (95% CI 0.88 to 0.99) for cancer mortality, 0.73 (95% CI 0.66 to 0.81) for respiratory mortality and 0.74 (95% CI 0.62 to 0.90) for digestive mortality. The inverse associations of glucosamine use with all-cause mortality seemed to be somewhat stronger among current than non-current smokers (p for interaction=0.00080).

Conclusions Regular glucosamine supplementation was associated with lower mortality due to all causes, cancer, CVD, respiratory and digestive diseases.

  • epidemiology
  • cardiovascular disease
  • outcomes research
https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/annrheumdis-2020-217176

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    Footnotes

    • Handling editor Josef S Smolen

    • Contributors CM and Z-HL contributed to the statistical analyses and had primary responsibility for writing the manuscript. CM, XY and VBK directed the study. WFZ, QF, Y-BL, Z-HW, DS, X-RZ, P-DZ, F-RL, Q-MH, QC and W-QS contributed to the data cleaning. CM, XY, VBK, X-MS, XG, VCHC and X-BW. All authors critically reviewed the manuscript for important intellectual content.

    • Funding This work was supported by the National Natural Science Foundation of China (81973109), the Project Supported by Guangdong Province Universities and Colleges Pearl River Scholar Funded Scheme (2019), the National Key Research and Development Program of China (2018YFC2000400), the Construction of High-level University of Guangdong (G619339521 and G618339167) and the National Institutes of Health (NIH)/National Institute on Ageing (NIA) of USA (P30-AG028716).

    • Disclaimer The funders played no role in the study design or implementation; data collection, management, analysis or interpretation; manuscript preparation, review or approval or the decision to submit the manuscript for publication.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

    • Patient consent for publication Not required.

    • Ethics approval The UK Biobank received ethical approval from the research ethics committee (REC reference for UK Biobank 11/NW/0382) and participants provided written informed consent.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available in a public, open access repository. The UK Biobank data are available from the UK Biobank on request (www.ukbiobank.ac.uk/).

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