Association between serum carotenoid concentrations and risk of all-cause and cause-specific mortality in individuals with osteoarthritis

OBJECTIVE: Osteoarthritis (OA) has been a major public health challenge. The role of non-negligible dietary factors in the development of OA and in mortality risk among OA patients is unclear. This study aims to investigate the associations of serum carotenoid levels with mortality in OA patients. METHODS: We analyzed data from 2051 OA patients in NHANES III. Mortality through December 31, 2019, was determined via the National Death Index. We assessed associations between carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lutein/zeaxanthin, lycopene) and mortality using cubic splines and Cox regression. Sensitivity and stratified analyses were performed. RESULTS: Overall, 942 deaths occurred during a median 12.58-year follow-up. Higher quartiles of all carotenoids (except lutein/zeaxanthin) were associated with lower all-cause mortality (hazard ratios and 95% confidence intervals: 0.53 [0.41, 0.67], 0.74 [0.59, 0.95], 0.75 [0.59, 0.96], and 0.66 [0.51, 0.86] for α-carotene, β-carotene, β-cryptoxanthin, and lycopene). BMI modified the relationship between β-carotene and mortality, showing a protective effect with BMI < 30 kg/m. CONCLUSION: Higher serum carotenoid levels are linked to reduced mortality. While suggesting potential benefits, carotenoid supplement use remains questionable due to possible antioxidant interactions and synergistic effects.