What question did this study set out to answer?

To investigate the relationship between vitamin B6 metabolism and age-related macular degeneration (AMD).

July 26, 2026Open Access

Association between vitamin B6 metabolism and the prevalence of age-related macular degeneration: A cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES)

MTMingxia TangNanjing University of Chinese Medicine SSShuai SunAnhui Medical University YLYu LiuNantong University

Key Points

To investigate the relationship between vitamin B6 metabolism and age-related macular degeneration (AMD).
Cross-sectional analysis of NHANES data (2005-2008) with participants aged ≥ 40 years
Evaluated vitamin B6 status using PLP and 4-PA serum levels
Performed weighted logistic regression to assess associations with AMD prevalence.
High PLP levels (Q4) associated with lower odds of AMD (OR 0.69; 95% CI [0.48–0.97])
High 4-PA/PLP levels (Q3 and Q4) related to increased odds of AMD (OR 1.57 and 2.00; 95% CI [1.07–2.29] and [1.35–2.96])
Significant associations of vitamin B6 levels with AMD prevalence were observed in individuals aged ≥ 65 years.

Abstract

B vitamins may be involved in the development of age-related macular degeneration (AMD). This investigation intended to examine the association between vitamin B6 catabolic status and the prevalence of AMD. Individuals ≥ 40 years old in the 2005 to 2008 National Health and Nutrition Examination Survey who had complete vitamin B6 measurement and AMD diagnostic data were included in this cross-sectional study. The catabolic status of vitamin B6 was evaluated using serum levels of pyridoxal 5’-phosphate (PLP) (the active form) and its metabolite 4-pyridoxic acid (4-PA). The analysis of 4-PA, PLP, and the 4-PA to PLP ratio (4-PA/PLP) used continuous variables and quartiles (Q1–Q4). The associations of 4-PA, PLP, and 4-PA/PLP with the prevalence of AMD were evaluated via weighted logistic regression, with odds ratio (OR) and 95% confidence interval (CI) estimates provided. Nonlinear relationships were explored utilizing restricted cubic splines. Of these 4202 included individuals, 549 were diagnosed with AMD and 3653 were non-AMD patients. High PLP levels (Q4 ≥ 55.475 nmol/L vs Q1: OR 95% CI = 0.69 0.48–0.97) were significantly associated with lower odds of AMD, whereas high 4-PA/PLP levels (Q3 0.668–0.976: OR 95% CI = 1.57 1.07–2.29; Q4 ≥ 0.976: OR 95% CI = 2.00 1.35–2.96) were related to higher odds of AMD. The associations of PLP levels (Q4: OR 95% CI = 0.49 0.32–0.76) and 4-PA/PLP levels (Q4: OR 95% CI = 2.18 1.27–3.75) with the prevalence of AMD were observed only in individuals aged ≥ 65 years and not in those aged .05). The restricted cubic splines curves demonstrated that the nonlinear relationships of 4-PA ( P overall = .002; P non-linear = .730) and PLP ( P overall < .001; P non-linear = .791) with the prevalence of AMD were not significant, whereas the levels of 4-PA/PLP ( P overall < .001; P non-linear < .001) had a significant nonlinear association with the prevalence of AMD. High 4-PA/PLP levels showed an association with high odds of AMD, suggesting that vitamin B6 catabolic status may influence the prevalence of AMD.

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