Still reduced cardiovascular mortality 12 years after supplementation with selenium and coenzyme Q10 for four years: A validation of previous 10-year follow-up results of a prospective randomized double-blind placebo-controlled trial in elderly.
Still reduced cardiovascular mortality 12 years after supplementation with selenium and coenzyme Q10 for four years: A validation of previous 10-year follow-up results of a prospective randomized double-blind placebo-controlled trial in elderly.
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DOI：
10.1371/journal.pone.0193120
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Johansson P
中科院分区：
文献类型：
--
作者：
Alehagen U;Aaseth J;Alexander J;Johansson P
硒和辅酶Q10都是体内最佳细胞功能所必需的。欧洲人硒的摄入量较低，内源性辅酶Q10的产生随着年龄的增长而减少。因此，进行了一项使用硒和辅酶Q10作为膳食补充剂的干预试验，为期四年。主要出版物报道了干预降低心血管死亡率的结果。在本亚研究中，目的是确定在补充人群或患有糖尿病、高血压、缺血性心脏病或由于心功能受损导致的功能容量降低的亚组中，心血管（CV）死亡率降低是否在12年后持续存在。来自瑞典农村自治市的443名健康老年人被纳入研究。所有的心血管死亡率都被记录下来，没有参与者在随访中丢失。根据死亡证明和尸检结果，登记了死亡率。12年后，补充硒和辅酶Q10的患者CV死亡率显著降低，积极治疗组的CV死亡率为28.1%，安慰剂组为38.7%。多因素Cox回归分析显示，积极治疗组的CV死亡风险降低（HR: 0.59; 95%CI: 0.42-0.81; P = 0.001）。在那些患有缺血性心脏病、糖尿病、高血压和功能受损的患者中，我们证明了心血管死亡风险显著降低。这是对一组健康的老年参与者进行了为期12年的随访，他们补充了硒和辅酶Q10四年。即使在12年后，我们也观察到该组以及糖尿病、高血压、缺血性心脏病或功能受损患者亚组中心血管死亡率的风险显著降低。因此，结果验证了在10年评估中获得的结果。这种保护作用并不局限于干预期，而是在随访期间持续存在。尽管之前已经发现了对心功能、氧化应激、纤维化和炎症的各种影响，但这种作用背后的机制仍有待完全阐明。由于这是一项小型研究，因此观察结果应被视为假设生成。Clinicaltrials.gov NCT01443780。
Selenium and coenzyme Q10 are both necessary for optimal cell function in the body. The intake of selenium is low in Europe, and the endogenous production of coenzyme Q10 decreases as age increases. Therefore, an intervention trial using selenium and coenzyme Q10 for four years as a dietary supplement was performed. The main publication reported reduced cardiovascular mortality as a result of the intervention. In the present sub-study the objective was to determine whether reduced cardiovascular (CV) mortality persisted after 12 years, in the supplemented population or in subgroups with diabetes, hypertension, ischemic heart disease or reduced functional capacity due to impaired cardiac function. From a rural municipality in Sweden, four hundred forty-three healthy elderly individuals were included. All cardiovascular mortality was registered, and no participant was lost to the follow-up. Based on death certificates and autopsy results, mortality was registered. After 12 years a significantly reduced CV mortality could be seen in those supplemented with selenium and coenzyme Q10, with a CV mortality of 28.1% in the active treatment group, and 38.7% in the placebo group. A multivariate Cox regression analysis demonstrated a reduced CV mortality risk in the active treatment group (HR: 0.59; 95%CI 0.42–0.81; P = 0.001). In those with ischemic heart disease, diabetes, hypertension and impaired functional capacity we demonstrated a significantly reduced CV mortality risk. This is a 12-year follow-up of a group of healthy elderly participants that were supplemented with selenium and coenzyme Q10 for four years. Even after twelve years we observed a significantly reduced risk for CV mortality in this group, as well as in subgroups of patients with diabetes, hypertension, ischemic heart disease or impaired functional capacity. The results thus validate the results obtained in the 10-year evaluation. The protective action was not confined to the intervention period, but persisted during the follow-up period. The mechanisms behind this effect remain to be fully elucidated, although various effects on cardiac function, oxidative stress, fibrosis and inflammation have previously been identified. Since this was a small study, the observations should be regarded as hypothesis-generating. Clinicaltrials.gov NCT01443780.
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