Serum Vitamin C Concentration Was Inversely Associated With Subsequent 20-Year Incidence of Stroke in a Japanese Rural Community: The Shibata Study
Serum Vitamin C Concentration Was Inversely Associated With Subsequent 20-Year Incidence of Stroke in a Japanese Rural Community: The Shibata Study
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日本农村社区的血清维生素 C 浓度与随后 20 年的中风发病率呈负相关：柴田研究
作者：
T. Yokoyama;C. Date;Y. Kokubo;N. Yoshiike;Y. Matsumura;Heizo Tanaka
背景和目的流行病学证据表明维生素C可以降低中风的风险。本研究的目的是检查血清维生素C浓度与随后的中风发病率的关系。方法在日本农村社区，一个队列的880名男性和1241名女性，年龄40岁以上，最初没有中风，于1977年进行了检查，并随访至1997年。基线检查包括血清维生素C浓度的测量。通过每年的随访检查和登记确定卒中的发生率。结果在20年的观察期内，记录了196例脑卒中事件，其中脑梗死109例，出血性脑卒中54例。观察到血清维生素C浓度与所有中风之间存在强负相关性。（与第一四分位数相比，第二四分位数的性别和年龄校正风险比分别为0.93、0.72和0.59;趋势P =0.002），脑梗死（0.71、0.59和0.51;趋势P =0.015）和出血性卒中（0.89、0.75和0.45;趋势P =0.013）。对血压、血清总胆固醇、体重指数、体力活动、吸烟、饮酒、抗高血压药物、房颤和缺血性心脏病史的额外调整并没有明显减弱这些相关性。结论血清维生素C浓度与脑卒中发病率呈负相关。这种关系在脑梗死和出血性卒中中均具有显著性。可能需要额外的机制假说来解释我们的发现。
Background and Purpose Epidemiological evidence suggests that vitamin C may decrease the risk of stroke. The purpose of the present study was to examine the association of serum vitamin C concentration with the subsequent incidence of stroke. Methods In a Japanese rural community, a cohort of 880 men and 1241 women aged 40 years and older who were initially free of stroke was examined in 1977 and followed until 1997. The baseline examination included a measurement of serum vitamin C concentration. The incidence of stroke was determined by annual follow-up examinations and registry. Results During the 20-year observation period, 196 incident cases of all stroke, including 109 cerebral infarctions and 54 hemorrhagic strokes, were documented. Strong inverse associations were observed between serum vitamin C concentration and all stroke (sex- and age-adjusted hazard ratios were 0.93, 0.72, and 0.59, respectively, for the second, third, and fourth quartiles compared with the first quartile;P for trend=0.002), cerebral infarction (0.71, 0.59, and 0.51;P for trend=0.015), and hemorrhagic stroke (0.89, 0.75, and 0.45;P for trend=0.013). Additional adjustments for blood pressure, serum total cholesterol, body mass index, physical activity, smoking, alcohol drinking, antihypertensive medication, atrial fibrillation, and history of ischemic heart disease did not attenuate these associations markedly. Conclusions Serum vitamin C concentration was inversely related to the subsequent incidence of stroke. This relationship was significant for both cerebral infarction and hemorrhagic stroke. Additional mechanistic hypotheses may be required to explain our findings.
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