Green tea consumption and mortality due to cardiovascular disease, cancer, and all causes in Japan - The Ohsaki Study
Green tea consumption and mortality due to cardiovascular disease, cancer, and all causes in Japan - The Ohsaki Study
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DOI：
10.1001/jama.296.10.1255
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发表时间：
2006-09-13
影响因子：
120.7
通讯作者：
Tsuji, Ichiro
中科院分区：
文献类型：
--
作者：
Kuriyama, Shinichi;Shimazu, Taichi;Tsuji, Ichiro
背景绿茶多酚在体外和动物实验中作为心血管疾病和癌症的化学预防药物已被广泛研究。目的研究绿茶消费与全因和特定原因死亡率之间的关系。设计、设置和参与者大阪国民健康保险队列研究是一项基于人群的前瞻性队列研究，于1994年启动，研究对象为40 530名日本成年人，年龄在40-79岁之间，没有中风、冠心病或癌症的基线病史。对受试者进行了长达11年(1995-2005)的全因死亡率和长达7年(1995-2001)的特定死因死亡率的随访。主要结果衡量因心血管疾病、癌症和所有原因导致的死亡率。结果在11年的随访率(随访率，86.1%)中，4209名参与者死亡，超过7年的随访率(随访率，89.6%)，892名参与者死于心血管疾病，1134名参与者死于癌症。饮用绿茶与各种原因和心血管疾病的死亡率呈负相关。在女性中，与全因死亡率的负相关性更强(与性行为相互作用的P=0.03)。在男性中，每天饮用绿茶少于1杯的男性因各种原因死亡的多变量风险比分别为1.00(参考)、0.93(95%可信区间，0.83~1.05)、0.95(95%可信区间，0.85~1.06)、0.88(95%可信区间，0.79~0.98)、0.88(95%可信区间，0.79~0.98)。女性的相应数据分别为1.00、0.98(95%CI，0.84-1.15)、0.82(95%CI，0.70-0.95)和0.77(95%CI，0.67-0.89)(P<；.001为趋势)。与心血管疾病死亡率成反比与全因死亡率成反比。这种反向关联在女性中也更强(与性互动的P=0.08)。在女性中，在绿茶消费增加的类别中，心血管疾病死亡的多因素风险比分别为1.00、0.84(95%CI，0.63-1.12)、0.69(95%CI，0.52-0.93)和0.69(95%CI，0.53-0.90)(趋势P=0.004)。在心血管疾病死亡率的类型中，观察到与中风死亡率的最强负相关。相反，与最低消费类别相比，所有绿茶类别的癌症死亡风险比从1.00开始没有显著差异。结论绿茶消费与各种原因和心血管疾病的死亡率降低有关，但与癌症死亡率的降低无关。
Context Green tea polyphenols have been extensively studied as cardiovascular disease and cancer chemopreventive agents in vitro and in animal studies. However, the effects of green tea consumption in humans remain unclear.Objective To investigate the associations between green tea consumption and all-cause and cause-specific mortality.Design, Setting, and Participants The Ohsaki National Health Insurance Cohort Study, a population-based, prospective cohort study initiated in 1994 among 40 530 Japanese adults aged 40 to 79 years without history of stroke, coronary heart disease, or cancer at baseline. Participants were followed up for up to 11 years (1995-2005) for all-cause mortality and for up to 7 years (1995-2001) for cause-specific mortality.Main Outcome Measures Mortality due to cardiovascular disease, cancer, and all causes.Results Over 11 years of follow-up (follow-up rate, 86.1%), 4209 participants died, and over 7 years of follow-up (follow-up rate, 89.6%), 892 participants died of cardiovascular disease and 1134 participants died of cancer. Green tea consumption was inversely associated with mortality due to all causes and due to cardiovascular disease. The inverse association with all-cause mortality was stronger in women (P = .03 for interaction with sex). In men, the multivariate hazard ratios of mortality due to all causes associated with different green tea consumption frequencies were 1.00 (reference) for less than 1 cup/d, 0.93 (95% confidence interval [CI], 0.83-1.05) for 1 to 2 cups/d, 0.95 (95% CI, 0.85-1.06) for 3 to 4 cups/d, and 0.88 (95% CI, 0.79-0.98) for 5 or more cups/d, respectively (P = .03 for trend). The corresponding data for women were 1.00, 0.98 (95% CI, 0.84-1.15), 0.82 (95% CI, 0.70-0.95), and 0.77 (95% CI, 0.67-0.89), respectively (P < .001 for trend). The inverse association with cardiovascular disease mortality was stronger than that with all-cause mortality. This inverse association was also stronger in women (P = .08 for interaction with sex). In women, the multivariate hazard ratios of cardiovascular disease mortality across increasing green tea consumption categories were 1.00, 0.84 (95% CI, 0.63-1.12), 0.69 (95% CI, 0.52-0.93), and 0.69 ( 95% CI, 0.53-0.90), respectively (P = .004 for trend). Among the types of cardiovascular disease mortality, the strongest inverse association was observed for stroke mortality. In contrast, the hazard ratios of cancer mortality were not significantly different from 1.00 in all green tea categories compared with the lowest-consumption category.Conclusion Green tea consumption is associated with reduced mortality due to all causes and due to cardiovascular disease but not with reduced mortality due to cancer.