Vitamin/mineral supplementation and cancer, cardiovascular, and all-cause mortality in a German prospective cohort (EPIC-Heidelberg)
Vitamin/mineral supplementation and cancer, cardiovascular, and all-cause mortality in a German prospective cohort (EPIC-Heidelberg)
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DOI：
10.1007/s00394-011-0224-1
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发表时间：
2012-06-01
影响因子：
5
通讯作者：
Rohrmann, Sabine
中科院分区：
文献类型：
--
作者：
Li, Kuanrong;Kaaks, Rudolf;Rohrmann, Sabine
为了前瞻性地评估维生素/矿物质补充与癌症、心血管疾病和全因死亡率的关系，在1994-1998年招募的欧洲癌症和营养前瞻性调查（EPIC-Heidelberg）的海德堡队列中，23，943名基线时无癌症和心肌梗死/卒中的参与者被纳入分析。在基线和随访期间评估维生素/矿物质补充。考克斯回归模型用于估计风险比（HR）和95%置信区间（CI）。在平均随访11年后，记录了1,101例死亡（癌症死亡= 513例，心血管死亡= 264例）。校正潜在混杂因素后，基线时任何维生素/矿物质补充剂或多种维生素补充剂与癌症、心血管或全因死亡率均无统计学显著相关性。然而，抗氧化剂维生素补充剂的基线使用者癌症死亡率（HR：0.52; 95% CI：0.28，0.97）和全因死亡率（HR：0.58; 95% CI：0.38，0.88）的风险显著降低。与从不服用者相比，在随访期间开始服用维生素/矿物质补充剂的基线非服用者癌症死亡风险显著增加（HR：1.74; 95% CI：1.09，2.77）和全因死亡率（HR：1.58; 95% CI：1.17、2.14）.根据有限的用户和案例，这项队列研究表明，补充抗氧化维生素可能会降低癌症和各种原因的死亡率。在随访期间开始服用补充剂的基线非使用者中，癌症和全因死亡率的风险显著增加，这可能表明存在“患病使用者效应”，研究人员在未来的观察性研究中应谨慎对待。
To prospectively evaluate the association of vitamin/mineral supplementation with cancer, cardiovascular, and all-cause mortality.In the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Heidelberg), which was recruited in 1994-1998, 23,943 participants without pre-existing cancer and myocardial infarction/stroke at baseline were included in the analyses. Vitamin/mineral supplementation was assessed at baseline and during follow-up. Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).After an average follow-up time of 11 years, 1,101 deaths were documented (cancer deaths = 513 and cardiovascular deaths = 264). After adjustment for potential confounders, neither any vitamin/mineral supplementation nor multivitamin supplementation at baseline was statistically significantly associated with cancer, cardiovascular, or all-cause mortality. However, baseline users of antioxidant vitamin supplements had a significantly reduced risk of cancer mortality (HR: 0.52; 95% CI: 0.28, 0.97) and all-cause mortality (HR: 0.58; 95% CI: 0.38, 0.88). In comparison with never users, baseline non-users who started taking vitamin/mineral supplements during follow-up had significantly increased risks of cancer mortality (HR: 1.74; 95% CI: 1.09, 2.77) and all-cause mortality (HR: 1.58; 95% CI: 1.17, 2.14).Based on limited numbers of users and cases, this cohort study suggests that supplementation of antioxidant vitamins might possibly reduce cancer and all-cause mortality. The significantly increased risks of cancer and all-cause mortality among baseline non-users who started taking supplements during follow-up may suggest a "sick-user effect," which researchers should be cautious of in future observational studies.