Vitamin E consumption and the risk of coronary disease in women.
Vitamin E consumption and the risk of coronary disease in women.
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DOI：
10.1097/00006205-199307000-00001
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发表时间：
1993-05
期刊：
影响因子：
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通讯作者：
M. Stampfer;C. Hennekens;J. Manson;G. Colditz;B. Rosner;W. Willett
中科院分区：
文献类型：
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作者：
M. Stampfer;C. Hennekens;J. Manson;G. Colditz;B. Rosner;W. Willett
随着氧化低密度脂蛋白可能参与动脉粥样硬化形成的认识，人们对抗氧化剂维生素E作为一种可能的预防冠心病的营养素的兴趣越来越大。方法：1980年，87,245名年龄在34 ~ 59岁之间的女性护士，没有被诊断出心血管疾病和癌症，完成了饮食问卷调查，评估了她们对各种营养素的摄入，包括维生素E。在长达8年（679，485人年）的随访中，完成了97%，我们记录了552例严重冠状动脉疾病（437例非致命性心肌梗死和115例因冠状动脉疾病死亡）。结果：与队列中维生素E摄入量最低的五分之一女性相比，在调整年龄和吸烟后，摄入量最高的五分之一女性患主要冠心病的相对风险为0.66（95%置信区间为0.50至0.87）。进一步调整各种其他冠状动脉风险因素和营养素，包括其他抗氧化剂，对结果几乎没有影响。大多数摄入量的变化和风险的降低可归因于作为补充剂摄入的维生素E。短期服用维生素E补充剂的女性几乎没有明显的益处，但那些服用两年以上的女性在调整年龄，吸烟状况，冠心病风险因素和使用其他抗氧化营养素（包括多种维生素）后，患主要冠心病的相对风险为0.59（95%置信区间，0.38至0.91）。结论：尽管这些前瞻性数据并不能证明两者之间存在因果关系，但它们表明，在中年女性中，维生素E补充剂的使用与冠心病风险降低有关。正在进行维生素E在冠心病初级和二级预防中的随机试验;关于广泛使用维生素E的公共政策建议应等待这些试验的结果。
BACKGROUND Interest in the antioxidant vitamin E as a possible protective nutrient against coronary disease has intensified with the recognition that oxidized low-density lipoprotein may be involved in atherogenesis. METHODS In 1980, 87,245 female nurses 34 to 59 years of age who were free of diagnosed cardiovascular disease and cancer completed dietary questionnaires that assessed their consumption of a wide range of nutrients, including vitamin E. During follow-up of up to eight years (679,485 person-years) that was 97 percent complete, we documented 552 cases of major coronary disease (437 nonfatal myocardial infarctions and 115 deaths due to coronary disease). RESULTS As compared with women in the lowest fifth of the cohort with respect to vitamin E intake, those in the top fifth had a relative risk of major coronary disease of 0.66 (95 percent confidence interval, 0.50 to 0.87) after adjustment for age and smoking. Further adjustment for a variety of other coronary risk factors and nutrients, including other antioxidants, had little effect on the results. Most of the variability in intake and reduction in risk was attributable to vitamin E consumed as supplements. Women who took vitamin E supplements for short periods had little apparent benefit, but those who took them for more than two years had a relative risk of major coronary disease of 0.59 (95 percent confidence interval, 0.38 to 0.91) after adjustment for age, smoking status, risk factors for coronary disease, and use of other antioxidant nutrients (including multi-vitamins). CONCLUSIONS Although these prospective data do not prove a cause-and-effect relation, they suggest that among middle-aged women the use of vitamin E supplements is associated with a reduced risk of coronary heart disease. Randomized trials of vitamin E in the primary and secondary prevention of coronary disease are being conducted; public policy recommendations about the widespread use of vitamin E should await the results of these trials.