VITAMIN-E CONSUMPTION AND THE RISK OF CORONARY HEART-DISEASE IN MEN
VITAMIN-E CONSUMPTION AND THE RISK OF CORONARY HEART-DISEASE IN MEN
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DOI：
10.1056/nejm199305203282004
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发表时间：
1993-05-20
影响因子：
158.5
通讯作者：
WILLETT, WC
中科院分区：
文献类型：
--
作者：
RIMM, EB;STAMPFER, MJ;WILLETT, WC
背景资料。低密度脂蛋白的氧化修饰增加了它们与动脉内膜的结合，这是动脉粥样硬化形成的关键步骤。虽然饮食中的抗氧化剂，如维生素C、胡萝卜素和维生素E，已经被假设可以预防冠心病，但前瞻性的流行病学数据很少。1986年，39,910名年龄在40岁至75岁之间的美国男性健康专业人员完成了详细的饮食问卷，评估了他们除其他营养素外的日常维生素C、胡萝卜素和维生素E的摄入量。在四年的随访中，我们记录了667例冠状动脉疾病。在控制了年龄和几个冠状动脉危险因素后，我们观察到维生素E摄入量较高的男性患冠心病的风险较低(趋势P=0.003)。对于每天摄入维生素E超过60IU的男性，与每天摄入低于7.5IU的男性相比，多变量相对风险为0.64(95%可信区间，0.49至0.83)。与没有服用维生素E补充剂的男性相比，在至少两年内每天至少服用100IU的男性患冠心病的多变量相对风险为0.63(95%可信区间为0.47至0.84)。在从不吸烟的人中，胡萝卜素摄入量与较低的冠状动脉疾病风险无关，但与当前吸烟者(相对风险为0.30；95%可信区间为0.11至0.82)和曾经吸烟者(相对风险为0.60；95%可信区间为0.38至0.94)的风险呈负相关。相反，维生素C的高摄入量与较低的冠状动脉疾病风险无关。这些数据没有证明因果关系，但它们提供了证据，表明男性摄入大量维生素E与较低的冠心病风险之间存在关联。有关使用维生素E补充剂的公共政策建议应等待更多研究的结果。
Background. The oxidative modification of low-density lipoproteins increases their incorporation into the arterial intima, an essential step in atherogenesis. Although dietary antioxidants, such as vitamin C, carotene, and vitamin E, have been hypothesized to prevent coronary heart disease, prospective epidemiologic data are sparse.Methods. In 1986, 39,910 U.S. male health professionals 40 to 75 years of age who were free of diagnosed coronary heart disease, diabetes, and hypercholesterolemia completed detailed dietary questionnaires that assessed their usual intake of vitamin C, carotene, and vitamin E in addition to other nutrients. During four years of follow-up, we documented 667 cases of coronary disease.Results. After controlling for age and several coronary risk factors, we observed a lower risk of coronary disease among men with higher intakes of vitamin E (P for trend = 0.003). For men consuming more than 60 IU per day of vitamin E, the multivariate relative risk was 0.64 (95 percent confidence interval, 0.49 to 0.83) as compared with those consuming less than 7.5 IU per day. As compared with men who did not take vitamin E supplements, men who took at least 100 IU per day for at least two years had a multivariate relative risk of coronary disease of 0.63 (95 percent confidence interval, 0.47 to 0.84). Carotene intake was not associated with a lower risk of coronary disease among those who had never smoked, but it was inversely associated with the risk among current smokers (relative risk, 0.30; 95 percent confidence interval, 0.11 to 0.82) and former smokers (relative risk, 0.60; 95 percent confidence interval, 0.38 to 0.94). In contrast, a high intake of vitamin C was not associated with a lower risk of coronary disease.Conclusions. These data do not prove a causal relation, but they provide evidence of an association between a high intake of vitamin E and a lower risk of coronary heart disease in men. Public policy recommendations with regard to the use of vitamin E supplements should await the results of additional studies.