Vitamin E supplement use and the incidence of cardiovascular disease and all-cause mortality in the Framingham Heart Study: Does the underlying health status play a role?
Vitamin E supplement use and the incidence of cardiovascular disease and all-cause mortality in the Framingham Heart Study: Does the underlying health status play a role?
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DOI：
10.1016/j.atherosclerosis.2008.12.019
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发表时间：
2009-08
期刊：
影响因子：
5.3
通讯作者：
Vasan, R. S.
中科院分区：
文献类型：
--
作者：
Dietrich, M.;Jacques, P. F.;Pencina, M. J.;Lanier, K.;Keyes, M. J.;Kaur, G.;Wolf, P. A.;D'Agostino, R. B.;Vasan, R. S.
关键词：
观察性研究普遍表明补充维生素E摄入量与心血管疾病（CVD）风险之间存在有益联系，而干预试验报告了维生素E补充剂的不利影响。我们假设这些不一致的发现是由于观察性和干预性研究中研究参与者的潜在健康状况不同造成的。确定补充维生素E摄入量与心血管疾病和全因死亡率（ACM）之间的关系是否取决于是否存在心血管疾病。4270名Framingham研究参与者按基线CVD状态分层，通过比例风险回归将补充维生素E摄入量与CVD和ACM的10年发病率联系起来。11%的参与者在基线时服用维生素E补充剂。在已有心血管疾病的参与者中，维生素E补充剂使用者中分别有28例（44%）和20例（32%）心血管疾病和ACM事件，而非使用者中分别有249例（47%）和202例（38%）（CVD HR, 0.90; 95% CL, 0.60-1.32; ACM HR, 0.74; 95% CL, 0.46-1.17）。在没有心血管疾病的参与者中，维生素E补充组有51例（13%）和47例（12%）心血管疾病和ACM病例，而非维生素E补充组分别有428例（13%）和342例（10%）（CVD HR, 1.00; 95% CL, 0.75-1.34; ACM HR 1.20; 95% CL, 0.89-1.64）。在这项以社区为基础的大型研究中，CVD状态对补充维生素E摄入量与CVD和ACM风险之间的关联没有明显影响。需要进一步的研究来澄清补充维生素E摄入的干预研究和观察研究之间差异结果的基础。
Observational studies generally showed beneficial associations between supplemental vitamin E intake and cardiovascular disease (CVD) risk whereas intervention trials reported adverse effects of vitamin E supplements. We hypothesize that these discordant findings result from differing underlying health status of study participants in observational and intervention studies. Determine if the relation between supplemental vitamin E intake and CVD and all-cause mortality (ACM) depends on pre-existing CVD. Proportional hazards regression to relate supplemental vitamin E intake to the 10-year incidence of CVD and ACM in 4,270 Framingham Study participants stratified by baseline CVD status. Eleven percent of participants used vitamin E supplements at baseline. In participants with pre-existing CVD, there were 28 (44%) and 20 (32%) incident cases of CVD and ACM in the vitamin E supplement users versus 249 (47%) and 202 (38%) in the non-users, respectively (CVD HR, 0.90; 95% CL, 0.60–1.32; ACM HR, 0.74; 95% CL, 0.46–1.17). In participants without pre-existing CVD, there were 51 (13%) and 47 (12%) cases of CVD and ACM in the vitamin E supplement group versus 428 (13%) and 342 (10%) in the non-vitamin E supplement group, respectively (CVD HR, 1.00; 95% CL, 0.75–1.34; ACM HR 1.20; 95% CL, 0.89–1.64). CVD status has no apparent influence on the association of supplemental vitamin E intake and risk for CVD and ACM in this large, community-based study. Further research is needed to clarify the basis for the discrepant results between intervention and observational studies of supplemental vitamin E intake.
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