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抗氧化剂的饮食摄入量与阿尔茨海默病风险

Dietary intake of antioxidants and risk of Alzheimer disease.

作者信息

Engelhart Marianne J, Geerlings Mirjam I, Ruitenberg Annemieke, van Swieten John C, Hofman Albert, Witteman Jacqueline C M, Breteler Monique M B

机构信息

Department of Epidemiology and Biostatistics, Erasmus Medical Center, 3000 DR Rotterdam, The Netherlands.

出版信息

JAMA. 2002 Jun 26;287(24):3223-9. doi: 10.1001/jama.287.24.3223.

DOI:10.1001/jama.287.24.3223

PMID:12076218

Abstract

CONTEXT

Laboratory findings have suggested that oxidative stress may contribute to the pathogenesis of Alzheimer disease. Therefore, the risk of Alzheimer disease might be reduced by intake of antioxidants that counteract the detrimental effects of oxidative stress.

OBJECTIVE

To determine whether dietary intake of antioxidants is related to risk of Alzheimer disease.

DESIGN AND SETTING

The Rotterdam Study, a population-based, prospective cohort study conducted in the Netherlands.

PARTICIPANTS

A total of 5395 participants who, at baseline (1990-1993), were aged at least 55 years, free of dementia, and noninstitutionalized and had reliable dietary assessment. Participants were reexamined in 1993-1994 and 1997-1999 and were continuously monitored for incident dementia.

MAIN OUTCOME MEASURES

Incidence of Alzheimer disease, based on Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R) criteria and National Institute of Neurological and Communicative Disorders and Stroke and Alzheimer Disease and Related Disorders Association (NINCDS-ADRDA) criteria, associated with dietary intake of beta carotene, flavonoids, vitamin C, and vitamin E.

RESULTS

After a mean follow-up of 6 years, 197 participants developed dementia, of whom 146 had Alzheimer disease. When adjustments were made for age, sex, baseline Mini-Mental State Examination score, alcohol intake, education, smoking habits, pack-years of smoking, body mass index, total energy intake, presence of carotid plaques, and use of antioxidative supplements, high intake of vitamin C and vitamin E was associated with lower risk of Alzheimer disease (rate ratios [RRs] per 1-SD increase in intake were 0.82 [95% confidence interval [CI], 0.68-0.99] and 0.82 [95% CI, 0.66-1.00], respectively). Among current smokers, this relationship was most pronounced (RRs, 0.65 [95% CI, 0.37-1.14] and 0.58 [95% CI, 0.30-1.12], respectively) and also was present for intake of beta carotene (RR, 0.49 [95% CI, 0.27-0.92]) and flavonoids (RR, 0.54 [95% CI, 0.31-0.96]). The associations did not vary by education or apolipoprotein E genotype.

CONCLUSION

High dietary intake of vitamin C and vitamin E may lower the risk of Alzheimer disease.

摘要

背景

实验室研究结果表明，氧化应激可能在阿尔茨海默病的发病机制中起作用。因此，摄入抗氧化剂以抵消氧化应激的有害影响可能会降低患阿尔茨海默病的风险。

目的

确定抗氧化剂的饮食摄入量是否与患阿尔茨海默病的风险相关。

设计与地点

鹿特丹研究，一项在荷兰进行的基于人群的前瞻性队列研究。

参与者

共有5395名参与者，在基线期（1990 - 1993年）年龄至少55岁，无痴呆症，未被机构收容，且有可靠的饮食评估。参与者在1993 - 1994年和1997 - 1999年接受复查，并持续监测新发痴呆症情况。

主要观察指标

根据《精神疾病诊断与统计手册》第三版修订本（DSM - III - R）标准和美国国立神经疾病与中风研究所及阿尔茨海默病及相关疾病协会（NINCDS - ADRDA）标准确定的阿尔茨海默病发病率，与β - 胡萝卜素、类黄酮、维生素C和维生素E的饮食摄入量相关。

结果

平均随访6年后，197名参与者患痴呆症，其中146名患有阿尔茨海默病。在对年龄、性别、基线简易精神状态检查得分、酒精摄入量、教育程度、吸烟习惯、吸烟包年数、体重指数、总能量摄入量、颈动脉斑块的存在情况以及抗氧化补充剂的使用情况进行调整后，维生素C和维生素E的高摄入量与较低的阿尔茨海默病风险相关（摄入量每增加1个标准差的率比[RRs]分别为0.82[95%置信区间[CI]，0.68 - 0.99]和0.82[95%CI，0.66 - 1.00]）。在当前吸烟者中，这种关系最为明显（RRs分别为0.65[95%CI，0.37 - 1.14]和0.58[95%CI，0.30 - 1.12]），β - 胡萝卜素（RR，0.49[95%CI，0.27 - 0.92]）和类黄酮（RR，0.54[95%CI，0.31 - 0.96]）的摄入量也存在这种关系。这些关联在不同教育程度或载脂蛋白E基因型之间没有差异。