Wright Margaret E, Lawson Karla A, Weinstein Stephanie J, Pietinen Pirjo, Taylor Philip R, Virtamo Jarmo, Albanes Demetrius
Nutritional Epidemiology Branch and the Genetic Epidemiology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
Am J Clin Nutr. 2006 Nov;84(5):1200-7. doi: 10.1093/ajcn/84.5.1200.
A meta-analysis of 19 trials suggested a small increase in the risk of all-cause mortality with high-dose vitamin E supplementation. Little is known, however, about the relation between mortality and circulating concentrations of vitamin E resulting from dietary intake, low-dose supplementation, or both.
We examined whether baseline serum alpha-tocopherol concentrations are associated with total and cause-specific mortality.
A prospective cohort study of 29 092 Finnish male smokers aged 50-69 y who participated in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study was carried out. Fasting serum alpha-tocopherol was measured at baseline by using HPLC. Only 10% of participants reported vitamin E supplement use at baseline, and thus serum concentrations of vitamin E mainly reflected dietary intake and other host factors. Risks of total and cause-specific mortality were estimated by using proportional hazards models.
During up to 19 y of follow-up, 13 380 deaths (including 4518 and 5776 due to cancer and cardiovascular disease, respectively) were identified. Men in the higher quintiles of serum alpha-tocopherol had significantly lower risks of total and cause-specific mortality than did those in the lowest quintile [relative risk (RR) = 0.82 (95% CI: 0.78, 0.86) for total mortality and 0.79 (0.72, 0.86), 0.81 (0.75, 0.88), and 0.70 (0.63, 0.79) for deaths due to cancer, cardiovascular disease, and other causes, respectively; P for trend for all < 0.0001]. Cubic regression spline analysis of continuous serum alpha-tocopherol values indicated greater risk reductions with increasing concentrations up to approximately 13-14 mg/L, after which no further benefit was noted.
Higher circulating concentrations of alpha-tocopherol within the normal range are associated with significantly lower total and cause-specific mortality in older male smokers.
一项对19项试验的荟萃分析表明，高剂量补充维生素E会使全因死亡率风险略有增加。然而，对于饮食摄入、低剂量补充或两者兼而有之导致的维生素E循环浓度与死亡率之间的关系，人们知之甚少。
我们研究了基线血清α-生育酚浓度与总死亡率和特定病因死亡率之间是否存在关联。
对29092名年龄在50 - 69岁的芬兰男性吸烟者进行了一项前瞻性队列研究，这些男性参与了α-生育酚、β-胡萝卜素癌症预防（ATBC）研究。在基线时使用高效液相色谱法测量空腹血清α-生育酚。只有10%的参与者报告在基线时使用维生素E补充剂，因此血清维生素E浓度主要反映饮食摄入和其他宿主因素。使用比例风险模型估计总死亡率和特定病因死亡率的风险。
在长达19年的随访期间，共确定了13380例死亡（分别包括4518例和5776例因癌症和心血管疾病死亡）。血清α-生育酚处于较高五分位数的男性与处于最低五分位数者相比，总死亡率和特定病因死亡率风险显著更低[总死亡率的相对风险（RR）=0.82（95%CI：0.78，0.86），因癌症、心血管疾病和其他原因死亡的RR分别为0.79（0.72，0.86）、0.81（0.75，0.88）和0.70（0.63，0.79）；所有趋势的P值均<0.0001]。对连续血清α-生育酚值进行三次回归样条分析表明，浓度增加至约13 - 14mg/L之前，风险降低幅度更大，此后未观察到进一步的益处。
在正常范围内，较高的α-生育酚循环浓度与老年男性吸烟者显著降低的总死亡率和特定病因死亡率相关。
