Ginter E
Public Health Authority of the Slovak Republic, Bratislava, Slovakia.
Bratisl Lek Listy. 2007;108(9):417-21.
The studies on experimental animals (guinea pigs, monkeys, fish) have confirmed the important role of ascorbic acid deficiency in the development of hypercholesterolemia and atherosclerosis, but the clinical experience is not quite uniform. Metaanalyses of randomized controlled trials performed on subjects without established vitamin C-deficiency conclud that the evidence of the presence or absence of benefits derived from the ability of ascorbic acid to prevent cardiovascular diseases is not sufficient. This review is an outline of numerous clinical, epidemiological and prospective studies that have found a positive role of vitamin C in the prevention of atherosclerosis. If we admit the possibility that vitamin C deficiency is a significant risk factor of atherogenesis, due to ethical reasons it is impossible to perform long-term controlled trials on subjects with proved vitamin C deficiency, to recommend them not to change their nutrition and lifestyle, and to administer placebo to the control group. Therefore the proof of atherogenic effect of chronic vitamin C deficiency is limited to indirect evidence only. In this review many new data on the positive effects of ascorbic acid on human cardiovascular system are summarized and the mechanisms of its protective influence on blood vessels are discussed (Fig.5, Ref. 45). Full Text (Free, PDF) www.bmj.sk.
对实验动物(豚鼠、猴子、鱼类)的研究证实了抗坏血酸缺乏在高胆固醇血症和动脉粥样硬化发展过程中的重要作用,但临床经验并不完全一致。对未确诊维生素C缺乏的受试者进行的随机对照试验的荟萃分析得出结论,关于抗坏血酸预防心血管疾病能力是否有益的证据并不充分。本综述概述了众多临床、流行病学和前瞻性研究,这些研究发现维生素C在预防动脉粥样硬化方面具有积极作用。如果我们承认维生素C缺乏是动脉粥样硬化发生的一个重要危险因素,出于伦理原因,不可能对已证实维生素C缺乏的受试者进行长期对照试验,建议他们不改变营养和生活方式,并对对照组给予安慰剂。因此,慢性维生素C缺乏致动脉粥样硬化作用的证据仅限于间接证据。本综述总结了许多关于抗坏血酸对人体心血管系统积极作用的新数据,并讨论了其对血管保护作用的机制(图5,参考文献45)。全文(免费,PDF)www.bmj.sk 。