Mursu Jaakko, Robien Kim, Harnack Lisa J, Park Kyong, Jacobs David R
Department of Health Sciences, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland.
Arch Intern Med. 2011 Oct 10;171(18):1625-33. doi: 10.1001/archinternmed.2011.445.
Although dietary supplements are commonly taken to prevent chronic disease, the long-term health consequences of many compounds are unknown.
We assessed the use of vitamin and mineral supplements in relation to total mortality in 38,772 older women in the Iowa Women's Health Study; mean age was 61.6 years at baseline in 1986. Supplement use was self-reported in 1986, 1997, and 2004. Through December 31, 2008, a total of 15,594 deaths (40.2%) were identified through the State Health Registry of Iowa and the National Death Index.
In multivariable adjusted proportional hazards regression models, the use of multivitamins (hazard ratio, 1.06; 95% CI, 1.02-1.10; absolute risk increase, 2.4%), vitamin B(6) (1.10; 1.01-1.21; 4.1%), folic acid (1.15; 1.00-1.32; 5.9%), iron (1.10; 1.03-1.17; 3.9%), magnesium (1.08; 1.01-1.15; 3.6%), zinc (1.08; 1.01-1.15; 3.0%), and copper (1.45; 1.20-1.75; 18.0%) were associated with increased risk of total mortality when compared with corresponding nonuse. Use of calcium was inversely related (hazard ratio, 0.91; 95% confidence interval, 0.88-0.94; absolute risk reduction, 3.8%). Findings for iron and calcium were replicated in separate, shorter-term analyses (10-year, 6-year, and 4-year follow-up), each with approximately 15% of the original participants having died, starting in 1986, 1997, and 2004.
In older women, several commonly used dietary vitamin and mineral supplements may be associated with increased total mortality risk; this association is strongest with supplemental iron. In contrast to the findings of many studies, calcium is associated with decreased risk.
尽管人们普遍服用膳食补充剂来预防慢性病，但许多化合物对健康的长期影响尚不清楚。
在爱荷华州妇女健康研究中，我们评估了38772名老年女性使用维生素和矿物质补充剂与全因死亡率之间的关系；1986年基线时的平均年龄为61.6岁。1986年、1997年和2004年通过自我报告补充剂的使用情况。截至2008年12月31日，通过爱荷华州州立健康登记处和国家死亡指数共确定了15594例死亡病例（40.2%）。
在多变量调整的比例风险回归模型中，与未使用相应补充剂相比，使用多种维生素（风险比，1.06；95%置信区间，1.02 - 1.10；绝对风险增加，2.4%）、维生素B6（1.10；1.01 - 1.21；4.1%）、叶酸（1.15；1.00 - 1.32；5.9%）、铁（1.10；1.03 - 1.17；3.9%）、镁（1.08；1.01 - 1.15；3.6%）、锌（1.08；1.01 - 1.15；3.0%）和铜（1.45；1.20 - 1.75；18.0%）与全因死亡风险增加相关。钙的使用呈负相关（风险比，0.91；95%置信区间，0.88 - 0.94；绝对风险降低，3.8%）。铁和钙的研究结果在分别进行的短期分析（10年、6年和4年随访）中得到重复，每次分析从1986年、1997年和2004年开始，约15%的原始参与者已经死亡。
在老年女性中，几种常用的膳食维生素和矿物质补充剂可能与全因死亡风险增加有关；这种关联在补充铁剂时最为明显
