Public Health, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
J Epidemiol. 2012;22(5):402-10. doi: 10.2188/jea.je20120002. Epub 2012 May 19.
There is limited evidence regarding the relationship between serum tocopherol levels and cardiovascular disease.
We conducted a nested case-control study as part of the Japan Collaborative Cohort Study for evaluation of cancer risk (JACC Study). Baseline serum samples were collected from 39 242 participants (age range, 40-79 years) between 1988 and 1990. During the 13-year follow-up, there were 530 stroke deaths (302 ischemic strokes and 210 hemorrhagic strokes) and 211 deaths from coronary heart disease. Controls were matched for sex, age, and area of residence.
Serum α-tocopherol level was not associated with any type of cardiovascular death in men; however, in women, it was inversely associated with total stroke mortality and hemorrhagic stroke mortality. The multivariate odds ratio (95% CI) for the highest versus the lowest quintile of serum α-tocopherol levels among women was 0.35 (0.16-0.77; P for trend = 0.009) for total stroke and 0.26 (0.07-0.97; P for trend = 0.048) for hemorrhagic stroke. Serum γ-tocopherol was inversely associated with ischemic stroke mortality in men but positively associated with hemorrhagic stroke mortality in women. The respective multivariate odds ratios (95% CI) for the highest versus the lowest quintile and for a 1-standard deviation increment in γ-tocopherol level were 0.48 (0.22-1.06; P for trend = 0.07) and 0.77 (0.58-1.02), respectively, for ischemic stroke in men and 3.10 (0.95-10.12; P for trend = 0.052) and 1.49 (1.04-2.13) for hemorrhagic stroke in women.
Among women, hemorrhagic stroke mortality was inversely associated with serum α-tocopherol and positively associated with serum γ-tocopherol. These findings are due in part to the antioxidative and antithrombotic activities of these tocopherols.
关于血清生育酚水平与心血管疾病之间的关系，目前的证据有限。
我们进行了一项嵌套病例对照研究，作为日本癌症风险合作队列研究（JACC 研究）的一部分。在 1988 年至 1990 年间，从 39242 名参与者（年龄范围为 40-79 岁）中采集了基线血清样本。在 13 年的随访期间，有 530 例中风死亡（302 例缺血性中风和 210 例出血性中风）和 211 例死于冠心病。对照与性别、年龄和居住地区相匹配。
男性血清 α-生育酚水平与任何类型的心血管死亡均无关；然而，在女性中，它与总卒中死亡率和出血性卒中死亡率呈负相关。女性血清 α-生育酚水平最高五分位组与最低五分位组相比，总卒中的多变量比值比（95%CI）为 0.35（0.16-0.77；趋势 P 值=0.009），出血性卒中为 0.26（0.07-0.97；趋势 P 值=0.048）。男性血清 γ-生育酚与缺血性卒中死亡率呈负相关，而女性则与出血性卒中死亡率呈正相关。男性最高五分位组与最低五分位组相比，以及 γ-生育酚水平每增加 1 个标准差，多变量比值比（95%CI）分别为 0.48（0.22-1.06；趋势 P 值=0.07）和 0.77（0.58-1.02），女性分别为 3.10（0.95-10.12；趋势 P 值=0.052）和 1.49（1.04-2.13）。
在女性中，出血性卒中死亡率与血清 α-生育酚呈负相关，与血清 γ-生育酚呈正相关。这些发现部分归因于这些生育酚的抗氧化和抗血栓形成活性。
