Epidemiology Research Program, American Cancer Society, Atlanta, GA 30303, USA.
Nutrients. 2013 Jul 31;5(8):2969-3004. doi: 10.3390/nu5082969.
Extensive evidence has demonstrated that many antioxidants such as vitamin C, vitamin E, carotenoids and polyphenols have protective effects in preventing cardiovascular disease (CVD), a chronic disease that is mediated by oxidative stress and inflammation. This review focuses on evidence from prospective cohort studies and clinical trials in regard to the associations between plasma/dietary antioxidants and cardiovascular events. Long-term, large-scale, population-based cohort studies have found that higher levels of serum albumin, bilirubin, glutathione, vitamin E, vitamin C, and carotenoids were associated with a lower risk of CVD. Evidence from the cohort studies in regard to dietary antioxidants also supported the protective effects of dietary vitamin E, vitamin C, carotenoids, and polyphenols on CVD risk. However, results from large randomized controlled trials did not support long-term use of single antioxidant supplements for CVD prevention due to their null or even adverse effects on major cardiovascular events or cancer. Diet quality indexes that consider overall diet quality rather than single nutrients have been drawing increasing attention. Cohort studies and intervention studies that focused on diet patterns such as high total antioxidant capacity have documented protective effects on CVD risk. This review provides a perspective for future studies that investigate antioxidant intake and risk of CVD.
大量证据表明，许多抗氧化剂，如维生素 C、维生素 E、类胡萝卜素和多酚，具有预防心血管疾病 (CVD) 的保护作用，CVD 是一种由氧化应激和炎症介导的慢性疾病。本综述重点关注前瞻性队列研究和临床试验的证据，这些证据涉及血浆/饮食抗氧化剂与心血管事件之间的关系。长期、大规模、基于人群的队列研究发现，血清白蛋白、胆红素、谷胱甘肽、维生素 E、维生素 C 和类胡萝卜素水平较高与 CVD 风险降低相关。关于饮食抗氧化剂的队列研究证据也支持饮食中维生素 E、维生素 C、类胡萝卜素和多酚对 CVD 风险的保护作用。然而，由于单一抗氧化补充剂对主要心血管事件或癌症的作用呈中性甚至不利，大型随机对照试验的结果并不支持其长期用于 CVD 预防。考虑整体饮食质量而不是单一营养素的饮食质量指数越来越受到关注。关注总抗氧化能力较高的饮食模式的队列研究和干预研究记录了对 CVD 风险的保护作用。本综述为未来研究提供了一个视角，以探讨抗氧化剂摄入与 CVD 风险的关系。
