Pfister Roman, Michels Guido, Brägelmann Johannes, Sharp Stephen J, Luben Robert, Wareham Nick J, Khaw Kay-Tee
Department III of Internal Medicine, Heart Centre of the University of Cologne, Cologne, Germany.
Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom.
Int J Cardiol. 2014 Dec 20;177(3):830-5. doi: 10.1016/j.ijcard.2014.11.016. Epub 2014 Nov 5.
Fruit and vegetable intake has been associated with lower risk for cardiovascular risk factors and disease. Data on its association with atrial fibrillation are lacking.
We examined the prospective association of plasma vitamin C concentration as a biomarker for fruit and vegetable intake with the risk of hospitalisation with diagnosis of atrial fibrillation in apparently healthy 8,760 men and 10,530 women aged 39-79 participating in the EPIC-study in Norfolk. The hazard ratios of atrial fibrillation comparing each quartile of plasma vitamin C concentration with the lowest were 0.76 (95% CI 0.57-1.00), 0.73 (95% CI 0.55-0.98) and 0.77 (95% CI 0.58-1.01) in women (p for trend 0.05) and 0.81 (95% CI 0.63-1.03), 0.96 (95% CI 0.76-1.22) and 1.01 (95% CI 0.79-1.28) in men (p for trend 0.66) after adjustment for age, smoking, alcohol consumption, physical activity, systolic blood pressure, diabetes, use of blood pressure medication and body-mass index, with a significant gender × vitamin C interaction (p=0.03). Assuming a linear association, a 20 μmol/l increase in plasma vitamin C concentration (1 standard deviation) was associated with a 13% (95% CI 3-22%) relative reduction in risk of atrial fibrillation in women.
Plasma vitamin C was inversely associated with the risk of atrial fibrillation in women, but there was no such association in men. Our findings suggest that intake of food rich in vitamin C might be preventive for atrial fibrillation with a significant benefit particularly in women with low baseline intake.
水果和蔬菜摄入量与心血管危险因素及疾病风险较低相关。但其与心房颤动的关联数据尚缺。
我们在诺福克郡参与欧洲癌症与营养前瞻性调查（EPIC）研究的8760名39 - 79岁健康男性和10530名健康女性中，检测了作为水果和蔬菜摄入量生物标志物的血浆维生素C浓度与因心房颤动诊断而住院风险的前瞻性关联。在校正年龄、吸烟、饮酒、体力活动、收缩压、糖尿病、血压药物使用和体重指数后，女性血浆维生素C浓度各四分位数与最低四分位数相比，心房颤动的风险比分别为0.76（95%可信区间0.57 - 1.00）、0.73（95%可信区间0.55 - 0.98）和0.77（95%可信区间0.58 - 1.01）（趋势p值为0.05）；男性分别为0.81（95%可信区间0.63 - 1.03）、0.96（95%可信区间0.76 - 1.22）和1.01（95%可信区间0.79 - 1.28）（趋势p值为0.66），存在显著的性别×维生素C交互作用（p = 0.03）。假设呈线性关联，血浆维生素C浓度每增加20μmol/L（1个标准差），女性心房颤动风险相对降低13%（95%可信区间3 - 22%）。
血浆维生素C与女性心房颤动风险呈负相关，但男性不存在这种关联。我们的研究结果表明，摄入富含维生素C的食物可能预防心房颤动，尤其对基线摄入量低的女性有显著益处。
