在美国，女性使用多种维生素矿物质补充剂与心血管疾病死亡率降低有关。
Multivitamin-mineral use is associated with reduced risk of cardiovascular disease mortality among women in the United States.
作者信息
Bailey Regan L, Fakhouri Tala H, Park Yikyung, Dwyer Johanna T, Thomas Paul R, Gahche Jaime J, Miller Paige E, Dodd Kevin W, Sempos Christopher T, Murray David M
机构信息
Offices of Dietary Supplements and
National Center for Health Statistics, CDC, Hyattsville, MD.
出版信息
J Nutr. 2015 Mar;145(3):572-8. doi: 10.3945/jn.114.204743. Epub 2015 Jan 7.
BACKGROUND
Multivitamin-mineral (MVM) products are the most commonly used supplements in the United States, followed by multivitamin (MV) products. Two randomized clinical trials (RCTs) did not show an effect of MVMs or MVs on cardiovascular disease (CVD) mortality; however, no clinical trial data are available for women with MVM supplement use and CVD mortality.
OBJECTIVE
The objective of this research was to examine the association between MVM and MV use and CVD-specific mortality among US adults without CVD.
METHODS
A nationally representative sample of adults from the restricted data NHANES III (1988-1994; n = 8678; age ≥40 y) were matched with mortality data reported by the National Death Index through 2011 to examine associations between MVM and MV use and CVD mortality by using Cox proportional hazards models, adjusting for multiple potential confounders.
RESULTS
We observed no significant association between CVD mortality and users of MVMs or MVs compared with nonusers; however, when users were classified by the reported length of time products were used, a significant association was found with MVM use of >3 y compared with nonusers (HR: 0.65; 95% CI: 0.49, 0.85). This finding was largely driven by the significant association among women (HR: 0.56; 95% CI: 0.37, 0.85) but not men (HR: 0.79; 95% CI: 0.44, 1.42). No significant association was observed for MV products and CVD mortality in fully adjusted models.
CONCLUSIONS
In this nationally representative data set with detailed information on supplement use and CVD mortality data ∼20 y later, we found an association between MVM use of >3 y and reduced CVD mortality risk for women when models controlled for age, race, education, body mass index, alcohol, aspirin use, serum lipids, blood pressure, and blood glucose/glycated hemoglobin. Our results are consistent with the 1 available RCT in men, indicating no relation with MVM use and CVD mortality.
背景
多种维生素矿物质（MVM）产品是美国最常用的补充剂，其次是多种维生素（MV）产品。两项随机临床试验（RCT）未显示MVM或MV对心血管疾病（CVD）死亡率有影响；然而，对于使用MVM补充剂的女性与CVD死亡率，尚无临床试验数据。
目的
本研究的目的是检验在美国无CVD的成年人中，MVM和MV的使用与CVD特异性死亡率之间的关联。
方法
来自受限数据的美国国家健康与营养检查调查（NHANES）III（1988 - 1994年；n = 8678；年龄≥40岁）的具有全国代表性的成年人样本，与通过2011年国家死亡指数报告的死亡率数据进行匹配，以使用Cox比例风险模型检验MVM和MV的使用与CVD死亡率之间的关联，并对多个潜在混杂因素进行调整。
结果
与未使用者相比，我们观察到CVD死亡率与MVM或MV使用者之间无显著关联；然而，当根据报告的产品使用时间长度对使用者进行分类时，发现使用MVM超过3年的使用者与未使用者相比存在显著关联（风险比：0.65；95%置信区间：0.49，0.85）。这一发现主要由女性中的显著关联驱动（风险比：0.56；95%置信区间：0.37，0.85），而男性中未观察到显著关联（风险比：0.79；95%置信区间：0.44，1.42）。在完全调整的模型中，未观察到MV产品与CVD死亡率之间的显著关联。
结论
在这个具有补充剂使用详细信息和约20年后CVD死亡率数据的全国代表性数据集中，当模型控制年龄、种族、教育程度、体重指数、酒精、阿司匹林使用、血脂、血压以及血糖/糖化血红蛋白时，我们发现使用MVM超过3年与女性CVD死亡率风险降低之间存在关联。我们的结果与一项针对男性的现有RCT一致，表明与MVM使用和CVD死亡率无关。
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