Colarusso Luca, Serafini Mauro, Lagerros Ylva Trolle, Nyren Olof, La Vecchia Carlo, Rossi Marta, Ye Weimin, Tavani Alessandra, Adami Hans-Olov, Grotta Alessandra, Bellocco Rino
Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.
Functional Food and Metabolic Stress Prevention Laboratory, Center for Food and Nutrition, Council for Agricultural Research and Economics CREA, Rome, Italy.
Nutrition. 2017 Jan;33:234-239. doi: 10.1016/j.nut.2016.07.009. Epub 2016 Jul 26.
Both observational studies and randomized trials have shown that a diet rich in antioxidants can reduce systemic inflammation and oxidative stress, two conditions that, together with obesity and smoking, are established risk factors for stroke. However, the association between antioxidant intake and risk for stroke is poorly understood, particularly when studying possible interaction with sex. We investigated the relationship of nonenzymatic antioxidant capacity (NEAC) on risk for stroke in a large Swedish prospective cohort.
The cohort study included 34 555 men and women from the Swedish National March Cohort. NEAC was assessed using a detailed food frequency questionnaire, collected at baseline. We achieved complete follow-up from enrollment in 1997 through 2010 by record linkage to nationwide registers. We identified 1186 incident cases of a first stroke, of which 860 were ischemic, 201 hemorrhagic, and 125 unspecified. We used multivariable Cox proportional hazards models to estimate adjusted hazard ratios (HR) with 95% confidence intervals (CIs).
Compared with women in the lowest quartile of NEAC, women in the highest quartile had a 27% lower incidence of total stroke (HR, 0.73; 95% CI, 0.53-0.99; P = 0.03) and 35% lower incidence of ischemic stroke (HR, 0.65; 95% CI, 0.43-0.99; P = 0.01). Among men, the relationship between NEAC and risk for stroke was not statistically significant and all HRs were close to unity.
Findings from the present study suggest that dietary antioxidant capacity from different foods and beverages is inversely associated with risk for stroke, more specifically ischemic stroke, in women.
观察性研究和随机试验均表明，富含抗氧化剂的饮食可减轻全身炎症和氧化应激，这两种情况与肥胖和吸烟一起，是公认的中风危险因素。然而，抗氧化剂摄入量与中风风险之间的关联尚不清楚，尤其是在研究与性别的可能相互作用时。我们在一个大型瑞典前瞻性队列中研究了非酶抗氧化能力（NEAC）与中风风险的关系。
队列研究纳入了瑞典国家三月队列的34555名男性和女性。使用在基线时收集的详细食物频率问卷评估NEAC。通过与全国登记册的记录链接，我们实现了从1997年入组到2010年的完整随访。我们确定了1186例首次中风的发病病例，其中860例为缺血性中风，201例为出血性中风，125例未明确类型。我们使用多变量Cox比例风险模型来估计调整后的风险比（HR）及95%置信区间（CI）。
与NEAC处于最低四分位数的女性相比，处于最高四分位数的女性总中风发病率低27%（HR，0.73；95%CI，0.53 - 0.99；P = 0.03），缺血性中风发病率低35%（HR，0.65；95%CI，0.43 - 0.99；P = 0.01）。在男性中，NEAC与中风风险之间的关系无统计学意义，所有HR均接近1。
本研究结果表明，来自不同食物和饮料的膳食抗氧化能力与女性中风风险，尤其是缺血性中风风险呈负相关。
