Lourenço Rosa, Vidal Pedro-Marques
University of Lausanne, Lausanne, Switzerland.
Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Office BH10-642, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
Eur J Nutr. 2025 Feb 1;64(2):81. doi: 10.1007/s00394-025-03593-1.
Vitamin-mineral and dietary supplements (VMDS) are taken by a large fraction of the population. Whether their long-term consumption impacts mortality and cardiovascular disease (CVD) has seldom been studied.
Prospective study from a population-based cohort from Lausanne, Switzerland. Participants were categorized as non-users (no consumption at baseline and first follow-up), persistent users (consumption at baseline and follow-up), and occasional users (consumption either at baseline or follow-up). Incidence of CVD and of total mortality was assessed after the first follow-up.
Data from 4261 participants (57.4 ± 10.4 years, 55% females) was used. Median follow-up was 9 years (interquartile range 7.0-9.2) After multivariable analysis, no association was found between VMDS use and total mortality: hazard ratio and (95% confidence interval) 0.95 (0.71-1.28) and 0.83 (0.55-1.26) for occasional and persistent consumers, respectively, CVD mortality: 1.00 (0.47-2.11) and 1.30 (0.53-3.18), or CVD events: 0.96 (0.72-1.27) and 0.95 (0.64-1.42). Similar findings were obtained after inverse probability weighting, using only vitamin-mineral supplement users, or considering only participants at baseline. When CVD events were split into coronary heart disease (CHD) or stroke, persistent use of VMDS was associated with a higher risk of CHD in females: 3.12 (1.52-6.41), p = 0.002, but not in males, 0.25 (0.03-1.82), p = 0.171, p for interaction < 0.05. No association was found between VMDS use and incidence of stroke in both sexes.
We found no association between vitamin and dietary supplement use and total or CVD mortality, or CVD events. The higher risk of CHD for persistent use in females should be further explored.
很大一部分人群服用维生素 - 矿物质及膳食补充剂(VMDS)。其长期服用是否会影响死亡率和心血管疾病(CVD),这方面的研究很少。
对来自瑞士洛桑的一个基于人群的队列进行前瞻性研究。参与者被分为非使用者(基线和首次随访时均未服用)、持续使用者(基线和随访时均服用)和偶尔使用者(仅在基线或随访时服用)。首次随访后评估心血管疾病和全因死亡率的发生率。
使用了4261名参与者的数据(年龄57.4±10.4岁,55%为女性)。中位随访时间为9年(四分位间距7.0 - 9.2)。多变量分析后,未发现服用VMDS与全因死亡率之间存在关联:偶尔使用者和持续使用者的风险比及(95%置信区间)分别为0.95(0.71 - 1.28)和0.83(0.55 - 1.26);心血管疾病死亡率分别为1.00(0.47 - 2.11)和1.30(0.53 - 3.18);心血管疾病事件分别为0.96(0.72 - 1.27)和0.95(0.64 - 1.42)。在采用逆概率加权、仅使用维生素 - 矿物质补充剂使用者或仅考虑基线参与者后,得到了类似的结果。当将心血管疾病事件分为冠心病(CHD)或中风时,持续服用VMDS与女性患冠心病的风险较高相关:3.12(1.52 - 6.41),p = 0.002,但男性中无此关联,0.25(0.03 - 1.82),p = 0.171,交互作用p < 0.05。未发现服用VMDS与男女中风发生率之间存在关联。
我们发现服用维生素和膳食补充剂与全因或心血管疾病死亡率以及心血管疾病事件之间无关联。女性持续服用导致冠心病风险较高这一情况应进一步探究。