Gaziano J M
Department of Medicine, Brigham and Women's Hospital, Boston, MA 02215-1204, USA.
Nutrition. 1996 Sep;12(9):583-8. doi: 10.1016/s0899-9007(96)00184-0.
The hypothesis that antioxidant vitamins might reduce cardiovascular disease risk is based on a large body of both basic and human epidemiologic research. One of the most consistent findings in dietary research is that those who consume higher amounts of fruits and vegetables have lower rates of heart disease and stroke as well as cancer. Recent attention has focused on the antioxidant content of fruits and vegetables as a possible explanation for the apparent protective effects. Basic research provides a plausible mechanism by which antioxidants might reduce the risk of atherosclerosis. A large number of descriptive, case-control and cohort studies provide data suggesting that consumption of antioxidant vitamins is associated with reduced risks of cardiovascular disease. These data raise the question of a possible role of antioxidants, such as vitamins C and E, and beta carotene, in the primary prevention of cardiovascular disease but do not provide a definitive answer. Results from several large-scale randomized trials of antioxidant supplements are now available; however, results are not entirely consistent. The results of the major trials do not prove or disprove the value of antioxidant vitamins, nor do they incriminate them as harmful. They do, however, raise the possibility that some of the benefits from observational epidemiology may have been overestimated and that there may be some adverse effects. At this point randomized trial data are not yet sufficient to fully assess the risk-to-benefit ratios for antioxidant supplements. More reliable data should be forthcoming in the near future which will better define the role of antioxidants in the primary and secondary prevention of atherosclerotic disease as well as cancer.
抗氧化维生素可能降低心血管疾病风险这一假说，是基于大量基础研究和人类流行病学研究得出的。饮食研究中最一致的发现之一是，摄入较多水果和蔬菜的人患心脏病、中风以及癌症的几率较低。最近，人们将注意力集中在水果和蔬菜的抗氧化成分上，将其作为这种明显保护作用的一种可能解释。基础研究提供了一种合理的机制，通过该机制抗氧化剂可能降低动脉粥样硬化的风险。大量描述性研究、病例对照研究和队列研究提供的数据表明，摄入抗氧化维生素与降低心血管疾病风险有关。这些数据提出了抗氧化剂（如维生素C、维生素E和β-胡萝卜素）在心血管疾病一级预防中可能发挥作用的问题，但并未给出明确答案。目前已有几项关于抗氧化剂补充剂的大规模随机试验结果；然而，结果并不完全一致。主要试验结果既没有证明也没有反驳抗氧化维生素的价值，也没有认定它们有害。然而，它们确实提出了一种可能性，即观察性流行病学的一些益处可能被高估了，而且可能存在一些不良影响。目前，随机试验数据尚不足以全面评估抗氧化剂补充剂的风险效益比。在不久的将来应该会有更可靠的数据，这将更好地确定抗氧化剂在动脉粥样硬化疾病以及癌症的一级和二级预防中的作用。
