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抗氧化维生素补充剂对传统心血管危险因素的影响。

The effect of antioxidant vitamin supplementation on traditional cardiovascular risk factors.

作者信息

Miller E R, Appel L J, Levander O A, Levine D M

机构信息

Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.

出版信息

J Cardiovasc Risk. 1997 Feb;4(1):19-24. doi: 10.1177/174182679700400104.

Abstract

BACKGROUND

Evidence from observational epidemiologic studies has indicated that antioxidants consumed through the diet or as dietary supplements lower the risk of developing atherosclerotic cardiovascular disease. Evidence suggesting that the major mechanism for the protective effect of antioxidants is mediated through decreased oxidation of lipids, particularly low-density lipoprotein (LDL) cholesterol is accumulating. Other evidence, however, suggests that antioxidants may influence traditional modifiable cardiovascular risk factors such as the blood pressure and serum lipids favorably. The purpose of this study was to determine the effect of antioxidant vitamin supplementation on modifiable risk factors for atherosclerotic cardiovascular disease.

DESIGN

A randomized, placebo-controlled, clinical trial of antioxidant vitamin supplementation, conducted at a single community-based clinical research center.

METHODS

We assigned 297 retired teachers who were members of the Maryland Retired Teachers Association randomly to 2-4 months of dietary supplementation with placebo or combined antioxidant vitamin capsules providing 400 IU/day vitamin E, 500 mg/day vitamin C, and 6 mg/day beta-carotene. The outcome measures were the blood pressure, fasting serum total cholesterol, high-density lipoprotein cholesterol, LDL cholesterol, and fasting glucose.

RESULTS

After 2-4 months of supplementation the combined antioxidant supplement had had no significant effect on the systolic and diastolic blood pressures, fasting serum lipids (total cholesterol, high-density lipoprotein cholesterol, and LDL cholesterol) and fasting glucose, with unadjusted and adjusted analyses.

CONCLUSION

Data from this trial suggest that the protective effect from antioxidant vitamin supplementation, if there is one, likely results from mechanisms other than modification of traditionally modifiable cardiovascular risk factors.

摘要

背景

观察性流行病学研究的证据表明,通过饮食摄入或作为膳食补充剂服用的抗氧化剂可降低患动脉粥样硬化性心血管疾病的风险。越来越多的证据表明,抗氧化剂发挥保护作用的主要机制是通过减少脂质氧化,特别是低密度脂蛋白(LDL)胆固醇的氧化来介导的。然而,其他证据表明,抗氧化剂可能会对传统的可改变的心血管危险因素如血压和血脂产生有利影响。本研究的目的是确定补充抗氧化剂维生素对动脉粥样硬化性心血管疾病可改变危险因素的影响。

设计

在一个基于社区的单一临床研究中心进行的一项关于补充抗氧化剂维生素的随机、安慰剂对照临床试验。

方法

我们将297名马里兰州退休教师协会的退休教师随机分配,让他们接受2 - 4个月的安慰剂或抗氧化剂维生素组合胶囊膳食补充,抗氧化剂维生素组合胶囊提供每日400国际单位维生素E、500毫克维生素C和6毫克β-胡萝卜素。观察指标为血压、空腹血清总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和空腹血糖。

结果

经过2 - 4个月的补充,无论未经调整还是调整后的分析,抗氧化剂组合补充剂对收缩压和舒张压、空腹血脂(总胆固醇、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇)以及空腹血糖均无显著影响。

结论

该试验数据表明,补充抗氧化剂维生素的保护作用(如果存在的话)可能源于除改变传统可改变的心血管危险因素之外的其他机制。

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