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Higher baseline serum concentrations of vitamin E are associated with lower total and cause-specific mortality in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study
- Wright, Margaret E., Lawson, Karla A., Weinstein, Stephanie J., Pietinen, Pirjo, Taylor, Philip R., Virtamo, Jarmo, Albanes, Demetrius
- American journal of clinical nutrition 2006 v.84 no.5 pp. 1200-1207
- human health, human diseases, mortality, etiology, human nutrition, nutrient intake, dietary nutrient sources, alpha-tocopherol, beta-carotene, vitamin supplements, megadose, anticarcinogenic activity, cardioprotective effect, epidemiological studies, cohort studies, men, middle-aged adults, smoking (habit), blood chemistry, beta-tocopherol, neoplasms, cardiovascular diseases, meta-analysis, Finland
- BACKGROUND: A meta-analysis of 19 trials suggested a small increase in the risk of all-cause mortality with high-dose vitamin E supplementation. Little is known, however, about the relation between mortality and circulating concentrations of vitamin E resulting from dietary intake, low-dose supplementation, or both. OBJECTIVE: We examined whether baseline serum α-tocopherol concentrations are associated with total and cause-specific mortality. DESIGN: A prospective cohort study of 29 092 Finnish male smokers aged 50-69 y who participated in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study was carried out. Fasting serum α-tocopherol was measured at baseline by using HPLC. Only 10% of participants reported vitamin E supplement use at baseline, and thus serum concentrations of vitamin E mainly reflected dietary intake and other host factors. Risks of total and cause-specific mortality were estimated by using proportional hazards models. RESULTS: During up to 19 y of follow-up, 13 380 deaths (including 4518 and 5776 due to cancer and cardiovascular disease, respectively) were identified. Men in the higher quintiles of serum α-tocopherol had significantly lower risks of total and cause-specific mortality than did those in the lowest quintile [relative risk (RR) = 0.82 (95% CI: 0.78, 0.86) for total mortality and 0.79 (0.72, 0.86), 0.81 (0.75, 0.88), and 0.70 (0.63, 0.79) for deaths due to cancer, cardiovascular disease, and other causes, respectively; P for trend for all < 0.0001]. Cubic regression spline analysis of continuous serum α-tocopherol values indicated greater risk reductions with increasing concentrations up to [almost equal to]13-14 mg/L, after which no further benefit was noted. CONCLUSION: Higher circulating concentrations of α-tocopherol within the normal range are associated with significantly lower total and cause-specific mortality in older male smokers.