荟萃分析:高剂量维生素E补充可能增加全因死亡率。
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Miller ER 3, Pastor-Barriuso R, Dalal D, Riemersma RA, Appel LJ, Guallar E
荟萃分析:高剂量维生素E补充可能增加全因死亡率。
中华外科杂志2005年1月4日;(1):37-46。Epub 2004 11月10日。
- PubMed ID
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15537682 (PubMed视图］
- 摘要
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背景:实验模型和观察性研究表明，补充维生素E可以预防心血管疾病和癌症。然而，几项高剂量维生素E补充试验显示，总死亡率有非统计学意义的增加。目的:利用随机对照试验数据，对维生素E补充与总死亡率之间的剂量-反应关系进行荟萃分析。患者:135,967人参与19项临床试验。在这些试验中，9项仅测试维生素E, 10项测试维生素E与其他维生素或矿物质联合使用。维生素E的剂量范围为16.5至2000 IU/d(中位数为400 IU/d)。数据来源:PubMed从1966年到200必威国际app4年8月的检索，补充检索了Cochrane临床试验数据库，并回顾了发表的综述和荟萃分析的引文。没有语言限制。资料提取:3名研究者独立提取研究报告。如果无法获得所需的资料，就联系了原始出版物的调查人员。 DATA SYNTHESIS: 9 of 11 trials testing high-dosage vitamin E (> or =400 IU/d) showed increased risk (risk difference > 0) for all-cause mortality in comparisons of vitamin E versus control. The pooled all-cause mortality risk difference in high-dosage vitamin E trials was 39 per 10,000 persons (95% CI, 3 to 74 per 10,000 persons; P = 0.035). For low-dosage vitamin E trials, the risk difference was -16 per 10,000 persons (CI, -41 to 10 per 10,000 persons; P > 0.2). A dose-response analysis showed a statistically significant relationship between vitamin E dosage and all-cause mortality, with increased risk of dosages greater than 150 IU/d. LIMITATIONS: High-dosage (> or =400 IU/d) trials were often small and were performed in patients with chronic diseases. The generalizability of the findings to healthy adults is uncertain. Precise estimation of the threshold at which risk increases is difficult. CONCLUSION: High-dosage (> or =400 IU/d) vitamin E supplements may increase all-cause mortality and should be avoided.
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