TY - JOUR
T1 - Association of serum levels of antioxidant micronutrients with mortality in US adults
T2 - National Health and Nutrition Examination Survey 1999-2002
AU - Peeri, Noah C.
AU - Chai, Weiwen
AU - Cooney, Robert V.
AU - Tao, Meng Hua
N1 - Funding Information:
Dr. Tao's effort was partially supported by the National Institute on Minority Health and Health Disparities of the National Institute of Health under Award U54MD006882
Publisher Copyright:
© The Author(s), 2020. Published by Cambridge University Press on behalf of The Nutrition Society.
PY - 2021/10/13
Y1 - 2021/10/13
N2 - Objective: To examine associations between serum antioxidant levels and mortality (all-cause, cancer and CVD) among US adults. Design: We examined the risk of death from all-cause and cause-specific mortality associated with serum antioxidant (vitamin E and carotenoids) and vitamin A levels using Cox regression models to estimate hazards ratios (HR) and 95 % CI. Setting: The National Health and Nutrition Examination Survey (NHANES) 1999-2002 was followed up through 31 December 2015. Participants: The NHANES 1999-2002 cohort included 8758 participants aged ≥ 20 years. Serum carotenoid levels were only assessed for the 1999-2000 cycle. Therefore, sample size for each assessed antioxidant ranged from 4633 to 8758. Results: Serum vitamin E level was positively associated with all-cause mortality (HR = 1·22, 95 % CI 1·04, 1·43, highest v. lowest quartile). No other antioxidants were associated with mortality in overall analysis. In race/ethnicity-specific analyses, high vitamin E and α-tocopherol levels were associated with increased risk of all-cause mortality among non-Hispanic Whites. Among non-Hispanic Blacks, serum α-tocopherol level was associated with decreased risk of cancer mortality (HR = 0·30, 95 % CI 0·12, 0·75, third v. first quartile) and total carotenoid levels with reduced risk of CVD mortality (HR = 0·26; 95 % CI 0·07, 0·97, second v. lowest quartile). Hispanics with high β-carotene levels had reduced risk of CVD mortality. Conclusions: Serum antioxidant levels may be related to mortality; these associations may differ by race/ethnicity and appeared to be non-linear for all-cause and cause-specific mortality. Further studies are needed to confirm our results.
AB - Objective: To examine associations between serum antioxidant levels and mortality (all-cause, cancer and CVD) among US adults. Design: We examined the risk of death from all-cause and cause-specific mortality associated with serum antioxidant (vitamin E and carotenoids) and vitamin A levels using Cox regression models to estimate hazards ratios (HR) and 95 % CI. Setting: The National Health and Nutrition Examination Survey (NHANES) 1999-2002 was followed up through 31 December 2015. Participants: The NHANES 1999-2002 cohort included 8758 participants aged ≥ 20 years. Serum carotenoid levels were only assessed for the 1999-2000 cycle. Therefore, sample size for each assessed antioxidant ranged from 4633 to 8758. Results: Serum vitamin E level was positively associated with all-cause mortality (HR = 1·22, 95 % CI 1·04, 1·43, highest v. lowest quartile). No other antioxidants were associated with mortality in overall analysis. In race/ethnicity-specific analyses, high vitamin E and α-tocopherol levels were associated with increased risk of all-cause mortality among non-Hispanic Whites. Among non-Hispanic Blacks, serum α-tocopherol level was associated with decreased risk of cancer mortality (HR = 0·30, 95 % CI 0·12, 0·75, third v. first quartile) and total carotenoid levels with reduced risk of CVD mortality (HR = 0·26; 95 % CI 0·07, 0·97, second v. lowest quartile). Hispanics with high β-carotene levels had reduced risk of CVD mortality. Conclusions: Serum antioxidant levels may be related to mortality; these associations may differ by race/ethnicity and appeared to be non-linear for all-cause and cause-specific mortality. Further studies are needed to confirm our results.
KW - All-cause
KW - Antioxidant micronutrients
KW - CVD
KW - Cancer
KW - Mortality
KW - Race/Ethnicity
UR - http://www.scopus.com/inward/record.url?scp=85096295273&partnerID=8YFLogxK
U2 - 10.1017/S1368980020004619
DO - 10.1017/S1368980020004619
M3 - Review article
C2 - 33183381
AN - SCOPUS:85096295273
SN - 1368-9800
VL - 24
SP - 4859
EP - 4868
JO - Public Health Nutrition
JF - Public Health Nutrition
IS - 15
ER -