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[大学生论坛]:维生素D和降低癌症和心血管疾病

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3151204002 发表于 2019-1-4 11:36:54 来自手机 | 显示全部楼层 |阅读模式
本帖最后由 3151204002 于 2019-1-4 12:09 编辑

ABSTRACT

      BACKGROUND

It is unclear whether supplementation with vitamin D reduces the risk of canceror cardiovascular disease, and data from randomized trials are limited.
目前尚不清楚补充维生素D是否能降低癌症或心血管疾病的风险,随机试验的数据也有限。
  METHODS

We conducted a nationwide, randomized, placebo-controlled trial, with a two-by-two factorial design, of vitamin D, (cholecalciferol) at a dose of 2000 IU per day and marine n-3 (also called omega-3) fatty acids at a dose of 1g per day for the pre-vention of cancer and cardiovascular disease among men 50 years of age or older and women 55 years of age or older in the United States. Primary end points were invasive cancer of any type and major cardiovascular events (a composite of myo-cardial infarction, stroke, or death from cardiovascular causes). Secondary end pointsincluded site-specific cancers, death from cancer, and additional cardiovascular events.This article reports the results of the comparison of vitamin D with placebo.
我们进行了一项全国性随机安慰剂对照试验,采用2×2因子设计,研究维生素D(胆钙化醇)每日剂量为2000 IU,海洋n-3(也称为omega-3)脂肪酸每日剂量为1g,用于美国50岁以上男性和55岁以下女性的癌症和心血管疾病的预防。主要目的是任何类型的侵袭性癌症和主要心血管事件(心肌梗塞、中风或心血管原因所致死亡的复合物)。次要目的包括特定部位的癌症、癌症死亡和其他心血管事件。本文报告了维生素D与安慰剂的比较结果。
  RESULTS

  A total of 25,871 participants, including 5106 black participants, underwent random-ization. Supplementation with vitamin D was not associated with a lower risk of either of the primary end points. During a median follow-up of 5.3 years, cancer was diagnosed in 1617 participants (793 in the vitamin D group and 824 in the placebo group; hazard ratio, 0.96; 95% confidence interval [CI], 0.88 to 1.06; P=0.47).A major cardiovascular event occurred in 805 participants (396 in the vitamin Dgroup and 409 in the placebo group; hazard ratio, 0.97; 95% CI, 0.85 to 1.12; P=0.69).In the analyses of secondary end points, the hazard ratios were as follows: for deathfrom cancer (341 deaths), 0.83 (95% cI, 0.67 to 1.02); for breast cancer, 1.02 (95% CI,0.79 to 1.31); for prostate cancer, 0.88 (95% CI, 0.72 to 1.07); for colorectal cancer, 1.09(95% CI, 0.73 to 1.62); for the expanded composite end point of major cardiovascular events plus coronary revascularization, 0.96 (95% cI, 0.86 to 1.08); for myocardial infarction, 0.96 (95% CI, 0.78 to 1.19); for stroke, 0.95 (95% CI, 0.76 to 1.20);and for death from cardiovascular causes, 1.11 (95% CI, 0.88 to 1.40). In the analysis of death from any cause (978 deaths), the hazard ratio was 0.99 (95% CI, 0.87 to1.12). No excess risks of hypercalcemia or other adverse events were identified.
共有25871名参与者,包括5106名黑人参与者,接受了随机分组。补充维生素D并不能降低主要终点的风险。在5.3年的中位随访中,1617名受试者(维生素D组793名,安慰剂组824名,风险比0.96,95%可信区间(CI)为0.88-1.06,P=0.47)被诊断为癌症。805名受试者(维生素D组396名,安慰剂组409名,风险比0.97,95名)发生了严重的心血管事件。%ci,0.85-1.12;p=0.69),在对次要终点的分析中,危险比如下:癌症死亡(341例死亡)为0.83(95%ci,0.67-1.02);乳腺癌为1.02(95%ci,0.79-1.31);前列腺癌为0.88(95%ci,0.72-1.07);结直肠癌为1.09(95%ci,0.73-1.62);复合终点扩大为1.09(95%ci,0.73-1.62)。主要心血管事件积分加上冠状动脉血运重建,0.96(95%CI,0.86-1.08);心肌梗死,0.96(95%CI,0.78-1.19);中风,0.95(95%CI,0.76-1.20);心血管原因死亡,1.11(95%CI,0.88-1.40)。在分析任何原因导致的死亡(978例死亡)时,危险比为0.99(95%可信区间,0.87-1.12)。未发现高钙血症或其他不良事件的过度风险。
CONCLUSIONS

Supplementation with vitamin D did not result in a lower incidence of invasivecancer or cardiovascular events than placebo. (Funded by the National Institutesof Health and others; VITAL ClinicalTrials.gov number, NCT01169259.)
与安慰剂相比,补充维生素D并不能降低侵袭性癌症或心血管事件的发生率。
来源:新英格兰杂志
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