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Association of serum levels of antioxidant micronutrients with mortality in US adults: National Health and Nutrition Examination Survey 1999-2002.

Authors
  • Peeri, Noah C1
  • Chai, Weiwen2
  • Cooney, Robert V3
  • Tao, Meng-Hua1
  • 1 Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, School of Public Health, Fort Worth, TX76107, USA.
  • 2 Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, USA.
  • 3 Office of Public Health Studies, University of Hawai'i at Manoa, Honolulu, HI, USA.
Type
Published Article
Journal
Public Health Nutrition
Publisher
Cambridge University Press
Publication Date
Oct 01, 2021
Volume
24
Issue
15
Pages
4859–4868
Identifiers
DOI: 10.1017/S1368980020004619
PMID: 33183381
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To examine associations between serum antioxidant levels and mortality (all-cause, cancer and CVD) among US adults. 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. The National Health and Nutrition Examination Survey (NHANES) 1999-2002 was followed up through 31 December 2015. 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. 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. 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.

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