Antioxidants in adipose tissue and risk of myocardial infarction: the EURAMIC study

doi:10.1016/0140-6736(93)92751-E

The Lancet

Volume 342, Issue 8884, 4 December 1993, Pages 1379-1384

https://doi.org/10.1016/0140-6736(93)92751-E Get rights and content

Abstract

Summary

Laboratory and epidemiological studies suggest that the antioxidants, vitamin E and β-carotene, protect against coronary heart disease. In a European multicentre case-control study α-tocopherol and β-carotene concentrations were measured in adipose-tissue samples collected in 1991-92 from 683 people with acute myocardial infarction and 727 controls.

Mean adipose-tissue β-carotene concentration was 0·35 μg/g in cases and 0·42 in controls, with age-adjusted and centre-adjusted mean difference 0·07 μg/g (95% confidence interval [Cl] 0 04-0·10). Mean α-tocopherol concentrations were 193 μg/g and 192 μg/g for cases and controls, respectively. The age-adjusted and centre-adjusted odds ratio for risk of myocardial infarction in the lowest quintile of β-carotene as compared with the highest was 2·62 (95% Cl 1·79-3·83). Additional control for body-mass index and smoking reduced the odds ratio to 1·78(95% Cl 1·17-2·71); other established risk factors did not substantially alter this ratio. The increased risk was mainly confined to current smokers: the multivariate odds ratio in the lowest β-carotene quintile in smokers was 2·39 (95% Cl 1·35-4 25), whereas it was 1·07 for people who had never smoked. A low α-tocopherol concentration was not associated with risk of myocardial infarction.

Our results support the hypothesis that high β-carotene concentrations within the normal range reduce the risk of a first myocardial infarction. The findings for α-tocopherol are compatible with previous observations of reduced risk among vitamin E supplement users only. The consumption of β-carotene-rich foods such as carrots and green-leaf vegetables may reduce the risk of myocardial infarction.

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Citation Excerpt :
However, the plasma level of zeaxanthin was only 17% of lutein and 34% of β-cryptoxanthin, which may explain the lack of biological effect of zeaxanthin in this study. Although observational studies generally indicated that serum or adipose β-carotene levels are inversely associated with CHD risk [16,21,22], our results on the null association between β-carotene and AMI risk concurred with intervention trials on β-carotene and CHD prevention [23–25]. In fact, human studies have showed that dietary supplementation of β-carotene alone is ineffective at preventing LDL oxidation in vitro [26,27].
Modification of low-density lipoprotein due to oxidative stress is essential in the development of coronary atherosclerosis. Data of specific carotenoids except β-carotene on cardioprotective effects in humans are limited.
This study examined the associations between plasma concentrations of specific carotenoids and incidence of acute myocardial infarction. The study included 280 incident cases of acute myocardial infarction and 560 matched controls nested within the Singapore Chinese Health Study, a prospective cohort of 63,257 Chinese men and women aged 45–74 years old enrolled in 1993–1998 in Singapore. Retinol and carotenoids in prediagnostic plasma were quantified using high-performance liquid chromatography. High levels of plasma β-cryptoxanthin and lutein were associated with decreased risk of acute myocardial infarction after adjustment for multiple risk factors for coronary heart disease. For β-cryptoxanthin, the odds ratio (95% confidence interval) for the highest (Q5) versus the lowest (Q1) quintile was 0.67 (0.37–1.21) (P for trend = 0.03). For lutein, the odds ratios (95% confidence intervals) for the combined Q2–Q3 and the combined Q4–Q5 versus Q1 were 0.71 (0.45–1.12) and 0.58 (0.35–0.94) respectively (P for trend = 0.03). There was no statistically significant association between other carotenoids or retinol and risk of acute myocardial infarction.
High plasma levels of β-cryptoxanthin and lutein were associated with decreased risk of acute myocardial infarction. The findings of this study support a cardioprotective role of these two carotenoids in humans.

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ArticlesAntioxidants in adipose tissue and risk of myocardial infarction: the EURAMIC study

Abstract

Lancet

Lancet

Am J Clin Nutr

Am J Cardiol

Am J Clin Nutr

J Chrom

Am J Clin Nutr

Am J Clin Nutr

Biochim Biophys Acta

Am J Clin Nutr

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J Clin Invest

The antioxidant butylated hydroxtoluene protects against atherosclerosis

Atherosclerosis Thromb

Effects of d-alpha-tocopherol supplementation on experimentally induced primate atherosclerosis

J Am Coll Nutr

Vitamin E consumption and the risk of coronary heart disease in men

N Engl J Med

Vitamin E consumption and the risk of coronary disease in women

N Engl J Med

Articles
Antioxidants in adipose tissue and risk of myocardial infarction: the EURAMIC study