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Cited by 80Antioxidant Activity and Oxidative StressNutritional Studies and DietExercise and Physiological Responses

Relationship Between Serum Alpha-Tocopherol and Overall and Cause-Specific Mortality: A 30-Year Prospective Cohort Analysis

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Huang, Jiaqi, Weinstein, Stephanie J., Yu, Kai, Männistö, Satu, Albanes, Demetrius·2019·Circulation Research
DOI 10.1161/circresaha.119.314944
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Abstract

Rationale: Although there has been a long-standing interest in the human health effects of vitamin E, a comprehensive analysis of the association between circulating vitamin E and long-term mortality has not been conducted. Objective: Determine whether serum α-tocopherol (the predominant form of vitamin E) is related to long-term overall and cause-specific mortality and elucidate the dose-response relationships with better quantification of the associations. Methods and Results: We conducted a biochemical analysis of 29 092 participants in the ATBC Study (Alpha-Tocopherol, Beta-Carotene Cancer Prevention) that originally tested vitamin E and β-carotene supplementation. Serum α-tocopherol was measured at baseline using high-performance liquid chromatography, and during a 30-year follow-up we identified 23 787 deaths, including deaths from cardiovascular disease (9867), cancer (7687), respiratory disease (2161), diabetes mellitus (119), injuries and accidents (1255), and other causes (2698). After adjusting for major risk factors, we found that men with higher serum α-tocopherol had significantly lower all-cause mortality (hazard ratios=0.83, 0.79, 0.75, and 0.78 for quintile 2 (Q2)–Q5 versus Q1, respectively; P trend <0.0001), and significantly decreased mortality from cardiovascular disease, heart disease, stroke, cancer, respiratory disease, and other causes, with risk reductions from 17% to 47% for the highest versus lowest quintile. The α-tocopherol association with overall mortality was similar across subgroups of smoking intensity, years of smoking, alcohol consumption, trial supplementation, and duration of follow-up. The association was, however, significantly modified by baseline age and body mass index, with stronger inverse associations for younger men and men with a lower body mass index ( P interaction ≤0.006). Conclusions: In this long-term prospective cohort study, higher baseline serum α-tocopherol biochemical status was associated with lower risk of overall mortality and mortality from all major causes. Our data support the long-term health benefits of higher serum α-tocopherol for overall and chronic disease mortality and should be replicated in other more diverse populations.

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  • Higher dietary intake of vitamin E, as measured by serum alpha tocopherol levels, was associated with reduced mortality from several chronic conditions (cardiovascular diseases, stroke, cancer).

    “Higher dietary intake of vitamin E, as measured by serum alpha tocopherol levels, was associated with reduced mortality from several chronic conditions (cardiovascular diseases, stroke, cancer)”

    From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [365]

    The Results report lower cardiovascular disease, stroke, and cancer mortality among men with higher serum α-tocopherol. But the study measured serum vitamin E status, not dietary intake directly, and its cohort comprised Finnish male smokers; the Discussion cautions that the findings may not generalize to other populations. (LLM, conf=0.86)

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Authors
Huang, J., Weinstein, S. J., Yu, K., Männistö, S., & Albanes, D.
Affiliations
  • National Institutes of Health (US)
  • Finnish Institute for Health and Welfare (FI)
Corresponding author
Huang, Jiaqi
ORCID
Venue
Circulation Research
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2019-06-21
Volume
125
Issue
1
Pages
29-40
ISSN
  • 0009-7330 (ISSN-L)
  • 1524-4571
DOI
10.1161/circresaha.119.314944
OpenAlex
W2978780575
Cited by
79
References
51
Citations by year
2026: 9 · 2025: 7 · 2024: 15 · 2023: 10 · 2022: 12 · 2021: 15 · 2020: 8 · 2019: 3
FWCI
5.86
Type
journal article
Language
en
Open access
Locations
  • Circulation Research (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health
  • National Cancer Institute (Z01SC000100, Z01CP010195)
Topics
  • Health Sciences › Medicine › Biochemistry › Antioxidant Activity and Oxidative Stress
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
Keywords
serum alpha-tocopherol, vitamin E, long-term mortality, cause-specific mortality, cardiovascular mortality, cancer mortality, respiratory mortality, dose-response relationship, ATBC Study, body mass index, age modification, smoking, alcohol consumption
MeSH terms
Aged, Cardiovascular Diseases, Cause of Death, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasms, Prospective Studies, Cohort Studies, Biomarkers, Dietary Supplements, alpha-Tocopherol

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