期刊
ARCHIVES OF INTERNAL MEDICINE
卷 169, 期 3, 页码 294-304出版社
AMER MEDICAL ASSOC
DOI: 10.1001/archinternmed.2008.540
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资金
- NHLBI NIH HHS [N01WH32105, N01WH32118, N01WH42124, N01WH42130, N01WH42118, N01WH42111, N01WH42126, N01WH42107, N01WH42131] Funding Source: Medline
- WHI NIH HHS [N01 WH 32122, N01 WH 32109, N01 WH 42125, N01WH32106, N01 WH 42121, N01 WH042116, N01WH42115, N01 WH 42112, N01WH42109, N01 WH042108-011, N01WH42123, N01 WH 42118, N01 WH042118, N01 WH 42132, N01 WH 42124, N01 WH042114, N01WH42132, N01 WH 42115, N01WH44221, N01 WH 42131, N01 WH 32106, N01 WH 42107, N01 WH 42120, N01WH32122, N01WH32109, N01 WH 32118, N01WH42125, N01WH24152, N01 WH 32113, N01 WH 42116, N01 WH 32115, N01 WH 42110, N01 WH 32108, N01 WH 44221, N01 WH 42129, N01WH42113, N01 WH042120, N01 WH 32105, N01 WH 42122, N01 WH032102, N01WH32119, N01 WH 42113, N01 WH 42130, N01WH42117, N01 WH 32112, N01WH32108, N01 WH 32100, N01WH22110, N01 WH 42119, N01 WH 42114, N01WH42122, N01WH42110, N01WH32112, N01 WH 24152, N01WH42119, N01 WH 42117, N01 WH 32111, N01 WH 32102, N01WH42129, N01 WH 42123, N01 WH 42127, N01 WH 42111, N01WH32100, N01WH32111, N01WH32115, N01 WH 32119, N01 WH042112, N01WH42121, N01 WH 42109, N01 WH 42108, N01WH32101, N01 WH 42126, N01WH32113, N01 WH 32101, N01 WH 22110] Funding Source: Medline
Background: Millions of postmenopausal women use multivitamins, often believing that supplements prevent chronic diseases such as cancer and cardiovascular disease (CVD). Therefore, we decided to examine associations between multivitamin use and risk of cancer, CVD, and mortality in postmenopausal women. Methods: The study included 161 808 participants from the Women's Health Initiative clinical trials (N = 68 132 in 3 overlapping trials of hormone therapy, dietary modification, and calcium and vitamin D supplements) or an observational study (N = 93 676). Detailed data were collected on multivitamin use at baseline and follow-up time points. Study enrollment occurred between 1993 and 1998; the women were followed up for a median of 8.0 years in the clinical trials and 7.9 years in the observational study. Disease end points were collected through 2005. We documented cancers of the breast (invasive), colon/rectum, endometrium, kidney, bladder, stomach, ovary, and lung; CVD (myocardial infarction, stroke, and venous thromboembolism); and total mortality. Results: A total of 41.5% of the participants used multivitamins. After a median of 8.0 years of follow-up in the clinical trial cohort and 7.9 years in the observational study cohort, 9619 cases of breast, colorectal, endometrial, renal, bladder, stomach, lung, or ovarian cancer; 8751 CVD events; and 9865 deaths were reported. Multivariate-adjusted analyses revealed no association of multivitamin use with risk of cancer (hazard ratio [HR], 0.98, and 95% confidence interval [CI], 0.91-1.05 for breast cancer; HR, 0.99, and 95% CI, 0.88-1.11 for colorectal cancer; HR, 1.05, and 95% CI, 0.90-1.21 for endometrial cancer; HR, 1.0, and 95% CI, 0.88-1.13 for lung cancer; and HR, 1.07, and 95% CI, 0.88-1.29 for ovarian cancer); CVD (HR, 0.96, and 95% CI, 0.89-1.03 for myocardial infarction; HR, 0.99, and 95% CI, 0.91-1.07 for stroke; and HR, 1.05, and 95% CI, 0.85-1.29 for venous thromboembolism); or mortality (HR, 1.02, and 95% CI, 0.97-1.07). Conclusion: After a median follow-up of 8.0 and 7.9 years in the clinical trial and observational study cohorts, respectively, the Women's Health Initiative study provided convincing evidence that multivitamin use has little or no influence on the risk of common cancers, CVD, or total mortality in postmenopausal women.
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