Decision analysis supports the paradigm that indiscriminate supplementation of vitamin E does more harm than good
- PMID: 19286632
- DOI: 10.1161/ATVBAHA.108.178699
Decision analysis supports the paradigm that indiscriminate supplementation of vitamin E does more harm than good
Abstract
Objective: For many years, the prevailing concept was that LDL oxidation plays a central role in atherogenesis. As a consequence, supplementation of antioxidants, particularly vitamin E, became very popular. Unfortunately, however, the major randomized clinical trials have yielded disappointing results on the effects of vitamin E on both mortality and morbidity. Moreover, recent meta-analyses have concluded that vitamin E supplementation increases mortality. This conclusion has raised much criticism, most of it relating to three issues: (1) the choice of clinical trials to be included in the meta-analyses; (2) the end point of these meta-analyses (only mortality); and (3) the heterogeneity of the analyzed clinical trials with respect to both population and treatment. Our goal was to bring this controversy to an end by using a Markov-model approach, which is free of most of the limitations involved in using meta-analyses.
Methods and results: We used a Markov model to compare the vitamin E supplemented virtual cohorts with nonsupplemented cohorts derived from published randomized clinical trials that were included in at least one of the major meta-analyses. The difference between the virtual supplemented and nonsupplemented cohorts is given in terms of a composite end point denoted quality-adjusted life year (QALY). The vitamin E supplemented virtual cohort had 0.30 QALY (95%CI 0.21 to 0.39) less than the nontreated virtual cohort.
Conclusions: Our study demonstrates that in terms of QALY, indiscriminate supplementation of high doses of vitamin E is not beneficial in preventing CVD. Selective supplementation of vitamin E to individuals under oxidative stress requires further investigation.
Similar articles
-
[Who is likely to gain from high dose supplementation of vitamin E?].Harefuah. 2011 Jan;150(1):37-40, 68. Harefuah. 2011. PMID: 21449155 Hebrew.
-
No evidence supports vitamin E indiscriminate supplementation.Biofactors. 2009 Nov-Dec;35(6):469-73. doi: 10.1002/biof.61. Biofactors. 2009. PMID: 19866453 Review.
-
The questionable association of vitamin E supplementation and mortality--inconsistent results of different meta-analytic approaches.Cell Mol Biol (Noisy-le-grand). 2009 Feb 25;55 Suppl:OL1111-20. Cell Mol Biol (Noisy-le-grand). 2009. PMID: 19267994
-
Vitamin C and vitamin E for Alzheimer's disease.Ann Pharmacother. 2005 Dec;39(12):2073-80. doi: 10.1345/aph.1E495. Epub 2005 Oct 14. Ann Pharmacother. 2005. PMID: 16227450 Review.
-
[Vitamin E and cardiovascular prevention].Ann Biol Clin (Paris). 2000 Sep-Oct;58(5):527-40. Ann Biol Clin (Paris). 2000. PMID: 11022097 Review. French.
Cited by
-
NADPH oxidases: Pathophysiology and therapeutic potential in age-associated pulmonary fibrosis.Redox Biol. 2020 Jun;33:101541. doi: 10.1016/j.redox.2020.101541. Epub 2020 Apr 17. Redox Biol. 2020. PMID: 32360174 Free PMC article. Review.
-
Redox phospholipidomics of enzymatically generated oxygenated phospholipids as specific signals of programmed cell death.Free Radic Biol Med. 2020 Feb 1;147:231-241. doi: 10.1016/j.freeradbiomed.2019.12.028. Epub 2019 Dec 25. Free Radic Biol Med. 2020. PMID: 31883467 Free PMC article. Review.
-
Antioxidant, Anti-Inflammatory, and Metabolic Properties of Tocopherols and Tocotrienols: Clinical Implications for Vitamin E Supplementation in Diabetic Kidney Disease.Int J Mol Sci. 2019 Oct 15;20(20):5101. doi: 10.3390/ijms20205101. Int J Mol Sci. 2019. PMID: 31618817 Free PMC article. Review.
-
"Redox lipidomics technology: Looking for a needle in a haystack".Chem Phys Lipids. 2019 Jul;221:93-107. doi: 10.1016/j.chemphyslip.2019.03.012. Epub 2019 Mar 27. Chem Phys Lipids. 2019. PMID: 30928338 Free PMC article. Review.
-
A thermodynamically-constrained mathematical model for the kinetics and regulation of NADPH oxidase 2 complex-mediated electron transfer and superoxide production.Free Radic Biol Med. 2019 Apr;134:581-597. doi: 10.1016/j.freeradbiomed.2019.02.003. Epub 2019 Feb 13. Free Radic Biol Med. 2019. PMID: 30769160 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Research Materials