Intake of antioxidants and B vitamins is inversely associated with ischemic stroke and cerebral atherosclerosis
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
BACKGROUND/OBJECTIVES: This study was conducted to examine relationships between dietary habits and intakes of antioxidants and B vitamins and the risk of ischemic stroke, and to compare dietary factors according to the presence of cerebral artery atherosclerosis and stroke subtypes. SUBJECTS/METHODS: A total of 147 patients and 144 control subjects were recruited consecutively in the metropolitan area of Seoul, Korea. Sixty participants each in the case and control groups were included in analyses after 1:1 frequency matching. In addition, 117 acute ischemic stroke patients were classified into subtypes according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) guidelines. Dietary intake was measured using a semi-quantitative food frequency questionnaire composed of 111 food items and plasma lipid and homocysteine levels were analyzed. RESULTS: When compared with control subjects, stroke patients had unfavorable dietary behaviors and lower intakes of fruits (73.1 ± 83.2 g vs. 230.9 ± 202.1 g, P < 0.001), vegetables (221.1 ± 209.0 g vs. 561.7 ± 306.6 g, P < 0.001), and antioxidants, including vitamins C, E, B6, β-carotene, and folate. The intakes of fruits, vegetables, vitamin C, and folate were inversely associated with the risk of ischemic stroke after adjusting for confounding factors. Intakes of vegetables, vitamins C, B6, B12, and folate per 1,000 kcal were lower in ischemic stroke with cerebral atherosclerosis than in those without. Overall vitamin B12 intake per 1,000 kcal differed according to the TOAST classification (P = 0.004), but no differences among groups existed based on the post-hoc test. CONCLUSIONS: When compared with control subjects, ischemic stroke patients, particularly those with cerebral atherosclerosis, had unfavorable dietary intake, which may have contributed to the development of ischemic stroke. These results indicate that proper dietary recommendations are important for the prevention of ischemic stroke.
Abstract
BACKGROUND/OBJECTIVES: This study was conducted to examine relationships between dietary habits and intakes of antioxidants and B vitamins and the risk of ischemic stroke, and to compare dietary factors according to the presence of cerebral artery atherosclerosis and stroke subtypes. SUBJECTS/METHODS: A total of 147 patients and 144 control subjects were recruited consecutively in the metropolitan area of Seoul, Korea. Sixty participants each in the case and control groups were included in analyses after 1:1 frequency matching. In addition, 117 acute ischemic stroke patients were classified into subtypes according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) guidelines. Dietary intake was measured using a semi-quantitative food frequency questionnaire composed of 111 food items and plasma lipid and homocysteine levels were analyzed. RESULTS: When compared with control subjects, stroke patients had unfavorable dietary behaviors and lower intakes of fruits (73.1 ± 83.2 g vs. 230.9 ± 202.1 g, P < 0.001), vegetables (221.1 ± 209.0 g vs. 561.7 ± 306.6 g, P < 0.001), and antioxidants, including vitamins C, E, B6, β-carotene, and folate. The intakes of fruits, vegetables, vitamin C, and folate were inversely associated with the risk of ischemic stroke after adjusting for confounding factors. Intakes of vegetables, vitamins C, B6, B12, and folate per 1,000 kcal were lower in ischemic stroke with cerebral atherosclerosis than in those without. Overall vitamin B12 intake per 1,000 kcal differed according to the TOAST classification (P = 0.004), but no differences among groups existed based on the post-hoc test. CONCLUSIONS: When compared with control subjects, ischemic stroke patients, particularly those with cerebral atherosclerosis, had unfavorable dietary intake, which may have contributed to the development of ischemic stroke. These results indicate that proper dietary recommendations are important for the prevention of ischemic stroke.
참고문헌 (46)
- "The top ten cause of death" (2014)[URL]
- Statistics Korea, "Death Rates for the 10 Leading Causes of Death" (2012), Statistics Korea
- Korea Health Statistics 2009: Korea National Health and Nutrition Examination Survey, "Ministry of Health and Welfare", Korea Centers for Disease Control and Prevention, ~, pp.KNHANES IV-3 (2010)
- Ullegaddi R, "Antioxidant supplementation enhances antioxidant capacity and mitigates oxidative damage following acute ischaemic stroke", Eur J Clin Nutr, 59, pp.1367~1373 (2005)
- Murat Sumer M, "Ischemic stroke subtypes: risk factors, functional outcome and recurrence", Neurol Sci, 22, pp.449~454 (2002)
- Holmstedt CA, "Atherosclerotic intracranial arterial stenosis: risk factors, diagnosis, and treatment", Lancet Neurol, 12, pp.1106~1114 (2013)
- Tholstrup T., "Dairy products and cardiovascular disease", Curr Opin Lipidol, 17, pp.1~10 (2006)
- Keli SO, "Dietary flavonoids, antioxidant vitamins, and incidence of stroke: the Zutphen study", Arch Intern Med, 156, pp.637~642 (1996)
- Hirvonen T, "Intake of flavonoids, carotenoids, vitamins C and E, and risk of stroke in male smokers", Stroke, 31, pp.2301~2306 (2000)
- Joshipura KJ, "Fruit and vegetable intake in relation to risk of ischemic stroke", JAMA, 282, pp.1233~1239 (1999)
- Witztum JL., "The oxidation hypothesis of atherosclerosis", Lancet, 344, pp.793~795 (1994)
- Navab M, "The oxidation hypothesis of atherogenesis: the role of oxidized phospholipids and HDL", J Lipid Res, 45, pp.993~1007 (2004)
- Sarkar PK, "Aetiology and treatment of hyperhomocysteinaemia causing ischaemic stroke", Int J Clin Pract, 55, pp.262~268 (2001)
- Sánchez-Moreno C, "Stroke: roles of B vitamins, homocysteine and antioxidants", Nutr Res Rev, 22, pp.49~67 (2009)
- North American Symptomatic Carotid Endarterectomy Trial Collaborators, "Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis", N Engl J Med, 325, pp.445~453 (1991)
- Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Trial Investigators, "Design, progress and challenges of a double-blind trial of warfarin versus aspirin for symptomatic intracranial arterial stenosis", Neuroepidemiology, 22, pp.106~117 (2003)
- Adams HP Jr, "Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment", Stroke, 24, pp.35~41 (1993)
- Oh SY, "Development and validation of food frequency questionnaire for adults", The Korean Society of Health Promotion Annual Spring Conference, pp.67~72 (2007), The Korean Society of Health Promotion
- The Korean Nutrition Society, "Dietary Reference Intakes for Koreans", The Korean Nutrition Society, ~ (2010)
- Willett WC, "Adjustment for total energy intake in epidemiologic studies", Am J Clin Nutr, 65, pp.1220S~1228S (1997)
- Leppälä JM, "Different risk factors for different stroke subtypes: association of blood pressure, cholesterol, and antioxidants", Stroke, 30, pp.2535~2540 (1999)
- Umesawa M, "Dietary intake of calcium in relation to mortality from cardiovascular disease: the JACC Study", Stroke, 37, pp.20~26 (2006)
- Liu S, "Whole grain consumption and risk of ischemic stroke in women: a prospective study", JAMA, 284, pp.1534~1540 (2000)
- Steffen LM, "Associations of whole-grain, refined-grain, and fruit and vegetable consumption with risks of all-cause mortality and incident coronary artery disease and ischemic stroke: the Atherosclerosis Risk in Communities (ARIC) Study", Am J Clin Nutr, 78, pp.383~390 (2003)
- Lim H, "Dietary pattern, nutritional density, and dietary quality were low in patients with cerebral infarction in Korea", Nutr Res, 31, pp.601~607 (2011)
- Carden DL, "Pathophysiology of ischaemia-reperfusion injury", J Pathol, 190, pp.255~266 (2000)
- Joshipura KJ, "The effect of fruit and vegetable intake on risk for coronary heart disease", Ann Intern Med, 134, pp.1106~1114 (2001)
- Johnsen SP, "Intake of fruit and vegetables and the risk of ischemic stroke in a cohort of Danish men and women", Am J Clin Nutr, 78, pp.57~64 (2003)
- Massey LK., "Dairy food consumption, blood pressure and stroke", J Nutr, 131, pp.1875~1878 (2001)
- Hak AE, "Prospective study of plasma carotenoids and tocopherols in relation to risk of ischemic stroke", Stroke, 35, pp.1584~1588 (2004)
- Vokó Z, "Dietary antioxidants and the risk of ischemic stroke: the Rotterdam Study", Neurology, 61, pp.1273~1275 (2003)
- Van Guelpen B, "Folate, vitamin B12, and risk of ischemic and hemorrhagic stroke: a prospective, nested case-referent study of plasma concentrations and dietary intake", Stroke, 36, pp.1426~1431 (2005)
- Larsson SC, "Folate, vitamin B6, vitamin B12, and methionine intakes and risk of stroke subtypes in male smokers", Am J Epidemiol, 167, pp.954~961 (2008)
- Gale CR, "Vitamin C and risk of death from stroke and coronary heart disease in cohort of elderly people", BMJ, 310, pp.1563~1566 (1995)
- González-Gross M, "Nutrition and cognitive impairment in the elderly", Br J Nutr, 86, pp.313~321 (2001)
- Weng LC, "Is ischemic stroke risk related to folate status or other nutrients correlated with folate intake?", Stroke, 39, pp.3152~3158 (2008)
- Hankey GJ, "Homocysteine and vascular disease", Lancet, 354, pp.407~413 (1999)
- Ullegaddi R, "Antioxidant supplementation with or without B-group vitamins after acute ischemic stroke: a randomized controlled trial", JPEN J Parenter Enteral Nutr, 30, pp.108~114 (2006)
- Choi-Kwon S, "Nutritional status in acute stroke: undernutrition versus overnutrition in different stroke subtypes", Acta Neurol Scand, 98, pp.187~192 (1998)
- Neaton JD, "Risk factors for death from different types of stroke", Ann Epidemiol, 3, pp.493~499 (1993)
- "WHO publishes definitive atlas on global heart disease and stroke epidemic", Indian J Med Sci, 58, pp.405~406 (2004)
- Mahe G, "An unfavorable dietary pattern is associated with symptomatic ischemic stroke and carotid atherosclerosis", J Vasc Surg, 52, pp.62~68 (2010)
- Fujishima M., "Cerebrovascular disorders among Japanese", Nihon Naika Gakkai zasshi, 85, pp.1407~1418 (1996)
- Evers S, "Features, symptoms, and neurophysiological findings in stroke associated with hyperhomocysteinemia", Arch Neurol, 54, pp.1276~1282 (1997)
- Eikelboom JW, "Association between high homocyst(e)ine and ischemic stroke due to large- and small-artery disease but not other etiologic subtypes of ischemic stroke", Stroke, 31, pp.1069~1075 (2000)
- Chambers JC, "Improved vascular endothelial function after oral B vitamins: an effect mediated through reduced concentrations of free plasma homocysteine", Circulation, 102, pp.2479~2483 (2000)
