EPIDEMIOLOGY

Serum carotenoids, vitamins A and E, and 8 year lung function decline in a general population

A Guénégou¹, B Leynaert¹, I Pin², G Le Moël³, M Zureik¹, F Neukirch¹

¹ Department of Epidemiology, INSERM Unit 700, University of Medicine Bichat, Paris, France
² Grenoble Teaching Hospital, Grenoble, France
³ Biochemistry A, Bichat Teaching Hospital APHP, Paris, France

Correspondence to:
Correspondence to:
Dr A Guénégou
Department of Epidemiology INSERM Unit 700, University of Medicine Bichat, 16 rue Henry Huchard, 75018 Paris, France; guenegou{at}bichat.inserm.fr

Background: Oxidative stress is thought to have a major role in the pathogenesis of airway obstruction. A study was undertaken to determine whether subjects with low levels of antioxidants (serum ß-carotene, -carotene, vitamins A and E) would be at a higher risk of accelerated decline in forced expiratory volume in 1 second (FEV₁) as their lungs would be less protected against oxidative stress.

Methods: 1194 French subjects aged 20–44 years were examined in 1992 as part of the European Community Respiratory Health Survey (ECRHS); 864 were followed up in 2000 and 535 (50% men, 40% lifelong non-smokers) had complete data for analysis.

Results: During the 8 year study period the mean annual decrease in FEV₁ (adjusted for sex, centre, baseline FEV₁, age, smoking, body mass index and low density lipoprotein cholesterol) was 29.8 ml/year. The rate of decrease was lower for the subjects in tertile I of ß-carotene at baseline than for those in the two other tertiles (–36.5 v –27.6 ml/year; p = 0.004). An increase in ß-carotene between the two surveys was associated with a slower decline in FEV₁. No association was observed between -carotene, vitamin A, or vitamin E and FEV₁ decline. However, being a heavy smoker (20 cigarettes/day) in combination with a low level of ß-carotene or vitamin E was associated with the steepest decline in FEV₁ (–52.5 ml/year, p = 0.0002 and –50.1 ml/year, p = 0.010, respectively).

Conclusions: These results strongly suggest that ß-carotene protects against the decline in FEV₁ over an 8 year period in the general population, and that ß-carotene and vitamin E are protective in heavy smokers.

Abbreviations: BMI, body mass index; FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity; LDL, low density lipoprotein

Keywords: carotenoids; antioxidants; lung function decline; epidemiology

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