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Serum carotenoids, vitamins A and E, and 8 year lung function decline in a general population
  1. A Guénégou1,
  2. B Leynaert1,
  3. I Pin2,
  4. G Le Moël3,
  5. M Zureik1,
  6. F Neukirch1
  1. 1Department of Epidemiology, INSERM Unit 700, University of Medicine Bichat, Paris, France
  2. 2Grenoble Teaching Hospital, Grenoble, France
  3. 3Biochemistry A, Bichat Teaching Hospital APHP, Paris, France
  1. Correspondence to:
    Dr A Guénégou
    Department of Epidemiology INSERM Unit 700, University of Medicine Bichat, 16 rue Henry Huchard, 75018 Paris, France; guenegou{at}


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 β-carotene, α-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 β-carotene at baseline than for those in the two other tertiles (−36.5 v −27.6 ml/year; p = 0.004). An increase in β-carotene between the two surveys was associated with a slower decline in FEV1. No association was observed between α-carotene, vitamin A, or vitamin E and FEV1 decline. However, being a heavy smoker (⩾20 cigarettes/day) in combination with a low level of β-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 β-carotene protects against the decline in FEV1 over an 8 year period in the general population, and that β-carotene and vitamin E are protective in heavy smokers.

  • BMI, body mass index
  • FEV1, forced expiratory volume in 1 second
  • FVC, forced vital capacity
  • LDL, low density lipoprotein
  • carotenoids
  • antioxidants
  • lung function decline
  • epidemiology

Statistics from


  • Data collection for the European Community Respiratory Health Survey follow up phase (ECRHS II) was supported by UCB Pharma, France and by the Programme Hospitalier de Recherche Clinique-DRC of Grenoble 2000 no. 2610.

  • Competing interests: none.

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