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Plasma retinol: A novel marker for cardiovascular disease mortality in Australian adults

  • L. Brazionis

      Affiliations

    • Discipline of Public Health, School of Public Health and Clinical Practice, The University of Adelaide, SA 5000, Australia
    • Corresponding Author InformationJoint first authors.
    • ,
  • K.Z. Walker

      Affiliations

    • Department of Nutrition and Dietetics, Monash University, Level 5 Block E Monash Medical Centre, Clayton Road, Clayton, VIC 3168, Australia
    • Corresponding Author InformationJoint first authors.
    • Corresponding Author InformationCorresponding author. Tel.: +61 03 9594 7077; fax: + 61 03 9594 6509.
    • ,
  • C. Itsiopoulos

      Affiliations

    • Department of Dietetics, La Trobe University, Bundoora, VIC 3086, Australia
    • ,
  • K. O’Dea

      Affiliations

    • Sansom Institute, Division of Health Sciences, University of South Australia, SA 5000, Australia

Received 4 December 2010; received in revised form 27 July 2011; accepted 22 August 2011. published online 28 November 2011.
Corrected Proof

Abstract 

Background and aims

Vitamin A affects inflammation and immune function and is thus a factor of interest in relation to cardiovascular disease (CVD). As vitamin A circulates in the plasma in the form of retinol, this study aims to describe the relationship between plasma retinol and the 5-year incidence of CVD mortality.

Methods and results

Community-dwelling adults (n = 441, 45% with type 2 diabetes) were recruited in Melbourne, assessed at baseline and followed for 5 years. At baseline, CVD risk factors were assessed by clinical evaluation, by personal lifestyle questionnaire and from biochemistry (plasma fasting glucose, lipids, total homocysteine, C-reactive protein, retinol and carotenoids plus the urinary albumin excretion rate over 24 h.). Dietary intake was assessed by a validated food frequency questionnaire. CVD mortality over 5-years was determined by consulting state or national registries. The majority of participants had adequate plasma retinol concentrations (≥30 μg/dL). The final Cox regression model indicated that those in the highest tertile of plasma retinol (mean ± SD) 76 ± 14 μg/dL) had a significantly lower risk of 5-year CVD mortality (hazard ratio 0.27 [95% confidence interval 0.11, 0.68], P = 0.005), an effect that was not readily explained in terms of traditional CVD risk factors or dietary intake.

Conclusion

In well-nourished older Australian adults, plasma retinol was inversely associated with CVD mortality via mechanisms apparently unrelated to established CVD risk factors and dietary intake.

Keywords: Plasma retinol, Mortality, CVD risk factors

Abbreviations: AER, albumin excretion rate, BMI, body mass index, CI, confidence interval, CVD, cardiovascular disease, CRP, C-reactive protein, FFQ, food frequency questionnaire, HR, hazard ratio, IQR, interquartile range, MCCS, Melbourne Collaborative Cohort Study, PRIME, Prospective Epidemiological Study of Myocardial Infarction, RE, retinol equivalents

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PII: S0939-4753(11)00216-X

doi:10.1016/j.numecd.2011.08.009

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