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American Journal of Clinical Nutrition, Vol. 79, No. 1, 47-53, January 2004
© 2004 American Society for Clinical Nutrition


ORIGINAL RESEARCH COMMUNICATIONS

Plasma lycopene, other carotenoids, and retinol and the risk of cardiovascular disease in women1,2,3

Howard D Sesso, Julie E Buring, Edward P Norkus and J Michael Gaziano

1 From the Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston (HDS, JEB, and JMG); the Department of Epidemiology, Harvard School of Public Health, Boston (HDS and JEB); the Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston (HDS and JMG); the Department of Ambulatory Care and Prevention, Harvard Medical School, Boston (JEB); and the Department of Medical Research, Our Lady of Mercy Medical Center, and Community and Preventive Medicine, New York Medical College, Bronx, NY (EPN).

Background: Growing evidence suggests that lycopene has significant in vitro antioxidant potential. Lycopene has rarely been tested in prospective studies for its role in cardiovascular disease (CVD) prevention.

Objective: We examined the association between plasma lycopene and the risk of CVD in middle-aged and elderly women.

Design: A prospective, nested, case-control study was conducted in 39 876 women initially free of CVD and cancer in the Women's Health Study. Baseline blood samples were collected from 28 345 (71%) of the women. During a mean of 4.8 y of follow-up, we identified 483 CVD cases and 483 control subjects matched by age, smoking status, and follow-up time. Plasma lycopene, other carotenoids, retinol, and total cholesterol were measured.

Results: In analyses matched for age and smoking, with adjustment for plasma cholesterol, the relative risks (RRs) and 95% CIs of CVD in increasing quartiles of plasma lycopene were 1.00 (referent), 0.78 (95% CI: 0.55, 1.11), 0.56 (0.39, 0.82), and 0.62 (0.43, 0.90). In multivariate models, the RRs were 1.00 (referent), 0.94 (0.60, 1.49), 0.62 (0.39, 1.00), and 0.67 (0.41, 1.11); those in the upper compared with the lower half of plasma lycopene had an RR of 0.66 (0.47, 0.95). For CVD, exclusive of angina, women in the upper 3 quartiles had a significant multivariate 50% risk reduction compared with those in the lowest quartile. The stepwise addition of individual plasma carotenoids did not affect the RRs.

Conclusions: Higher plasma lycopene concentrations are associated with a lower risk of CVD in women. These findings require confirmation in other cohorts, and the determinants of plasma lycopene concentrations need to be better understood.

Key Words: Lycopene • cardiovascular disease • women • prospective studies • nutrition




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