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Low plasma retinol predicts coronary events in healthy middle-aged men: the PRIME Study

K Fred Gey1, Pierre Ducimetière, Alun Evans

  • 1MONICA Reference Centre for Vitamins-Bern, Department of Biochemistry and Molecular Biology, University of Bern, Switzerland.

Atherosclerosis
|August 8, 2009
PubMed

Insights

Low plasma retinol, a form of vitamin A, significantly increases coronary heart disease risk in middle-aged men. This finding suggests potential vitamin A deficiency in this population.

Area of Science:

  • Cardiovascular epidemiology
  • Nutritional science
  • Public health

Background:

  • The association between plasma concentrations of retinol and carotenoids and coronary heart disease (CHD) is not well-established.
  • Previous research has yielded conflicting results regarding the role of these micronutrients in cardiovascular health.

Purpose of the Study:

  • To prospectively investigate the relationship between plasma retinol and carotenoid levels and the incidence of coronary heart disease (CHD) in a large cohort of European men.
  • To determine if low levels of these nutrients are associated with an increased risk of developing CHD.

Main Methods:

  • The PRIME Study prospectively followed 9758 men aged 50-59 years, free of CHD at baseline, in France and Northern Ireland.
  • Incident CHD cases (n=150) over five years were compared to matched controls (n=285).
  • Plasma levels of retinol and major carotenoids were measured and analyzed in relation to CHD incidence, adjusting for cardiovascular risk factors.

Main Results:

  • Plasma retinol levels were significantly lower (9%) in men who developed CHD compared to controls (P<0.002).
  • No significant differences in major carotenoid levels were observed between cases and controls.
  • Men in the lowest quintile of plasma retinol (< or =601 microg/l) had a 2.65-fold increased risk of CHD (P=0.0009), with a linear trend observed across retinol quintiles (P=0.0001).
  • The 10th percentile of lipid-standardized retinol (< or =544 microg/l) predicted a 4.7-fold increased risk of CHD (P<0.001).
  • Low plasma retinol was comparable in risk magnitude to established factors like low HDL-cholesterol and high Interleukin-6.

Conclusions:

  • Plasma retinol levels below 601 microg/l in approximately 20% of middle-aged European men are associated with a threefold increased risk of developing coronary heart disease.
  • These findings suggest that vitamin A intake may be insufficient in this demographic group.
  • Further research is warranted to confirm these results and explore potential interventions.

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