Zusammenfassung
In nur einem Jahr - 2005 - sind mindestens zehn randomisierte Langzeitstudien über
eineinhalb bis dreizehn Jahre mit antioxidativ wirksamen Vitaminen veröffentlicht
worden. Die Zahl der beteiligten Gesunden und Patienten ging von wenigen 100 Personen
bis zu über 135 000 Männern und Frauen in Nordamerika, Europa und China. In erster
Linie wurde Vitamin E allein in Dosierungen von 100 bis zu 5000 mg oder in Kombination
mit Vitamin C oder Betakarotin verwendet. Somit können weder eine zu kurze Dauer der
Studien noch eine zu geringe Dosis der antioxidativ wirksamen Vitamine für das Fehlen
von Erfolgen bei der Prävention und Therapie von kardiovaskulären und malignen Erkrankungen
verantwortlich gemacht werden. In den letzten zwei Jahren tauchten zum ersten Mal
Hinweise auf, dass hoch dosierte antioxidativ wirksame Vitamine nicht nur unwirksam,
sondern auch schädlich sein können (Myokardversagen, Zunahme der Gesamtsterblichkeit).
Damit wird die Diskussion um den Wert oder Unwert einer von den Bevölkerungen in zahlreichen
Ländern erstaunlich akzeptierten Selbstmedikation mit Vitaminsupplementen besonders
aktuell.
Abstract
Within only one year - 2005 - at least ten longterm studies lasting between 1.5 and
13 years with antioxidant vitamins have been published. The number of involved healthy
persons and sick patients was ranging between a few hundred to over 135 000 men and
women in North America, Europe und China. Vitamin E was most widely used in dosages
from 100 to 5000 mg or in combination with vitamin C and beta carotene. Neither the
duration of the randomised studies with supplements nor the number of participants
can be blamed for the failure of antioxidants to prevent or treat cardiovascular and
malignant diseases. During the last two years evidence has been demonstrated, that
high dosed antioxidant vitamins not only are ineffective but may be dangerous (myocardial
failure and increased total mortality). Thus the evaluation of the value of antioxidant
vitamins becomes even more important among large segments of the population world-wide
who have accepted self-medication with vitamin supplements in a surprisingly large
number.
Schlüsselwörter
Vitamin E - Supplemente - Alzheimer - Herzmuskelversagen - Gesamtmortalität
Key words
Vitamin E - supplements - Alzheimer - myocardial failure - total mortality
Literatur
- 1
Ford E S, Umed A A, Mokdad A H.
Brief communication: the prevalence of high intake of vitamin E from the use of supplements
among U. S. adults.
Ann Intern Med.
2005;
143
116-120
- 2
Mehta J.
Intake of antioxidants among American cardiologists.
Am J Cardiol .
1997;
79
1558-1560
- 3
Graf M, Ecker D, Horowski R. et al .
High dose vitamin E therapy in amyotrophic lateral sclerosis as add-on therapy to
riluzole: results of a placebo-controlled double-blind study.
J Neural Transm.
2005;
112
649-660
- 4
Miller E R, Pastor-Barriuso R, Dalal D. et al .
Meta Analysis: high-dosage vitamin E supplementation may increase all-cause mortality.
Ann Intern Med.
2005;
142
37-46
- 5
Lee I M, Cook N R, Gaziano J M. et al .
Vitamin E in the primary prevention of cardiovascular disease and cancer. The Women's
Health Study.
JAMA.
2005;
294
56-65
- 6
Marras C, McDermott M P, Rochon P A. et al .
Survival in Parkinson disease, Thirteen-year follow-up of the DATATOP cohort.
Neurol.
2005;
64
87-93
- 7
Petersen R C, Thomas R G, Grundman M. et al .
Vitamin E and Donepezil for the treatment of mild cognitive impairment.
N Engl J Med.
2005;
352
2379-2388
- 8
Bairati I, Meyer F, Gélinas M. et al .
A randomized trial of antioxidant vitamins to prevent second primary cancers in head
and neck cancer patients.
J Natl Cancer Inst .
2005;
97
481-488
- 9
Bairati I, Meyer F, Gélinas M. et al .
Randomized trial of antioxidant vitamins to prevent acute adverse effects of radiation
therapy in head and neck cancer patients.
J Clin Oncol.
2005;
23
5805-5813
- 10
The HOPE and HOPE-TOO Trial Investigators .
Effects of long-term vitamin E supplementation on cardiovascular events and cancer.
JAMA.
2005;
293
1338-1347
- 11
Stone P H, Lloyd-Jones D M, Kinlay S. et al .
Effect of intensive lipid lowering, with or without antioxidant vitamins.
Circulation.
2005;
111
1747-1757
- 12
Wolf R L, Cauley J A, Pettinger M. et al .
Lack of a relation between vitamin and mineral antioxidants and bone mineral density:
results from the Women's Health Initiative.
Am J Clin Nutr.
2005;
82
581-588
- 13
Ruo B, Tripputi M T, Hsue P Y. et al .
Usefulness of serum endothelin levels in predicting death and myocardial infarction
but not coronary progression in postmenopausal women with coronary disease (from the
Women's Angiographic Vitamin and Estrogen [WAVE] Study).
Am J Cardiol.
2005;
96
335-338
- 14
Waters D D, Alderman E L, Hsia J. et al .
Effects of hormone replacement therapy and antioxidant vitamin supplements on coronary
atherosclerosis in postmenopausal women.
JAMA.
2002;
288
2432-2440
- 15
Arad Y, Spadaro L A, Roth M. et al .
Treatment for asymptomatic adults with elevated coronary calcium scores with atorvastatin,
vitamin C, and vitamin E.
J Am Coll Cardiol.
2005;
46
166-172
- 16
Bjelakovic G, Nikolava D, Simonetti R G. et al .
Antioxidant supplements for prevention of gastrointestinal cancers: a systematic review
and meta-analysis.
Lancet.
2004;
364
1219-1228
- 17
Guallar E, Hanley D F, Miller E R.
An Editorial Update: Annus horribilis for Vitamin E.
Ann Intern Med.
2005;
143
143-145
- 18
Brown B G, Crowley J.
Is there any hope for vitamin E?.
JAMA.
2005;
293
1387-1390
Prof. Dr. med. Siegfried Heyden
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