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维他命也未必安全

Posted: 2010-05-05 15:34
by Jun
最近看见两篇新研究,显示补充维他命可能有增加癌症机率的危险。

1. Multivitamin use and breast cancer incidence in a prospective cohort of Swedish women
Susanna C Larsson, Agneta Åkesson, Leif Bergkvist and Alicja Wolk
American Journal of Clinical Nutrition, May 2010
http://www.ajcn.org/cgi/content/abstract/91/5/1268
长期服用多种维他命的高龄妇女患乳腺癌机率稍微高于不服用者。

2. Physiological Levels of Reactive Oxygen Species are Required to Maintain Genomic Stability in Stem Cells
Tao-Sheng Li, Eduardo Marbán
Stem Cell, Published online May 4, 2010
http://www3.interscience.wiley.com/jour ... 6/abstract
高剂量抗氧化成份维他命C&E对细胞内DNA修补机制起到抑制作用,可能增加stem cells发生癌变的机会。

Re: 维他命也未必安全

Posted: 2010-05-05 16:19
by Elysees
倒地不起。。。这叫人如何是好啊。。。吃。。。还是不吃 :cool2: :f22:

Re: 维他命也未必安全

Posted: 2010-05-05 22:20
by dropby
Elysees wrote:倒地不起。。。这叫人如何是好啊。。。吃。。。还是不吃 :cool2: :f22:
是啊,吃还是不吃呢?我们自己也就算了,尤其我现在每天还给欢欢一片小熊维生素,欢欢喜欢吃得不得了,很哭过几次才接受了一天只能吃一片的现实。那我以后还给不给呢?不给肯定又要哭死了。而且我觉得她饮食并不均衡,好像应该持的样子。

Re: 维他命也未必安全

Posted: 2010-05-05 23:44
by qinger
我姐一直觉得药补不如食补,反对给小孩吃任何维生素片钙片之类的东西,看来她还蒙对了。

Re: 维他命也未必安全

Posted: 2010-05-05 23:53
by dropby
可是欢欢不吃蔬菜。 :cry:

Re: 维他命也未必安全

Posted: 2010-05-06 12:19
by Elysees
啥叫我们自己也就算了,我们自己也不能算啊!我孜孜不倦每天吃维生素钙片已经吃了3、4年了,我妈更久,难道居然是有害无益吗?
人民群众要求个说法,哼!我要求那些维生素生产商one a day啊善存啊,出来给我赔钱 :f19:

Re: 维他命也未必安全

Posted: 2010-05-28 17:55
by ruby
我没仔细看文章哈,就看了看study design,首先这是个observational trial,不是randomization trial,解释是不一样的;2. 关于维他命摄入情况是9年的问卷,这个最多是个非常weak的surrogate for长期吃维他命, 3.‘机率稍微高于’很难说明什么,假设真正原因是激素-用激素的吃维他命比例显著高于不用激素的,如果没有control for 激素使用,那么看上去就是吃维他命的几率高点,当然一般建模都应该control for这些well-known的risk factor比如激素等等。

Re: 维他命也未必安全

Posted: 2010-05-28 20:37
by Jun
作者有 control for 激素使用:
The covariates chosen for inclusion in the multivariable
model were based on previously identified risk factors
for breast cancer. Multivariable models were adjusted for age,
education (primary school, high school, and university), family
history of breast cancer (no or yes), history of benign breast
disease (no or yes), parity (nulliparous, 1–2 or >=3 births), age at
first birth (nulliparous or ,26, 26–30, or >=31 y), age at
menarche (<=12, 13, or >=14 y), age at menopause (<51 or
>=51 y), oral contraceptive use (never or ever), postmenopausal
hormone use (never and ,3, 3–5, or >=6 y; or users with
missing data on duration), body mass index (in kg/m2) (,18.5,
18.5–24.9, 25–29.9, or >=30), total physical activity (in quartiles
of metabolic equivalent hours per day), smoking status
(never, past, or current), calcium supplement use (no or yes),
and alcohol intake (nondrinkers or ,3.4, 3.4–9.9, or >=10.0 g
alcohol/d).
We conducted stratified analyses to examine whether the association
between multivitamin use and breast cancer was
modified by the use of postmenopausal hormones (never, quit ,5
or >=5 y ago, or current), smoking status (never, past, or current),
and alcohol intake (0–4, 5–9, or >=10 g alcohol/d). To test the
statistical significance of interactions on a multiplicative scale,
we used the log-likelihood ratio test and compared the models
with or without interaction terms. All statistical analyses were
performed with SAS version 9.1 (SAS Institute Inc, Cary, NC).
All P values were 2-sided.
当然靠这点儿数据远远不能证明服用维他命会增加乳腺癌几率,而且这么微弱的信号差别也实在不足提出什么警告或者危险。

反过来说,吃 vitamin supplement 有什么具体的长寿或防病好处,似乎也没看见有 longitudinal, large, randomized or observational study 证明过,大家就是觉着反正无害随便吃,医生也觉着无害随便推荐。

说实话我引用这两篇研究只是觉得很好笑又很荒诞。医学看上去多么昌明,其实我们还啥也不知道,医生科学家也就是瞎子摸象 ...

另外一个感慨就是人生无常,所有的控制感都是虚幻的,所有的“我只要努力做好ABC就可以XYZ”念头都是虚幻的,说不定适得其反也有可能,只好及时行乐。

Re: 维他命也未必安全

Posted: 2010-05-29 19:15
by ruby
Jun wrote: 另外一个感慨就是人生无常,所有的控制感都是虚幻的,所有的“我只要努力做好ABC就可以XYZ”念头都是虚幻的,说不定适得其反也有可能,只好及时行乐。
就是这句话,及时行乐别想太多啦

Re: 维他命也未必安全

Posted: 2010-06-01 4:02
by Knowing
每次讨论社会问题,医学问题,都会令人沮丧的达成及时行乐的结论。