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Research: ERLINGER and colleagues,
Listed in Issue 70
Abstract
ERLINGER and colleagues, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, 2024 E. Monument Street, Suite 2-600, Baltimore, MD 21205, USA, terlinge@jhmi.edu, assessed the relationship between serum beta-carotene and markers of inflammation in a very large number of adult subjects who were current smokers, ex-smokers or never smokers .
Background
Low serum levels of beta-carotene have been associated with increased risk of cancer and cardiovascular disease . However, in clinical trials, dietary supplementation with beta-carotene either had no benefit or caused harm . These findings raise the possibility that confounding by other factors might explain the association between serum beta-carotene level and disease risk.
Methodology
The investigators analysed data from 14,470 subjects aged 18 years or older who participated in the Third National Health and Nutrition Examination Survey. C-reactive protein (CRF) and white blood cell (WBC) count were the markers of inflammation examined.
Results
After adjusting for beta-carotene intake and other factors, geometric mean levels of serum beta-carotene for subjects with undetectable (0.22 mg/dL), mildly elevated (0.22-0.99 mg/dL) and clinically elevated (1.0 mg/dL) CRP were 18.0, 16.1 and 13.6 ug/dL respectively in never smokers; 18.1, 15.7 and 13.9 ug/dL in ex-smokers; and 11.3, 10.2 and 9.4 ug/dL in current smokers (p<0.001 in all cases). In corresponding analyses, WBC count was also inversely related to serum beta-carotene levels (p<0.05 in all cases).
Conclusion
The strong and inverse associations of serum beta-carotene level with CRP and WBC count suggest that the relationship between serum beta-carotene level and disease risk might be confounded by inflammation . More broadly, for beta-carotene, and probably other nutrients, it seems unwise to interpret biomarker data as prima facie evidence of dietary intake without a more complete understanding of the physiological processes that affect nutrient levels .
References
Erlinger TP et al. Relationship between systemic markers of inflammation and serum beta-carotene levels. Archives of Internal Medicine 161 (15): 1903-8. Aug 2001.
