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Plasma retinol and total carotenes and fracture risk after long-term supplementation with high doses of retinol.
Nutrition. 2014 May; 30(5):551-6.N

Abstract

OBJECTIVE

Observational studies suggest that moderate intakes of retinol and increased circulating retinol levels may increase fracture risk. Easy access to supplements, combined with an aging population, makes this a potentially important association. The aim of this study was to investigate plasma retinol and total carotene concentrations in relation to fracture risk after long-term supplementation with retinol and/or beta-carotene in 998 adults between 1990 and 2007.

METHODS

Participants were 663 men and 335 women in a cancer prevention program who were initially randomized to a retinol (7.5 mg RE/d) or beta-carotene (30 mg/d) supplement between 1990 and 1996. After 1996, all participants received the retinol supplement only. Plasma retinol and total carotene, medication use and various lifestyle factors were measured at annual clinic visits. Fractures were identified by self-report in 2007. The risk for any fracture or osteoporotic fracture was modeled using Cox proportional hazard models.

RESULTS

Over a median follow-up of 7.8 y, 123 participants with plasma samples reported an incident fracture. Although plasma retinol concentrations were markedly higher than those reported in observational studies, no association was observed between plasma retinol and risk for any fracture (hazard ratio [HR], 0.86 μmol/L; 95% confidence interval [CI], 0.65-1.14) or osteoporotic fracture (HR, 0.97 μmol/L; 95% CI, 0.66-1.43). A lower risk for any fracture was suggested with increasing plasma total carotenes (HR, 0.85 μmol/L; 95% CI, 0.71-1.01).

CONCLUSIONS

This study does not support earlier reports of an increased fracture risk associated with increased plasma retinol concentration. The potential for carotenes to prevent fractures deserves further investigation.

Authors+Show Affiliations

School of Population Health, The University of Western Australia, Perth, Western Australia.Western Australian Centre for Health and Ageing, The University of Western Australia, Perth, Western Australia.Centre for Medical Research, The University of Western Australia, Perth, Western Australia.Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, Northern Territory, Australia; Food Standards Australia New Zealand, Canberra, Australian Capital Territory, Australia.School of Population Health, The University of Western Australia, Perth, Western Australia.School of Pathology and Laboratory Medicine, The University of Western Australia, Perth, Western Australia; Department of Molecular Genetics, PathWest Laboratories, Perth, Western Australia.School of Population Health, The University of Western Australia, Perth, Western Australia; Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia.School of Population Health, The University of Western Australia, Perth, Western Australia; Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia.Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia. Electronic address: Nickdk@ichr.uwa.edu.au.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24698346

Citation

Ambrosini, Gina L., et al. "Plasma Retinol and Total Carotenes and Fracture Risk After Long-term Supplementation With High Doses of Retinol." Nutrition (Burbank, Los Angeles County, Calif.), vol. 30, no. 5, 2014, pp. 551-6.
Ambrosini GL, Alfonso H, Reid A, et al. Plasma retinol and total carotenes and fracture risk after long-term supplementation with high doses of retinol. Nutrition. 2014;30(5):551-6.
Ambrosini, G. L., Alfonso, H., Reid, A., Mackerras, D., Bremner, A. P., Beilby, J., Olsen, N. J., Musk, A. W., & de Klerk, N. H. (2014). Plasma retinol and total carotenes and fracture risk after long-term supplementation with high doses of retinol. Nutrition (Burbank, Los Angeles County, Calif.), 30(5), 551-6. https://doi.org/10.1016/j.nut.2013.10.007
Ambrosini GL, et al. Plasma Retinol and Total Carotenes and Fracture Risk After Long-term Supplementation With High Doses of Retinol. Nutrition. 2014;30(5):551-6. PubMed PMID: 24698346.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Plasma retinol and total carotenes and fracture risk after long-term supplementation with high doses of retinol. AU - Ambrosini,Gina L, AU - Alfonso,Helman, AU - Reid,Alison, AU - Mackerras,Dorothy, AU - Bremner,Alexandra P, AU - Beilby,John, AU - Olsen,Nola J, AU - Musk,Arthur W, AU - de Klerk,Nicholas H, Y1 - 2013/10/16/ PY - 2012/10/10/received PY - 2013/10/01/revised PY - 2013/10/03/accepted PY - 2014/4/5/entrez PY - 2014/4/5/pubmed PY - 2014/12/15/medline KW - Biomarkers KW - Carotene KW - Fractures KW - Intervention study KW - Plasma KW - Retinol KW - Vitamin A SP - 551 EP - 6 JF - Nutrition (Burbank, Los Angeles County, Calif.) JO - Nutrition VL - 30 IS - 5 N2 - OBJECTIVE: Observational studies suggest that moderate intakes of retinol and increased circulating retinol levels may increase fracture risk. Easy access to supplements, combined with an aging population, makes this a potentially important association. The aim of this study was to investigate plasma retinol and total carotene concentrations in relation to fracture risk after long-term supplementation with retinol and/or beta-carotene in 998 adults between 1990 and 2007. METHODS: Participants were 663 men and 335 women in a cancer prevention program who were initially randomized to a retinol (7.5 mg RE/d) or beta-carotene (30 mg/d) supplement between 1990 and 1996. After 1996, all participants received the retinol supplement only. Plasma retinol and total carotene, medication use and various lifestyle factors were measured at annual clinic visits. Fractures were identified by self-report in 2007. The risk for any fracture or osteoporotic fracture was modeled using Cox proportional hazard models. RESULTS: Over a median follow-up of 7.8 y, 123 participants with plasma samples reported an incident fracture. Although plasma retinol concentrations were markedly higher than those reported in observational studies, no association was observed between plasma retinol and risk for any fracture (hazard ratio [HR], 0.86 μmol/L; 95% confidence interval [CI], 0.65-1.14) or osteoporotic fracture (HR, 0.97 μmol/L; 95% CI, 0.66-1.43). A lower risk for any fracture was suggested with increasing plasma total carotenes (HR, 0.85 μmol/L; 95% CI, 0.71-1.01). CONCLUSIONS: This study does not support earlier reports of an increased fracture risk associated with increased plasma retinol concentration. The potential for carotenes to prevent fractures deserves further investigation. SN - 1873-1244 UR - https://www.unboundmedicine.com/medline/citation/24698346/Plasma_retinol_and_total_carotenes_and_fracture_risk_after_long_term_supplementation_with_high_doses_of_retinol_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0899-9007(13)00452-8 DB - PRIME DP - Unbound Medicine ER -