Abstract
How retinol as a clinical indicator of vitamin A status is related to long-term mortality is unknown. Here we report the results of a prospective analysis examining associations between serum retinol and risk of overall and cause-specific mortality. During a 30-year cohort follow-up, 23,797 deaths were identified among 29,104 men. Participants with higher serum retinol experienced significantly lower overall, CVD, heart disease, and respiratory disease mortality compared to men with the lowest retinol concentrations, reflecting 17–32% lower mortality risk (Ptrend < 0.0001). The retinol-overall mortality association is similar across subgroups of smoking intensity, alcohol consumption, body mass index, trial supplementation, serum alpha-tocopherol and beta-carotene concentrations, and follow-up time. Mediation analysis indicated that <3% of the effects of smoking duration and diabetes mellitus on mortality were mediated through retinol concentration. These findings indicate higher serum retinol is associated with lower overall mortality, including death from cardiovascular, heart, and respiratory diseases.
Highlights
How retinol as a clinical indicator of vitamin A status is related to long-term mortality is unknown
According to the WHO criteria, the present study had only two participants identified with severe vitamin A deficiency (≤98 μg/L), and 21 participants identified with subclinical vitamin A deficiency (98 to ≤196 μg/L)
Serum retinol was positively associated with serum total and high-density lipoprotein (HDL) cholesterol and alcohol consumption[12,13,14], and inversely associated with serum beta-carotene
Summary
How retinol as a clinical indicator of vitamin A status is related to long-term mortality is unknown. Mediation analysis indicated that
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