20 / 10 / 16
关于“维生素D补充剂与癌症和心血管疾病的预防”一文医学翻译摘要学习情况，记录于此。
Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease
摘要
Abstract
背景
BACKGROUND
目前尚不清楚补充维生素D是否能降低癌症或心血管疾病的风险，来自随机试验的数据也有限。
It is unclear whether supplementation with vitamin D reduces the risk of cancer or cardiovascular disease, and data from randomized trials are limited.
方法
METHODS
我们进行了一项全国性的随机、安慰剂对照试验，采用2×2析因设计，研究2,000 IU/d剂量的维生素D3（胆钙化醇）和1 g/d剂量的海洋n-3（也称为ω-3）脂肪酸用于预防美国≥50岁男性和≥55岁女性的癌症和心血管疾病。主要终点是任何类型的侵袭性癌症和主要心血管事件（心肌梗死、卒中或心血管原因死亡构成的复合终点）。次要终点包括特定部位癌症、癌症死亡和其他心血管事件。本文报告维生素D与安慰剂的比较结果。
We conducted a nationwide, randomized, placebo-controlled trial, with a two-by-two factorial design, of vitamin D3 (cholecalciferol) at a dose of 2000 IU per day and marine n−3 (also called omega-3) fatty acids at a dose of 1 g per day for the prevention of cancer and cardiovascular disease among men 50 years of age or older and women 55 years of age or older in the United States. Primary end points were invasive cancer of any type and major cardiovascular events (a composite of myocardial infarction, stroke, or death from cardiovascular causes). Secondary end points included site-specific cancers, death from cancer, and additional cardiovascular events. This article reports the results of the comparison of vitamin D with placebo.
笔记：
结果
RESULTS
共有25,871名参与者接受了随机分组，其中包括5,106名黑种人参与者。补充维生素D并未与任一主要终点的较低风险相关。在5.3年的中位随访期间，1,617名参与者被诊断出癌症（维生素D组793人，安慰剂组824人；风险比，0.96；95%置信区间[CI]，0.88～1.06；P=0.47）。805名参与者发生了主要心血管事件（维生素D组396人，安慰剂组409人；风险比，0.97；95%CI，0.85～1.12；P=0.69）。在次要终点分析中，风险比如下：癌症死亡（341例死亡），0.83（95% CI，0.67～1.02）；乳腺癌，1.02（95% CI，0.79～1.31）；前列腺癌，0.88（95% CI，0.72～1.07）；结直肠癌，1.09（95% CI，0.73～1.62）；主要心血管事件加冠状动脉血运重建构成的扩展复合终点，0.96（95% CI，0.86～1.08）；心肌梗死，0.96（95% CI，0.78～1.19）；卒中，0.95（95% CI，0.76～1.20）；心血管原因死亡，1.11（95% CI，0.88～1.40）。在全因死亡（978例死亡）分析中，风险比为0.99（95% CI，0.87～1.12）。本研究未发现高钙血症或其他不良事件的超额危险度。
A total of 25,871 participants, including 5106 black participants, underwent randomization. Supplementation with vitamin D was not associated with a lower risk of either of the primary end points. During a median follow-up of 5.3 years, cancer was diagnosed in 1617 participants (793 in the vitamin D group and 824 in the placebo group; hazard ratio, 0.96; 95% confidence interval [CI], 0.88 to 1.06; P=0.47). A major cardiovascular event occurred in 805 participants (396 in the vitamin D group and 409 in the placebo group; hazard ratio, 0.97; 95% CI, 0.85 to 1.12; P=0.69). In the analyses of secondary end points, the hazard ratios were as follows: for death from cancer (341 deaths), 0.83 (95% CI, 0.67 to 1.02); for breast cancer, 1.02 (95% CI, 0.79 to 1.31); for prostate cancer, 0.88 (95% CI, 0.72 to 1.07); for colorectal cancer, 1.09 (95% CI, 0.73 to 1.62); for the expanded composite end point of major cardiovascular events plus coronary revascularization, 0.96 (95% CI, 0.86 to 1.08); for myocardial infarction, 0.96 (95% CI, 0.78 to 1.19); for stroke, 0.95 (95% CI, 0.76 to 1.20); and for death from cardiovascular causes, 1.11 (95% CI, 0.88 to 1.40). In the analysis of death from any cause (978 deaths), the hazard ratio was 0.99 (95% CI, 0.87 to 1.12). No excess risks of hypercalcemia or other adverse events were identified.
结论
CONCLUSIONS
补充维生素D并未使侵袭性癌症或心血管事件的发生率低于安慰剂（由美国国立卫生研究院等资助；VITAL在ClinicalTrials.gov注册号为NCT01169259）。
Supplementation with vitamin D did not result in a lower incidence of invasive cancer or cardiovascular events than placebo. (Funded by the National Institutes of Health and others; VITAL ClinicalTrials.gov number, NCT01169259 .)