title: Vitamins and abdominal aortic aneurysm.
abstract: BACKGROUND
  To summarize the association of vitamins (B6, B12, C, D, and E) and abdominal aortic aneurysm (AAA), we reviewed clinical studies with a comprehensive literature research and meta-analytic estimates.
  
  
  METHODS
  To identify all clinical studies evaluating the association of vitamins B6/B12/C/D/E and AAA, databases including MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched through April 2015, using Web-based search engines (PubMed and OVID). For each case-control study, data regarding vitamin levels in both the AAA and control groups were used to generate standardized mean differences (SMDs) and 95% confidence intervals (CIs).
  
  
  RESULTS
  Pooled analyses of the 4 case-control studies demonstrated significantly lower circulating vitamin B6 levels (SMD, -0.33; 95% CI, -0.55 to -0.11; P=0.003) but non-significantly lower vitamin B12 levels (SMD, -0.42; 95% CI, -1.09 to 0.25; P=0.22) in patients with AAA than subjects without AAA. Pooled analyses of the 2 case-control studies demonstrated significantly lower levels of circulating vitamins C (SMD, -0.71; 95% CI, -1.23 to -0.19; P=0.007) and E (SMD, -1.76; 95% CI, -2.93 to 0.60; P=0.003) in patients with AAA than subjects without AAA. Another pooled analysis of the 3 case-control studies demonstrated significantly lower circulating vitamin D (25-hydroxyvitamin D) levels (SMD, -0.25; 95% CI, -0.50 to -0.01; P=0.04) in patients with AAA than subjects without AAA. In a double-blind controlled trial, 4.0-year treatment with a high-dose folic acid and vitamin B6/B12 multivitamin in kidney transplant recipients did not reduce a rate of AAA repair despite significant reduction in homocysteine level. In another randomized, double-blind, placebo-controlled trial, 5.8-year supplementation with α-tocopherol (vitamin E) had no preventive effect on large AAA among male smokers.
  
  
  CONCLUSIONS
  In clinical setting, although low circulating vitamins B6/C/D/E (not B12) levels are associated with AAA presence, vitamins B6/B12/E supplementation may not reduce AAA incidence.
authors.affiliation: Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan - kfgth963@ybb.ne.jp.
authors.forename: Hisato
authors.initials: H
authors.lastname: Takagi
authors.affiliation: Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Umemoto
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000453:epidemiology*; D001205:Ascorbic Acid / Q000097:blood; D019587:Dietary Supplements / Q000592:standards*; D005492:Folic Acid / Q000008:administration & dosage; D006801:Humans; D015994:Incidence; D016032:Randomized Controlled Trials as Topic; D014805:Vitamin B 12 / Q000097:blood; D025101:Vitamin B 6 / Q000097:blood; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014810:Vitamin E / Q000097:blood; D014815:Vitamins / Q000008:administration & dosage / Q000097:blood*
chemical_list: D014815:Vitamins; D014807:Vitamin D; D014810:Vitamin E; D025101:Vitamin B 6; D005492:Folic Acid; C104450:25-hydroxyvitamin D; D014805:Vitamin B 12; D001205:Ascorbic Acid