Negative Association between Vitamin E Intake and Remnant Cholesterol: The National Health and Nutrition Examination Survey 2007-2020

Abstract

Background: Remnant cholesterol (RC) is a risk factor for the development of atherosclerosis. Vitamin E has antioxidant properties, making it a potentially effective management tool for preventing cardiovascular disease (CVD). However, the relationship between vitamin E intake and RC remains unclear.

Methods: We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) Survey 2007-2020. 11,585 participants (aged ≥20, 48% male) were included. Information on vitamin E intake (dietary vitamin E intake and total vitamin E intake) was collected. RC was defined as serum total cholesterol minus high-density lipoprotein and low-density lipoprotein cholesterol. Survey-weighted linear regression models and a restricted cubic spline (RCS) were used to test the relationship between vitamin E intake and RC. Subgroup analyses and interaction tests were also performed to verify the robustness of the results.

Results: After adjusting for all potential confounders (demographics, socioeconomic status, lifestyle, diet, and comorbidities), dietary vitamin E intake was negatively associated with RC (β = -0.21, 95% CI: (-0.29, -0.12), p < 0.0001), and this negative association was also present between total vitamin E intake and RC (β = -0.12, 95% CI: (-0.18, -0.06), p < 0.0001). The RCS analysis revealed a nonlinear negative association between vitamin E intake and RC. The negative correlation existed in different subgroups, with no interaction except for the "use of vitamin E supplements" subgroup.

Conclusion: Vitamin E intake showed a protective association with RC. The results suggest that increasing dietary vitamin E intake may help reduce RC levels and CVD risk.

Keywords: NHANES; cardiovascular disease; cross-sectional study; remnant cholesterol; vitamin E.