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P80 Background: In observational studies, low serum β-carotene  levels have been associated with an increased risk of CVD and cancer.  However, in clinical trials, supplementation of diet with β-carotene  has had no benefit. This pattern of findings raises the possibility  that confounding with other factors may explain the association of  serum β-carotene with disease risk. Objective: To determine the  association between serum β-carotene levels and markers of  inflammation. Setting: 14,470 participants, ages 17 years and older, in  NHANES III. Results: In multivariate models that adjusted for  β-carotene intake and other factors associated with serum  β-carotene, the geometric means of serum β-carotene for those with  undetectable (&lt;0.22 mg/dl), mildly elevated (0.22-0.99 mg/dl) and  clinically elevated (≥ 1.0 mg/dl) CRP were 18.0, 16.1 and 13.6 μg/dl  in never smokers (P-value for trend &lt; 0.001), 18.1, 15.7 and 13.9  μg/dl in ex-smokers (P-value for trend &lt; 0.001), and 11.3, 10.2  and 9.4 ìg/dl in current smokers (P-value for trend &lt;  0.001). In corresponding analyses, WBC count was inversely related to  serum β-carotene (P-value for trend &lt;0.05 in each group).  Conclusions: Serum β-carotene is strongly and inversely related to  systemic inflammation. These results suggest that the relationship  between serum β-carotene and disease risk is confounded by  inflammation, which itself is a risk factor for CVD and perhaps cancer.  More broadly, these results highlight the potential limitations of  using serum nutrient levels as a surrogate for dietary  intake. Figure 1.

Is the Relationship Between Serum β-carotene and Cardiovascular Disease (CVD) Risk Confounded by Inflammation?