本研究的目的是调查与氧化应激、抗氧化维生素摄入有关的基因变异，以及这些因素之间的潜在相互作用对完整腹主动脉瘤（AAA）发病率及其破裂（rAAA）的影响，并尽可能考虑性别差异。本回顾性队列研究（n = 25 252）使用大型群体为基础的马尔摩饮食与癌症研究中的基线单核苷酸多态性（SNP）和总抗氧化维生素摄入数据。经过中位随访24.3年后，完整AAA的累积发病率为1.6%，rAAA的累积发病率为0.3%。NOX3基因（rs3749930）的一个变体与男性[rAAA调整风险比（aHR）：2.49；95%置信区间（CI）：1.36-4.35]以及总体人群（aHR：1.88；95%CI：1.05-3.37）中更高的rAAA风险相关。抗氧化维生素、核黄素和叶酸的较高摄入分别与完整AAA发病率的减少20%和19%相关。有趣的是，核黄素和维生素D摄入与完整AAA发病率的反向关联在携带NOX3基因变异的个体中比野生型隐性基因型的个体中更强，即分别增加了60%和66% （交互作用P<0.05）。较高的核黄素摄入与33%男性特异性完整AAA风险降低相关，而较高的维生素B12摄入与55%女性特异性完整AAA风险增加相关；这两种关联均在性别上有显著差异（交互作用P<0.05）。我们的发现凸显了氧化应激基因变异和抗氧化维生素摄入在AAA中的作用。虽然AAA/rAAA样本数量有限，特别是在女性中，但我们的发现强调了未来随机对照试验和机制研究的需求，以探索在考虑基因和性别差异的情况下，抗氧化维生素的潜在益处。 © 2023作者。由牛津大学出版社代表欧洲心脏学会出版。

The aim of this study is to investigate how genetic variations in genes related to oxidative stress, intake of antioxidant vitamins, and any potential interactions between these factors affect the incidence of intact abdominal aortic aneurysm (AAA) and its rupture (rAAA), accounting for sex differences where possible.The present retrospective cohort study (n = 25 252) uses baseline single-nucleotide polymorphisms (SNPs) and total antioxidant vitamin intake data from the large population-based, Malmö Diet and Cancer Study. Cumulative incidence of intact AAA was 1.6% and of rAAA 0.3% after a median follow-up of 24.3 years. A variant in NOX3 (rs3749930) was associated with higher rAAA risk in males [adjusted hazard ratio (aHR): 2.49; 95% confidence interval (CI): 1.36-4.35] and the overall population (aHR: 1.88; 95% CI: 1.05-3.37). Higher intakes of antioxidant vitamins, riboflavin, and folate were associated with 20% and 19% reduced intact AAA incidence, respectively. Interestingly, the inverse associations between riboflavin and vitamin D intake with intact AAA incidence were stronger in the individuals carrying the NOX3 variant as compared with the wild-type recessive genotype, i.e. by 60% and 66%, respectively (P for interaction < 0.05). Higher riboflavin intake was associated with a 33% male-specific intact AAA risk reduction, while higher intake of vitamin B12 intake was associated with 55% female-specific intact AAA risk increase; both these associations were significantly modified by sex (P for interaction < 0.05).Our findings highlight the role of oxidative stress genetic variations and antioxidant vitamin intake in AAA. Although a low AAA/rAAA sample size limited some analyses, especially in females, our findings highlight the need for future randomized controlled trials and mechanistic studies, to explore the potential benefits of antioxidant vitamins while accounting for genetic and sex differences.© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.