Effect of Vitamin E on Subclinical Atherosclerosis in Patients with Newly Diagnosed Type 2 Diabetes Mellitus_Chinese Journal of Evidence-Based Medicine

Authors：

chen Xiaoyan ¹ , ZHOU Zhiguang ¹ , TANG Weili ¹ , ZHOU Qichang ² , LI Xia ¹ , YAN Xiang ¹ , PENG Jian ¹ , LIU Zhiwen ¹

1. Institute of Metabolism and Endocrinology; Changsha; Hunan 410011; China2. Department of Ultrasonic Diagnosis; Xiangya Second Hospital; Central South University; Changsha; Hunan 410011; China;

Corresponding author：

Keywords：

Vitamin E; Type 2 diabetes mellitus; Multifactorial intervention; Subclinical ath erosclerosis

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Objective 　To explore the effect of vitamin E (VE) on subclinical atherosclerosis (AS) in patients with newly diagnosed type 2 diabetes mellitus.
Methods 　Eighty-five newly diagnosed type 2 diabetic patients without AS were divided into two groups [VE group (n =43) and control group (n =42)] according to the random numeration table. All the patients received comprehensive intervention including the control of blood glucose, blood pressure, blood lipid and body weight and anti-platelet drugs. VE capsule (200 mg/d) was added to VE group (n =41) to evaluate its effects on the incidence of subclinical AS after one year intervention.
Results 　Three patients withdrew during one year follow up. No significant differences of age, sex, baseline body mass index, waist to hip ratio, blood lipid, blood pressure, 24 h urinary albuminuria, insulin resistance index, high sensitive C-reactive protein level, intima-medial thickness (IMT) of common carotid artery, femoral artery and common iliac artery were found between VE group and control group (P gt;0.05). The decrease of IMT of common carotid artery in VE group after one year intervention was more significant than that in control group (P lt;0.05), whereas the other metabolic parameters mentioned above showed no significant differences between the two groups (P gt;0.05). The incidence of subclinical AS was significantly higher in VE group(26.8%, 11/41) than that in control group (7.3%, 3/41) (P lt;0.05).
Conclusions 　One year VE supplementation with multifactorial intervention has no beneficial effect on subclinical AS in newly diagnosed type 2 diabetic patients.

Citation： chen Xiaoyan,ZHOU Zhiguang,TANG Weili,ZHOU Qichang,LI Xia,YAN Xiang,PENG Jian,LIU Zhiwen. Effect of Vitamin E on Subclinical Atherosclerosis in Patients with Newly Diagnosed Type 2 Diabetes Mellitus. Chinese Journal of Evidence-Based Medicine, 2004, 04(7): 460-463. doi: Copy

1.	［1］Terasawa Y,Ladha Z,Leonard SW,Morrow JD,Newland D,Sanan D.Increased atherosclerosis in hyperlipidemic mice deficient in alpha-tocopherol transfer protein and vitamin E[J].Proc Natl Acad Sci USA,2000; 97(25):13 830-13 834.
2.	［2］Pryor WA.Vitamin E and heart disease:basic science to clinical intervention trials[J].Free Radic Biol med,2000; 28(1):141-164.
3.	［3］Salonen JT,Nyyssonen K,Salonen R,Lakka HM,Kaikkonen J,Porkkala-Sarataho E.Antioxidant Supplementation in Atherosclerosis Prevention(ASAP) study:a randomized trial of the effect of vitamins E and C on 3-year progression of carotid atherosclerosis[J].J Intern Med,2000; 248(5):377-386.
4.	［4］Haidara M,Khloussy H,Ammar H,Aal Kassem LA.Impact of α-tocopherol and vitamin C on endothelial markers in rats with streptozotocin-induced diabetes[J].Med Sci Monit,2004; 10(2):BR41-46.
5.	［5］Regensteiner JG,Popylisen S,Bauer TA,Lindenfeld J,Gill E,Smith S.Oral L-arginine and vitamins E and C improve endothelial function in women with type 2 diabetes[J].Vasc Med,2003; 8(3):169-175.
6.	［6］Munteanu A,Zingg JM,Azzi A.Anti-atherosclerotic effects of vitamin E-myth or reality[J].J Cell Mol Med,2004; 8(1):59-76.
7.	［7］Heitzer T,Schlinzig T,Krohn K,Meinertz T,Munzel T.Endothelial dysfunction,oxidation stress,and risk of cardiovascular events in patients with coronary artery disease[J].Circulation,2001; 104(22):2 673-2 678.
8.	［8］Upritchard JE,Sutherland WHF,Mann JI.Effect of supplementation with tomato juice,vitamin E,and vitamin C on LDL oxidation and products of inflammatory activity in type 2 diabetes[J].Diabetes Care,2000; 23(6):733-738.
9.	［9］Yusuf S,Dagenais G,Pogue J,Bosch J,Sleight P.Vitamin E supplementation and cardiovascular events in high-risk patients:the Heart Outcomes Prevention Evaluation Study Investigators[J].N Engl J Med,2000; 342(3):154-160.
10.	［10］Lonn E,Yusuf S,Dzavik V,Ian Doris C,Yi Q,Smith S.Effects of ramipril and vitamin E on atherosclerosis:the study to evaluate carotid ultrasound changes in patients treated with ramipril and vitamin E (SECURE)[J].Circulation,2001; 103(7):919-925.
11.	［11］Terentis AC,Thomas SR,Burr JA,Liebler DC,Stocker R.Vitamin E oxidation in human atherosclerotic lesions[J].Circ Res,2002; 90(3):333-339.

1. ［1］Terasawa Y,Ladha Z,Leonard SW,Morrow JD,Newland D,Sanan D.Increased atherosclerosis in hyperlipidemic mice deficient in alpha-tocopherol transfer protein and vitamin E[J].Proc Natl Acad Sci USA,2000; 97(25):13 830-13 834.
2. ［2］Pryor WA.Vitamin E and heart disease:basic science to clinical intervention trials[J].Free Radic Biol med,2000; 28(1):141-164.
3. ［3］Salonen JT,Nyyssonen K,Salonen R,Lakka HM,Kaikkonen J,Porkkala-Sarataho E.Antioxidant Supplementation in Atherosclerosis Prevention(ASAP) study:a randomized trial of the effect of vitamins E and C on 3-year progression of carotid atherosclerosis[J].J Intern Med,2000; 248(5):377-386.
4. ［4］Haidara M,Khloussy H,Ammar H,Aal Kassem LA.Impact of α-tocopherol and vitamin C on endothelial markers in rats with streptozotocin-induced diabetes[J].Med Sci Monit,2004; 10(2):BR41-46.
5. ［5］Regensteiner JG,Popylisen S,Bauer TA,Lindenfeld J,Gill E,Smith S.Oral L-arginine and vitamins E and C improve endothelial function in women with type 2 diabetes[J].Vasc Med,2003; 8(3):169-175.
6. ［6］Munteanu A,Zingg JM,Azzi A.Anti-atherosclerotic effects of vitamin E-myth or reality[J].J Cell Mol Med,2004; 8(1):59-76.
7. ［7］Heitzer T,Schlinzig T,Krohn K,Meinertz T,Munzel T.Endothelial dysfunction,oxidation stress,and risk of cardiovascular events in patients with coronary artery disease[J].Circulation,2001; 104(22):2 673-2 678.
8. ［8］Upritchard JE,Sutherland WHF,Mann JI.Effect of supplementation with tomato juice,vitamin E,and vitamin C on LDL oxidation and products of inflammatory activity in type 2 diabetes[J].Diabetes Care,2000; 23(6):733-738.
9. ［9］Yusuf S,Dagenais G,Pogue J,Bosch J,Sleight P.Vitamin E supplementation and cardiovascular events in high-risk patients:the Heart Outcomes Prevention Evaluation Study Investigators[J].N Engl J Med,2000; 342(3):154-160.
10. ［10］Lonn E,Yusuf S,Dzavik V,Ian Doris C,Yi Q,Smith S.Effects of ramipril and vitamin E on atherosclerosis:the study to evaluate carotid ultrasound changes in patients treated with ramipril and vitamin E (SECURE)[J].Circulation,2001; 103(7):919-925.
11. ［11］Terentis AC,Thomas SR,Burr JA,Liebler DC,Stocker R.Vitamin E oxidation in human atherosclerotic lesions[J].Circ Res,2002; 90(3):333-339.

Chinese Journal of Evidence-Based Medicine

Effect of Vitamin E on Subclinical Atherosclerosis in Patients with Newly Diagnosed Type 2 Diabetes Mellitus

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