Impact of Vitamin E supplementation on vascular function in haptoglobin genotype stratified diabetes patients (EVAS Trial): a randomised controlled trial.
Aged
Antioxidants
/ administration & dosage
Blood Circulation
/ drug effects
Carotid Intima-Media Thickness
Diabetes Mellitus, Type 2
/ drug therapy
Dietary Supplements
Double-Blind Method
Female
Genotype
Haptoglobins
/ genetics
Humans
Inflammation
/ metabolism
Male
Middle Aged
Oxidative Stress
/ drug effects
Singapore
Vascular Resistance
/ drug effects
Vitamin E
/ administration & dosage
Journal
Nutrition & diabetes
ISSN: 2044-4052
Titre abrégé: Nutr Diabetes
Pays: England
ID NLM: 101566341
Informations de publication
Date de publication:
27 04 2020
27 04 2020
Historique:
received:
30
09
2019
accepted:
30
03
2020
revised:
24
03
2020
entrez:
29
4
2020
pubmed:
29
4
2020
medline:
23
1
2021
Statut:
epublish
Résumé
Vitamin E (Vit-E) may preferentially improve cardiovascular risk in haptoglobin 2-2 (Hp2-2) genotype diabetes individuals. We studied the impact of Vit-E supplementation on vascular function in diabetes individuals stratified by haptoglobin genotype in Singapore. In this 24-week, double blind, placebo-controlled RCT, we recruited 187 subjects (101 Hp2-2, 86 non-Hp2-2). alpha-tocopherol-400 IU. Change in EndoPAT-derived reactive-hyperaemia index (RHI) and augmentation index (AIx); Secondary Outcomes: Pulse-Wave velocity (Sphygmocor-PWV), carotid intima media thickness (CIMT), inflammation (hsCRP), derivatives of reactive-oxygen metabolites (dROMs), biological antioxidant-potential (BAPs), HbA1c, LDL-C, HDL-C and oxidised LDL-C (ox-LDL). Overall, with Vit-E supplementation no significant change in RHI, PWV, CIMT, hsCRP, dROMS, BAPs, HDL-C and HbA1c was observed (p > 0.05); an increase in LDL-C with concomitant decrease in ox-LDL, and incidentally increase in eGFR was observed (p < 0.05). No interaction effect with haptoglobin genotype was seen for all outcomes (p > 0.05). Subgroup analysis: In the non-Hp-2-2 group, Vit-E supplementation led to a higher EndoPAT-derived AIx, accompanied by higher LDL and ox-LDL concentrations (p < 0.05); Hp2-2 group: Vit-E supplementation led to higher eGFR when compared to the non-Hp2-2 group (exploratory) (p < 0.05). We observed an interaction effect for baseline haptoglobin concentration (threshold > 119 mg/dl) with intervention in terms of increased EndoPAT-derived AIx in the Hp > 119 mg/dl group whereas no change in the group with Hp ≤ 119 mg/dl. Vit-E supplementation did not show any preferential benefit or deleterious effect on vascular function in Hp2-2 diabetes subjects in Singapore. A possible deleterious effect of an increase in arterial stiffness in individuals with Hp > 119 mg/dl was observed. Future studies should consider personalisation based on baseline Hp concentrations in patients with T2DM rather than just Hp2-2 genotype to evaluate impact on the detailed lipid pathways, cardiac and renal physiology. The impact of ethnic differences needs to be explored in greater details.
Identifiants
pubmed: 32341356
doi: 10.1038/s41387-020-0116-7
pii: 10.1038/s41387-020-0116-7
pmc: PMC7186220
doi:
Substances chimiques
Antioxidants
0
Haptoglobins
0
Vitamin E
1406-18-4
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
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