The effect of vitamin E on endothelial function of micro- and macrocirculation and left ventricular function in type 1 and type 2 diabetic patients

  • Economides P
  • Khaodhiar L
  • Caselli A
 et al. 
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Abstract

We examined the effects of high-dosage vitamin E treatment over a 12-month period on the vascular reactivity of micro- and macrocirculation and left ventricular function in diabetic patients. Subjects (n = 89) were randomized to vitamin E (1,800 IU daily) or placebo and were followed for 12 months. High-resolution ultrasound images were used to measure the flow-mediated dilation (FMD; endothelium dependent) and nitroglycerin-induced dilation (NID; endothelium independent) of the brachial artery. Laser Doppler perfusion imaging was used to measure vascular reactivity in the forearm skin. Left ventricular function was evaluated using transthoracic echocardiogram. At the end of the 6-month period, a worsening in endothelium-dependent skin vasodilation (P = 0.02) and rise in endothelin levels (P = 0.01) were found in the vitamin E compared with the placebo group. At the end of the 12-month period, a worsening was observed in NID (P = 0.02) and a marginal worsening was seen in systolic blood pressure (P = 0.04) and FMD (P = 0.04) in the vitamin E compared with the placebo group. In addition C-reactive protein levels decreased marginally in the vitamin E compared with the placebo group (P = 0.05). No changes were observed in left ventricular function. We concluded that long-term treatment with 1,800 IU of vitamin E has no beneficial effects on endothelial or left ventricular function in diabetic patients. Because vitamin E-treated patients had a worsening in some vascular reactivity measurements when compared with control subjects, the use of high dosages of vitamin E cannot be recommended.

Author-supplied keywords

  • C reactive protein/ec [Endogenous Compound]
  • adult
  • aged
  • alpha tocopherol/do [Drug Dose]
  • alpha tocopherol/dt [Drug Therapy]
  • article
  • blood flow
  • blood vessel reactivity
  • brachial artery
  • clinical trial
  • controlled clinical trial
  • controlled study
  • drug megadose
  • echography
  • endothelin/ec [Endogenous Compound]
  • endothelium
  • female
  • follow up
  • forearm
  • glyceryl trinitrate
  • heart left ventricle function
  • human
  • insulin dependent diabetes mellitus/dt [Drug Thera
  • laser Doppler flowmetry
  • major clinical study
  • male
  • microcirculation
  • non insulin dependent diabetes mellitus/dt [Drug T
  • perfusion
  • placebo
  • priority journal
  • protein blood level
  • randomized controlled trial
  • systolic blood pressure
  • transthoracic echocardiography
  • vasodilatation

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Authors

  • P A Economides

  • L Khaodhiar

  • A Caselli

  • A E Caballero

  • H Keenan

  • S E Bursell

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