Oxidative damage and inflammation in obese diabetic Emirati subjects supplemented with antioxidants and B-vitamins: a randomized placebo-controlled trail

Salah Gariballa, Bachar Afandi, Mamoun Abuhaltem, Javed Yassin, Hosam Habib, Wissam Ibrahim, Salah Gariballa, Bachar Afandi, Mamoun Abuhaltem, Javed Yassin, Hosam Habib, Wissam Ibrahim

Abstract

Background: Obesity and related morbidities are reaching epidemic proportions in the Arab populations. Possible mechanisms that link obesity/visceral fat to diabetes and cardiovascular (CVD) complications include inflammation and increased oxidative stress. The aim of this study is to test whether supplementary antioxidants with B-group vitamins enhance antioxidant capacity and/or mitigate oxidative damage and subclinical inflammation in obese diabetic patients.

Methods: Hundred diabetic patients were randomly assigned to receive either oral dose of daily B-group vitamins (1.67 mg folic acid, 1.67 mg vitamin B-2, 20 mg vitamin B-6, 0.134 mg vitamin B-12) and antioxidant vitamins (221 mg of α-tocopherol and 167 mg of vitamin C) [n = 50], or an identical placebo [n = 50] daily for 90 days. Blood was obtained before treatment, and after 90 days for measurements of plasma antioxidant vitamins status, markers of oxidative damage [malondialdehyde (MDA) and protein carbonyls] and inflammation (C-Reactive Proteins [CRP], IL6 & TNFα).

Results: Supplementation with antioxidant and B-group vitamins increased plasma concentration of vitamin E and folate and reduced homocysteine in the intervention groups compared with the placebo group. Vitamin B12 improved in the supplement group compared with the decline seen in the placebo group however, this did not reach statistical significance. Vitamin C declined in both groups but more so in the intervention group. Both MDA and Protein carbonyls increased in both the supplement and the placebo group. IL6 concentration increased in both groups but less so in the supplement group (p = 0.023). TNF showed more pronounced decline in the supplement group compared with the placebo group but the difference between cumulative changes did not reach statistical significance (p = 0.204). CRP concentrations declined in the supplement group in contrast to the rise seen in the placebo group however, the difference between cumulative changes was not statistically significant (p = 0.205).

Conclusions: Antioxidants supplementation with B-group vitamins enhances antioxidant capacity, and may have an anti-inflammatory effect in obese diabetic patients.

Figures

Figure 1
Figure 1
Enrolment, treatment and follow up of study patients.

References

    1. Malik A, Babir A, Abi Saab B, Roglic G, King H. Glucose intolerance and associated factors in the UAE. Diabetes Res Clin Pract. 2005;69:188–195. doi: 10.1016/j.diabres.2004.12.005.
    1. Hill MF. Emerging role for antioxidant therapy in protection against diabetic cardiac complications: Experimental and clinical evidence for utilization of classic and new antioxidants. Curr Cardiol Rev. 2008;4:259–268. doi: 10.2174/157340308786349453.
    1. He FJ, Nowson CA, MacGregor GA. Fruit and vegetable consumption and stroke: meta-analysis of cohort studies. Lancet. 2006;367:320–326. doi: 10.1016/S0140-6736(06)68069-0.
    1. Evans JL. Antoxidants: do they have a role in the treatment of insulin resistance? Indian J Med Res. 2007;125:355–372.
    1. Evans J, Goldfine ID, Maddux BA, Grodsky GM. Oxidative stress and stress activated signalling pathways: a unifying hypothesis of type 2 diabetes. Endocr Rev. 2002;23:599–622. doi: 10.1210/er.2001-0039.
    1. Brattstrom L, Wilcken DE. Homocysteine and cardiovascular disease: cause or effect? Am J Clin Nutr. 2000;72:315–323.
    1. Ullegaddi R, Powers HJ, Gariballa SE. Antioxidant supplementation with or without B-group vitamins after acute ischemic stroke: a randomized controlled trial. American J Parenter Enteral Nutr. 2006;30(2):108–114. doi: 10.1177/0148607106030002108.
    1. Li XY, Chow CK. An improved method for the measurement of malondialdehyde in biological samples. Lipids. 2004;29:73–75.
    1. Levine RL, Garland D, Oliver CN, Amici A, Climent I, Lenz A, Ahn B, Shaltiel S, Stadtman E. Determination of carbonyl content in oxidatively modified proteins. Methods Enzymol. 1990;186:464–478.
    1. Nyyssonen K, Porkkala E, Salonen R, Korpela H, Salonen JT. Increase in oxidation resistance of atherogenic serum lipoproteins following antioxidant supplementation: a randomised double-blind placebo-controlled supplementation study. Eur J Clin Nutr. 1994;48:633–642.
    1. Vickers AJ, Altman DG. Analysing controlled trials with baseline and follow up measurements. BMJ. 2001;323:1123–1124. doi: 10.1136/bmj.323.7321.1123.
    1. Carter P, Gray LJ, Troughton J, Khunti K, Davies MJ. Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis. BMJ. 2010;341:c4229. doi: 10.1136/bmj.c4229.
    1. Puchau B, Zulet A, Gonzalez A, Hermsdorff H, Martinez J. Dietary total antioxidant capacity is negatively associated with some metabolic syndrome features in healthy young men. Nutrition. 2010;26:534–541. doi: 10.1016/j.nut.2009.06.017.
    1. Kumanyika S, Jeffery RW, Morabia A, Ritenbaugh C, Antipatis VJ. Obesity prevention: the case for action. Int J Obes Relat Metab Disord. 2002;26(3):425–436. doi: 10.1038/sj.ijo.0801938.
    1. Romeo GR, Lee J, Shoelson SE. Metabolic syndrome, insulin resistance, and roles ofinflammation--mechanisms and therapeutic targets. Arterioscler Thromb Vasc Biol. 2012;32(8):177. 1-6.
    1. Hamilton IM, Gilmore WS, Benzie IFF, Mulholand CW, Strain JJ. Interactions between vitamins C and E in human subjects. Br J Nutr. 2000;84(3):261. doi: 10.1017/S0007114500001537.
    1. May JN, Qu Z. Mendiratta S protection and recycling of alpha-tocopherol in human erythrocytes by intracellular ascorbic acid. Arch Biochem Biophys. 1998;349:281–289. doi: 10.1006/abbi.1997.0473.
    1. Ullegaddi R, Powers HJ, Gariballa SE. B-group vitamin supplementation mitigates oxidative damage after acute ischaemic stroke. Clin Sci. 2004;107:477–484. doi: 10.1042/CS20040134.
    1. Yusuf S, Hawken S, Ounpuu S, Baustista L. et al.Obesity and risk of myocardial infarction in 27 000 participants from 52 countrries: A case–control study. Lancet. 2006;366:1640–1649.

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다