Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1 (5-Year IF – 2.0)
Journal Citation Indicator (JCI) (2023) – 0.4
Scopus CiteScore – 3.7 (CiteScore Tracker 3.8)
Index Copernicus  – 171.00; MNiSW – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2016, vol. 25, nr 4, July-August, p. 689–700

doi: 10.17219/acem/41049

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Lower Plasma Levels of Antioxidant Vitamins in Patients with Metabolic Syndrome: A Case Control Study

Małgorzata M. Godala1,A,B,C,D, Izabela Materek-Kuśmierkiewicz2,A,B,D, Dariusz Moczulski2,A,E, Maciej Rutkowski3,A, Franciszek Szatko4,A,E, Ewelina Gaszyńska4,B,C, Sławomir Tokarski5,B,C, Jan Kowalski6,A,F

1 Department of Nutrition and Epidemiology, Chair of Hygiene and Epidemiology, Medical University of Lodz, Poland

2 Department of Internal Medicine and Nephrodiabetology, Chair of Internal Diseases and Cardiology, Medical University of Lodz, Poland

3 Department of Military Toxicology and Radiological Protection, Medical University of Lodz, Poland

4 Department of Hygiene and Health Promotion, Chair of Hygiene and Epidemiology, Medical University of Lodz, Poland

5 Faculty of Medicine, University of Rzeszów, Poland

6 Department of Internal and Infectious Diseases, Medical University of Lodz, Poland

Abstract

Background. Metabolic syndrome (MS) is a coexistence of metabolic risk factors affecting the development of cardiovascular diseases. Reactive oxygen species, which are excessively produced in MS, participate in its pathogenesis. Vitamins A, C and E are an important part of the non-enzymatic antioxidative barrier in humans.
Objectives. The aim of the study was to estimate plasma vitamin A, C and E levels and the intake of these vitamins from the diet in patients with MS.
Material and Methods. The study included 182 patients with MS, 94 men and 88 women, aged 30–65 years (mean 57.31 ± 8.28 years). The control group was comprised of 91 subjects, 56 men and 35 women, aged 41–65 years (mean 57.75 ± 5.84 years). The MS diagnosis was based on IDF criteria. The determination of the serum level of vitamin A, C and E was performed using the spectrophotometric method. The food intake was assessed by 24-h dietary recall.
Results. The mean plasma vitamin A, C and E levels were significantly lower in MS patients than in the controls (p = 0.05). No correlation was found between vitamin A, C and E intake from the diet and their plasma concentrations in MS patients. Plasma vitamin A, C and E deficiency was observed significantly more often in MS patients than in the control group (15.38% vs. 2.19%, 79.12% vs. 8.79% and 60.45% vs. 5.49%, p < 0.0001, respectively). BMI was the one factor significantly affecting the mean value of vitamin A, C and E levels in MS patients.
Conclusion. MS patients demonstrated significantly lower plasma levels of vitamin A, C and E compared to the healthy subjects. Lower plasma levels of antioxidant vitamins with their high intake from the diet indicate antioxidant barrier impairment in MS patients.

Key words

metabolic syndrome, diet, oxidative stress, antioxidant vitamins

References (47)

  1. Alberti KG, Zimmet P, Shaw J: IDF Epidemiology Task Force Consensus Group. The metabolic syndrome – a new worldwide definition. Lancet 2005, 366, 1059–1062.
  2. Kowalski J, Godala M: Prevention and treatment of the metabolic syndrome. In: Metabolic syndrome – prevention and treatment. Akademia Medycyny, Warsaw 2007, 173–175.
  3. Fujita K, Nischizawa H, Funahashi T, Shimomura I, Shimabukuro M: Systemic oxidative stress is associated with visceral fat accumulation and the metabolic syndrome. Circ J 2006, 70, 1437–1442.
  4. Lamb RE, Goldstein BJ: Modulating an oxidative-inflammatory cascade: Potential new treatment strategy for improving glucose metabolism, insulin resistance, and vascular function. Int J Clin Pract 2008, 62, 1087–1095.
  5. Grundy SM: Obesity, metabolic syndrome, and cardiovascular disease. J Clin Endocrinol Metab 2004, 89, 2750–2755.
  6. Roberts CK, Bernard RJ, Sindhu RK, Jurczak M, Ehdaie A, Vaziri ND: Oxidative stress and dysregulation of NAD(P)H oxidase and antioxidant enzymes in diet-induced metabolic syndrome. Metabolism 2006, 55, 928–934.
  7. Garcia-Bailo B, El-Sohemy A, Haddad PS, BenZaied F, Karmali M, Badawi A: Vitamins D, C, and E in the prevention of type 2 diabetes mellitus: modulation of inflammation and oxidative stress. Biologics: Targets and Therapy 2011, 5, 7–19.
  8. Rutkowski M, Grzegorczyk K, Greger J: Adaptation of the phosphotungstate method to determine reduced and oxidized vitamin C in blood plasma. Zeitschr Naturforsch 2004, 59, 762–767.
  9. Rutkowski M, Grzegorczyk K, Kędziora J: Laboratory convenient modification of Bessey method for vitamin A determination in blood plasma. J Physiol Pharmacol 2006, 57, 221–226.
  10. Rutkowski M, Grzegorczyk K, Paradowski MT: Colorimetric determination of total vitamin E concentration in plasma – own modification of Tsen’s method. Diagn Lab 2005, 41, 375–385.
  11. Rutkowski M, Grzegorczyk K: Colorimetric determination of vitamin C concentration with the use of phosphotungstate reagent – modification of Kyawa’s method. Diagn Lab 1998, 34, 511–520.
  12. Jarosz M: Standards of Human Nutrition. National Food and Nutrition Institute in Warsaw, 2012.
  13. Szponar L, Wolnicka K, Rychlik E: Album of photographs of food products and dishes. National Food and Nutrition Institute, Warsaw, 2000.
  14. Kunachowicz H, Nadolna I, Przygoda B, Iwanow K: Charts of nutritive values of products and foods. Third edition expanded and updated. PZWL, Warsaw, 2005.
  15. Ford ES: Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the USA. Diabetes Care 2005, 28, 2745–2749.
  16. White E, Kristal AR, Shikany JM, Wilson AC, Chen C, Mares-Perlman JA, Masaki KH, Caan BJ: Correlates of serum alphaand gamma-tocopherol in the Women’s Health Initiative. Ann Epidemiol 2001, 11, 136–144.
  17. Zdrojewski T, Bandosz P, Szpakowski P: The prevalence of major risk factors for cardiovascular diseases in Poland. The results of NATPOL PLUS study. Kardiol Pol 2004, 61, Suppl 4, 5–26.
  18. Kowalski J, Śliwczyńska-Rodziewicz D, Ciećwierz J, Kowalczyk E, Pawlicki L, Irzmański R, Mejer A, Szadkowska I, Barylski M: Vascular complications in patients with metabolic syndrome. Pol Merk Lek 2011, 178, 241–245.
  19. Kowalski J, Śliwczyńska-Rodziewicz D, Kowalczyk E, Ciećwierz J, Irzmański R, Pawlicki L, Mejer A, Barylski M: Plasma nitric oxide and vascular endothelial growth factor levels in patients with metabolic syndrome and coexisting vascular complications. Pol Merk Lek 2011, 178, 249–252.
  20. Ford ES, Mokdad AH, Giles WH, Brown DW: The metabolic syndrome and antioxidant concentration. Findings from the Third National Health and Nutrition Examination Survey. Diabetes 2003, 52, 2346–2352.
  21. Beydoun MA, Shroff MR, Chen X, Beydoun HA, Wang Y, Zonderman AB: Serum antioxidant status is associated with metabolic syndrome among U.S. adults in recent national surveys. J Nutr 2011, 141, 903–913.
  22. Sharma P, Mishra S, Ajmera P, Mathur S: Oxidative stress in metabolic syndrome. Indian J Clin Biochem 2005, 20, 145–149.
  23. Odum EP, Orluwene CG, Ejilemele AA, Wakwe VC: Antioxidant status of subject with metabolic syndrome in Port Harcourt, Nigeria. Niger Postgrad Med J 2012, 19, 199–203.
  24. Illison VK, de Oliveira AM, Rondó PHC, D’Abronzo FH, Campos KF: The relation between plasma alphatocopherol concentration and vitamin E intake in patients with type 2 diabetes mellitus. Int J Vitam Nutr Res 2011, 81, 12–20.
  25. Singh RB, Ghosh S, Niaz MA, Singh R, Beegum R, Chibo H, Shoumin C, Postiglione A: Dietary intake, plasma levels of antioxidant vitamins and oxidative stress in relation to coronary artery disease in elderly subjects. Am J Cardiol 1995, 76, 1233–1238.
  26. Cahill L, Corey PN, El-Sohemy A: Vitamin C deficiency in a population of young Canadian adults. Am J Epidemiol 2009, 170, 464–471.
  27. Hubert HB, Finleib M, McNamara PM: Obesity as an independent risk factor for cardiovascular disease: A 26 years follow up of participants in the Framingham Heart Study. Circulation 1983, 67, 968–977.
  28. Gascon-Vila P, Garcia-Closas R, Serra-Majem L, Pastor MC, Ribas L, Ramon JM, Mariné-Font A, Salleras L: Determinants of the nutritional status of vitamin E in non-smoking Mediterranean population. Analysis of the effect of vitamin E intake, alcohol consumption and body mass index on the serum alpha-tocopherol concentration. Eur J Clin Nutr 1997, 51, 723–728.
  29. Neuhouser ML, Rock CI, Eldridge AL, Kristal AR, Patterson RE, Cooper DA, Neumark-Sztainer D, Cheskin LJ, Thornquist MD: Serum concentration of retinol, α-tocopherol and the carotenoids are influenced by diet, race and obesity in a sample of healthy adolescents. J Nutr 2001, 131, 2184–2191.
  30. Rock CL, Thornquist MD, Kristal AR, Patterson RE, Cooper DA, Neuhouser ML, Neumark-Sztainer D, Cheskin LJ: Demographic dietary and lifestyle factors differentially explain variability in serum carotenoids and fat-soluble vitamins: Baseline results from the Olestra Post-Marketing Surveillence Study. J Nutr 1999, 129, 855–864.
  31. Galan P, Viteri FE, Bertrais S, Czernichow S, Faure H, Arnaud J, Ruffieux D, Chenal S, Arnault N, Favier A, Roussel A-M, Hercberg S: Serum concentration of β-carotene, vitamins C and E, zinc and selenium are influenced by sex, age, diet, smoking status, alcohol consumption and corpulence in a general French adult population. Eur J Clin Nutr 2005, 59, 1181–1190.
  32. Öhrvall M, Tengblad S, Vessby B: Lower tocopherol serum levels in subject with abdominal adiposity. Int J Med 1993, 234, 53–60.
  33. Knekt P, Seppänen R, Aaran RK: Determinants of serum α-tocopherol in Finnish adults. Prev Med 1988, 17, 725–735.
  34. Sinha R, Patterson BH, Mangels AR, Levander OA, Gibson T, Taylor PR, Block G: Determinants of plasma vitamin E in healthy males. Cancer Epidemiol Biomarkers Prec 1993, 2, 473–479.
  35. Hebert JR, Hurley TG, Hsieh J, Rogers E, Stoddard AM, Sorensen G, Nicolosi RJ: Determinants of plasma vitamins and lipids: The Working Well Study. Am J Epidemiol 1994, 140, 132–147.
  36. Wallstrom P, Wirfalt E, Lahmann PH, Gullberg B, Janzon L, Berglund G: Serum concentration of β-carotene and α-tocopherol are associated with diet, smoking, and general and central adiposity. Am J Clin Nutr 2001, 73, 777–785.
  37. Sluijs I, Beulens WJ, Grobbee DE, van der Schouw YT: Dietary carotenoid intake is associated with lower prevalence of metabolic syndrome in middle-aged and elderly men. J Nutr 2009, 139, 987–992.
  38. Sohn C, Kim J, Bae W: The Framingham risk score, diet, and inflammatory markers in Korean men with metabolic syndrome. Nutr Res Pract 2012, 6, 246–253.
  39. Al-Daghri NM, Khan N, Alkharfy KM, Al-Attas OS, Alokail MS, Alfawaz HA, Alothman A, Vanhoutte PM: Selected dietary nutrients and the prevalence of metabolic syndrome in adult males and females in Saudi Arabia: A pilot study. Nutrients 2013, 5, 4587–4604.
  40. Czernichow S, Vergnaud AC, Galan P, Arnaud J, Favier A, Faure H, Huxley R, Hercberg S, Ahluwalia N: Effects of long-term antioxidant supplementation and association of serum antioxidant concentration with risk of metabolic syndrome in adults. Am J Clin Nutr 2009, 90, 329–335.
  41. Bartosz G: Second face of oxygen. PWN, Warszawa 1995.
  42. Tokarski S, Rutkowski M, Mejer A, Godala M, Kowalski J: The impact of ascorbic acid on the concentrations of antioxidative vitamins in the plasma of patients with non-small cell lung cancer undergoing first-line chemotherapy. Pol Merk Lek 2013, 35, 136–140.
  43. Losonczy KG, Harris TB, Havlic RJ: Vitamin E and vitamin C supplement use and the risk of all-cause and coronary heart disease mortality in older persons: The established populations for epidemiological studies of the elderly. Am J Clin Nutr 1996, 64, 190–196.
  44. Liu C, Russel RM, Wang XD: Alpha-tocopherol and ascorbic acid decrease the production of beta-apo-carotenals and increase the formation of retinoids from beta-carotene in the lung tissues of cigarette smoke-exposed ferrets in vitro. J Nutr 2004, 134, 426–430.
  45. Kim KN, Pie JE, Park JH, Park YH, Kim HW, Kim MK: Retinoic acid and ascorbic acid act synergistically in inhibiting human breast cancer cell proliferation. J Nutr Biochem 2006, 17, 454–462.
  46. Kuzuya M, Naito M, Funaki C, Hayashi T, Asai K, Kuzuya F: Probucol prevents oxidative injury to endothelial cells. J Lipid Res 1991, 32, 197–204.
  47. Riemersma RA, Wood DA, Macintyre CC, Elton RA, Gey KF, Oliver MF: Risk of angina pectoris and plasma concentration of vitamins A, C and E and carotene. Lancet 1991, 337, 1–4.