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Effects of long-term supplementation with moderate pharmacologic doses of vitamin E are saturable and reversible in patients with type 1 diabetes.

Engelen W; Keenoy BM; Vertommen J; De Leeuw I

Am J Clin Nutr 2000 Nov;72(5):1142-9

BACKGROUND: Vitamin E supplementation has been proposed as adjunctive therapy to counteract the increased LDL oxidation in diabetes and thus prevent or delay cardiovascular complications. OBJECTIVE: The objective of this study was to investigate the effect of a moderate pharmacologic dose of vitamin E for </=1 y in patients with type 1 diabetes. DESIGN: The study was double blind and the subjects were randomly assigned to 2 groups: the supplemented group (group S; n = 22) received 250 IU (168 mg) RRR-alpha-tocopherol 3 times/d for 1 y and the placebo group (group P; n = 22) received a placebo for 6 mo followed by 250 IU (168 mg) RRR-alpha-tocopherol 3 times/d for an additional 6 mo. RESULTS: Serum vitamin E doubled after 3 mo of supplementation, from a mean (+/-SD) of 36.9 +/- 10.9 to 66.4 +/- 18.3 micromol/L (P: < 0.0005). Although lipid profiles, glycated hemoglobin, and blood biochemistry values did not change significantly, copper-induced in vitro peroxidizability of LDL and VLDL decreased after 3 mo of supplementation: the production of thiobarbituric acid-reactive substances decreased by 30-60% (P: < 0. 005) and the lag time for the appearance of fluorescent products increased from 107 +/- 25 to 123 +/- 30 min in group S (P: = 0.002 compared with group P). Vitamin E supplementation for an additional 3-9 mo resulted in no further changes in serum vitamin E and lipoprotein peroxidizability. Values returned to baseline after supplementation ended. CONCLUSIONS: Because the improvement in lipoprotein peroxidizability is saturable and reversible, life-long supplementation with vitamin E should be considered in patients with type 1 diabetes.

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