Main Article Content
metabolic syndrome; vitamin E; oxidative stress; antioxidant vitamins.
Background. Metabolic syndrome (MetS) is a cluster of clinical and metabolic features that include central obesity, dyslipidemia, hypertension and impaired glucose tolerance. These features are accompanied by increased oxidative stress and impaired antioxidant defenses. Vitamin E is a major factor in the non-enzymatic antioxidant defenses. The aim of present study was to investigate the association between serum levels of vitamin E and the presence of MetS and its components in a sample population of Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort study.
Methods. This cross-sectional study was carried out in 128 subjects with MetS and 235 subjects without MetS. MetS was defined according to the International-Diabetes-Federation criteria. Serum levels of vitamin E were measured using the HPLC method. Anthropometric and biochemical parameters were measured using standard protocols.
Results. MetS patients had significantly lower serum levels of vitamin E (Vit E), Vit E/Total cholesterol (TC), and Vit E/ (TC+triglyceride(TG)) compared to the control group (P < 0.05). Vit E/ (TG+TC) was also significantly lower in diabetics or those with elevated levels of high sensitive C-reactive protein (hs-CRP). Additionally, there was a significant association between Vit E/ (TG + Total Cho) and the number of components of the metabolic syndrome (p= 0.02)
Conclusions. There is a significant inverse association between indices of Vit E status and the presence of MetS. Moreover, a significantly lower Vit E/ (TC+TG) was observed along with individuals with increasing numbers of components of the MetS.
2. Grundy, S.M., et al., Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Circulation, 2005. 112(17): p. 2735-2752.
3. Mirhafez, S.R., et al., Cytokine and growth factor profiling in patients with the metabolic syndrome. Br J Nutr, 2015. 113(12): p. 1911-9.
4. Naziroglu, M., et al., The effects of hormone replacement therapy combined with vitamins C and E on antioxidants levels and lipid profiles in postmenopausal women with Type 2 diabetes. Clin Chim Acta, 2004. 344(1-2): p. 63-71.
5. Jones, D.P. and Y.M. Go, Redox compartmentalization and cellular stress. Diabetes Obes Metab, 2010. 12 Suppl 2: p. 116-25.
6. Sauberlich, H.E., Laboratory tests for the assessment of nutritional status. Vol. 21. 1999: CRC press.
7. Jiang, Q., Natural forms of vitamin E: metabolism, antioxidant, and anti-inflammatory activities and their role in disease prevention and therapy. Free Radical Biology and Medicine, 2014. 72: p. 76-90.
8. Albahrani, A.A. and R.F. Greaves, Fat-Soluble Vitamins: Clinical Indications and Current Challenges for Chromatographic Measurement. Clin Biochem Rev, 2016. 37(1): p. 27-47.
9. Byers, T. and G. Perry, Dietary carotenes, vitamin C, and vitamin E as protective antioxidants in human cancers. Annual review of Nutrition, 1992. 12(1): p. 139-159.
10. Diaz, M.N., et al., Antioxidants and atherosclerotic heart disease. New England Journal of Medicine, 1997. 337(6): p. 408-416.
11. Hickman, I. and G. Macdonald, Is vitamin E beneficial in chronic liver disease? Hepatology, 2007. 46(2): p. 288-290.
12. Wong, S.K., et al., Vitamin E As a Potential Interventional Treatment for Metabolic Syndrome: Evidence from Animal and Human Studies. Frontiers in pharmacology, 2017. 8: p. 444.
13. Zhao, L., et al., Gamma-tocotrienol attenuates high-fat diet-induced obesity and insulin resistance by inhibiting adipose inflammation and M1 macrophage recruitment. International Journal of Obesity, 2015. 39(3): p. 438.
14. Zaiden, N., et al., Gamma delta tocotrienols reduce hepatic triglyceride synthesis and VLDL secretion. Journal of atherosclerosis and thrombosis, 2010. 17(10): p. 1019-1032.
15. Budin, S.B., et al., The effects of palm oil tocotrienol-rich fraction supplementation on biochemical parameters, oxidative stress and the vascular wall of streptozotocin-induced diabetic rats. Clinics, 2009. 64(3): p. 235-244.
16. Newaz, M., et al., Nitric oxide synthase activity in blood vessels of spontaneously hypertensive rats: antioxidant protection by gamma-tocotrienol. Journal of physiology and pharmacology, 2003. 54(3): p. 319-327.
17. Godala, M.M., et al., Lower plasma levels of antioxidant vitamins in patients with metabolic syndrome: a case control study. Adv Clin Exp Med, 2016. 25(4): p. 689-700.
18. Bian, S., et al., Dietary nutrient intake and metabolic syndrome risk in Chinese adults: a case–control study. Nutrition journal, 2013. 12(1): p. 106.
19. Motamed, S., et al., Micronutrient intake and the presence of the metabolic syndrome. North American journal of medical sciences, 2013. 5(6): p. 377.
20. Ford, E.S., et al., The metabolic syndrome and antioxidant concentrations: findings from the Third National Health and Nutrition Examination Survey. Diabetes, 2003. 52(9): p. 2346-2352.
21. Bruscato, N.M., et al., Dietary intake is not associated to the metabolic syndrome in elderly women. North American journal of medical sciences, 2010. 2(4): p. 182.
22. Alberti, G., et al., The IDF consensus worldwide definition of the metabolic syndrome. Brussels: International Diabetes Federation, 2006. 23(5): p. 469-80.
23. Mirhafez, S.R., et al., Relationship between serum cytokine and growth factor concentrations and coronary artery disease. Clinical biochemistry, 2015. 48(9): p. 575-580.
24. Mirhafez, S.R., et al., Cytokine and growth factor profiling in patients with the metabolic syndrome. British Journal of Nutrition, 2015. 113(12): p. 1911-1919.
25. Papas, A., et al., Plasma retinol and tocopherol levels in relation to demographic, lifestyle and nutritional factors of plant origin in Greece. Br J Nutr, 2003. 89(1): p. 83-7.
26. Mohammadi, A., et al., Effects of Curcumin on Serum Vitamin E Concentrations in Individuals with Metabolic Syndrome. Phytother Res, 2017. 31(4): p. 657-662.
27. Thurnham, D., et al., The use of different lipids to express serum tocopherol: lipid ratios for the measurement of vitamin E status. Annals of Clinical Biochemistry, 1986. 23(5): p. 514-520.
28. Barzegar-Amini, M., et al., Serum vitamin E as a significant prognostic factor in patients with dyslipidemia disorders. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2019. 13(1): p. 666-671.
29. Galan, P., et al., Serum concentrations 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. European Journal Of Clinical Nutrition, 2005. 59: p. 1181.
30. Kim, Y.-N. and Y.-O. Cho, Vitamin E status of 20- to 59-year-old adults living in the Seoul metropolitan area of South Korea. Nutrition Research and Practice, 2015. 9(2): p. 192-198.
31. Ford, E.S., et al., Distribution of serum concentrations of α-tocopherol and γ-tocopherol in the US population 1–3. The American Journal of Clinical Nutrition, 2006. 84(2): p. 375-383.
32. Meraji, S., et al., Relationship between classic risk factors, plasma antioxidants and indicators of oxidant stress in angina pectoris (AP) in Tehran. Atherosclerosis, 2000. 150(2): p. 403-12.
33. Karajibani, M., et al., The status of glutathione peroxidase, superoxide dismutase, vitamins A, C, E and malondialdehyde in patients with cardiovascular disease in Zahedan, Southeast Iran. Journal of nutritional science and vitaminology, 2009. 55(4): p. 309-316.
34. Hekmat, K., et al., The relationship of fat soluble antioxidants with gestational diabetes in Iran: a case–control study. The Journal of Maternal-Fetal & Neonatal Medicine, 2014. 27(16): p. 1676-1679.
35. Mohammadi, A., et al., Effects of Curcumin on Serum Vitamin E Concentrations in Individuals with Metabolic Syndrome. Phytotherapy research, 2017. 31(4): p. 657-662.
36. Tavallaie, S., et al., Serum vitamin E concentration in Iranian population with angiography defined coronary artery disease. Asian Biomedicine, 2012. 6(1): p. 19-25.
37. Ghayour-Mobarhan, M., et al., An investigation of the relationship between serum vitamin E status and coronary risk factors in dyslipidaemic patients. Iranian Journal of Basic Medical Sciences, 2008. 10(4): p. 206-215.
38. Gross, M., et al., Lipid standardization of serum fat-soluble antioxidant concentrations: the YALTA study. The American Journal of Clinical Nutrition, 2003. 77(2): p. 458-466.
39. Thurnham, D.I., et al., The Use of Different Lipids to Express Serum Tocopherol: Lipid Ratios for the Measurement of Vitamin E Status. Annals of Clinical Biochemistry, 1986. 23(5): p. 514-520.
40. Horwitt, M.K., et al., Relationship between tocopherol and serum lipid levels for determination of nutritional adequacy. Ann N Y Acad Sci, 1972. 203: p. 223-36.
41. Mahan, L.K. and J.L. Raymond, Krause's Food & the Nutrition Care Process - E-Book. 2016: Elsevier Health Sciences.
42. Thurnham, D.I., et al., The use of different lipids to express serum tocopherol: lipid ratios for the measurement of vitamin E status. Ann Clin Biochem, 1986. 23 ( Pt 5): p. 514-20.
43. Palmieri, V.O., et al., Systemic Oxidative Alterations Are Associated with Visceral Adiposity and Liver Steatosis in Patients with Metabolic Syndrome. The Journal of Nutrition, 2006. 136(12): p. 3022-3026.
44. Sempértegui, F., et al., Metabolic syndrome in the elderly living in marginal peri-urban communities in Quito, Ecuador. Public Health Nutrition, 2010. 14(5): p. 758-767.
45. Bieri, J.G. and R.P. Evarts, Effect of Plasma Lipid Levels and Obesity on Tissue Stores of α-Tocopherol. Proceedings of the Society for Experimental Biology and Medicine, 1975. 149(2): p. 500-502.
46. Mah, E., et al., α-Tocopherol bioavailability is lower in adults with metabolic syndrome regardless of dairy fat co-ingestion: a randomized, double-blind, crossover trial. The American Journal of Clinical Nutrition, 2015. 102(5): p. 1070-1080.
47. Yen, C.-H., et al., The Antioxidant Status and Concentrations of Coenzyme Q10 and Vitamin E in Metabolic Syndrome. The Scientific World Journal, 2013. 2013: p. 767968.
48. Kim, S., et al., Total Antioxidant Capacity from Dietary Supplement Decreases the Likelihood of Having Metabolic Syndrome in Korean Adults. Nutrients, 2017. 9(10): p. 1055.
49. Beydoun, M.A., et al., Serum Antioxidant Concentrations and Metabolic Syndrome Are Associated among U.S. Adolescents in Recent National Surveys. The Journal of Nutrition, 2012. 142(9): p. 1693-1704.
50. Traber, M.G., et al., Metabolic syndrome increases dietary α-tocopherol requirements as assessed using urinary and plasma vitamin E catabolites: a double-blind, crossover clinical trial. The American Journal of Clinical Nutrition, 2017. 105(3): p. 571-579.
51. Ford, E.S., et al., The Metabolic Syndrome and Antioxidant Concentrations. Findings From the Third National Health and Nutrition Examination Survey, 2003. 52(9): p. 2346-2352.
52. Al-Daghri, N., et al., Selected Dietary Nutrients and the Prevalence of Metabolic Syndrome in Adult Males and Females in Saudi Arabia: A Pilot Study. Nutrients, 2013. 5(11): p. 4587.
53. Wei, J., et al., Associations between Dietary Antioxidant Intake and Metabolic Syndrome. PLoS ONE, 2015. 10(6): p. e0130876.
54. Beydoun, M.A., et al., Serum Antioxidant Status Is Associated with Metabolic Syndrome among U.S. Adults in Recent National Surveys. The Journal of Nutrition, 2011. 141(5): p. 903-913.
55. Faure, H., et al., Factors influencing blood concentration of retinol, α-tocopherol, vitamin C, and β-carotene in the French participants of the SU.VI.MAX trial. European Journal Of Clinical Nutrition, 2006. 60: p. 706.
56. Garcia, O.P., et al., Zinc, vitamin A, and vitamin C status are associated with leptin concentrations and obesity in Mexican women: results from a cross-sectional study. Nutr Metab (Lond), 2012. 9(1): p. 59.
57. Wallström, P., et al., Serum concentrations of β-carotene and α-tocopherol are associated with diet, smoking, and general and central adiposity. The American Journal of Clinical Nutrition, 2001. 73(4): p. 777-785.
58. Waniek, S., et al., Association of Vitamin E Levels with Metabolic Syndrome, and MRI-Derived Body Fat Volumes and Liver Fat Content. Nutrients, 2017. 9(10): p. 1143.
59. Czernichow, S., et al., Effects of long-term antioxidant supplementation and association of serum antioxidant concentrations with risk of metabolic syndrome in adults. The American Journal of Clinical Nutrition, 2009. 90(2): p. 329-335.