The effect of vitamin E on endothelial function of micro- and macrocirculation and left ventricular function in type 1 and type 2 diabetic patients
The effect of vitamin E on endothelial function of micro- and macrocirculation and left ventricular function in type 1 and type 2 diabetic patients
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DOI：
10.2337/diabetes.54.1.204
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发表时间：
2005-01-01
期刊：
影响因子：
7.7
通讯作者：
Veves, A
中科院分区：
文献类型：
--
作者：
Economides, PA;Khaodhiar, L;Veves, A
我们研究了12个月内高剂量维生素E治疗对糖尿病患者微循环和大循环血管反应性以及左心室功能的影响。受试者（n = 89）随机接受维生素E（每日1，800 IU）或安慰剂，并随访12个月。使用高分辨率超声图像测量肱动脉的血流介导的扩张（FMD;内皮依赖性）和硝酸甘油诱导的扩张（NID;内皮非依赖性）。激光多普勒灌注成像用于测量前臂皮肤的血管反应性。采用经胸超声心动图评价左室功能。在6个月结束时，与安慰剂组相比，维生素E组内皮依赖性皮肤血管舒张功能恶化（P = 0.02），内皮素水平升高（P = 0.01）。在12个月结束时，与安慰剂组相比，维生素E组的NID（P = 0.02）恶化，收缩压（P = 0.04）和FMD（P = 0.04）轻微恶化。此外，与安慰剂组相比，维生素E组的C反应蛋白水平略有下降（P = 0.05）。左心室功能未见变化。我们的结论是，长期服用1,800 IU维生素E对糖尿病患者的内皮或左心室功能没有有益的影响。由于维生素E治疗的患者与对照组相比，某些血管反应性测量结果恶化，因此不建议使用高剂量的维生素E。
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.