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Yuanyuan G, Wang D, Hao Y, Guan Y, Bu H, Wang H. Study on serum vitamin A level in patients with type 1 diabetes: A systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e40029. [PMID: 39465858 PMCID: PMC11479461 DOI: 10.1097/md.0000000000040029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 09/20/2024] [Indexed: 10/29/2024] Open
Abstract
BACKGROUND There is controversy about the relationship between type 1 diabetes and vitamin A (VA) levels in the body. Through meta-analysis, the results of related studies can be aggregated to more accurately estimate the relationship between type 1 diabetes mellitus (T1DM) patients and the level of VA in the body. METHODS Our purpose is to review the study to investigate VA levels in type T1DM patients and to provide recommendations for future studies. Until January 2024, we searched the National Library of Medicine (PubMed), Cochrane Library, Embase Databases, Web of Sciences, Scopus, China National Knowledge Infrastructure (CNKI), VIP databases (VIP) and WAN FANG databases. After a systematic search, 8 case-control studies were included in our meta-analysis. In the process of data inclusion and extraction, the 2 reviewers selected literature independently of each other. In this study, RevMan5.3 software was used for meta-analysis. RESULTS Eight case-control studies involving 689 participants were screened. The results after meta-analysis showed that there was a significant difference in serum VA between the patients with T1DM and the control group (standardized mean difference [SMD] = -0.82, 95% CI [-1.29, -0.36], P < .001, random effects model) with significant heterogeneity among these studies (P < .001, I2 = 84%). Similarly, the difference in the high-performance liquid chromatography (HPLC) subgroup on serum VA (SMD = -0.99, 95% CI [-1.60, -0.38], P = .002) as well as the difference in the countries of Asia and Europe subgroup on serum VA (SMD = -0.60, 95% CI [-1.15, -0.05], P = .03; SMD = -1.06, 95% CI [-1.88, -0.24], P = .01) were suggested to be statistically significant. A significant result was also observed in the National Diabetes Data Group (NDDG) criteria subgroup (SMD = -0.48, 95% CI [-0.85, -0.12]). CONCLUSION Serum VA levels seem to have decreased in T1DM patients. Further research is needed to strengthen this finding and clarify possible impact mechanisms.
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Affiliation(s)
- Guan Yuanyuan
- School of Public Health and Health Sciences, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Dongjun Wang
- School of Public Health and Health Sciences, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yang Hao
- Department of Traditional Chinese Medicine, Tianjin First Central Hospital, Tianjin, China
| | - Yun Guan
- Crawford School of Public Policy, Asia and Pacific College, Australian National University, Canberra, Australia
| | - Huaien Bu
- School of Public Health and Health Sciences, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Hongwu Wang
- School of Public Health and Health Sciences, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Lu J, Wang D, Ma B, Gai X, Kang X, Wang J, Xiong K. Blood retinol and retinol-binding protein concentrations are associated with diabetes: a systematic review and meta-analysis of observational studies. Eur J Nutr 2022; 61:3315-3326. [PMID: 35318493 DOI: 10.1007/s00394-022-02859-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 03/02/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE The associations between blood retinol, retinol-binding protein (RBP) concentrations and diabetes mellitus were inconsistent in literature. The objective is to investigate these associations by a systematic review and meta-analysis and provide basis for clinical intervention. METHODS PubMed, Web of science, and Cochrane databases were searched from the beginning to July 1, 2021. A total of 13 studies on retinol and 31 studies on RBP are included in the current meta-analysis. RESULTS The blood retinol concentration was significantly lower in the type I diabetes mellitus (T1DM) [standardized mean difference (SMD) (95% CI): - 0.59 (- 0.81, - 0.37), P < 0.01] and gestational diabetes mellitus (GDM) patients [SMD (95% CI): - 0.54 (- 0.87, - 0.20), P < 0.01] than in the controls. However, the difference was not significant between the type II diabetes mellitus (T2DM) patients and the controls. The RBP concentration was significantly higher in the diabetic patients than in the controls [SMD (95% CI): 0.24 (0.12, 0.35), P < 0.01]. Particularly, the RBP concentration was significantly higher in the T2DM and GDM patients. CONCLUSION The blood retinol concentration was negatively associated with T1DM and GDM, while the blood RBP concentration was positively associated with T2DM and GDM. Future work should use a more sensitive retinol measurement method like retinol isotope dilution method to confirm whether blood retinol concentration differs between the diabetes patients and the controls.
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Affiliation(s)
- Jialin Lu
- Institute of Nutrition and Health, School of Public Health, Qingdao University, Qingdao, Shandong, China
| | - Dandan Wang
- Department of Nutrition, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Baolan Ma
- Health Management Center, The 971 Naval Hospital, Qingdao, Shandong, China
| | - Xiaochun Gai
- Institute of Nutrition and Health, School of Public Health, Qingdao University, Qingdao, Shandong, China
| | - Xiao Kang
- Institute of Nutrition and Health, School of Public Health, Qingdao University, Qingdao, Shandong, China
| | - Jinyu Wang
- Institute of Nutrition and Health, School of Public Health, Qingdao University, Qingdao, Shandong, China
| | - Ke Xiong
- Institute of Nutrition and Health, School of Public Health, Qingdao University, Qingdao, Shandong, China.
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Abstract
Recently, research data have shown that vitamin A (VA, retinol) as a micronutrient participates in the regulation of glucose and lipid metabolism. Since diabetes is a metabolic disease, it is imperative to reveal the relationship of VA and diabetes. This review was aimed to summarize the current understanding of VA and its metabolites in diabetes. Since April of 2020, the authors have searched the PubMed using key words and retrieved articles that focused on diabetes and VA or its metabolites. Based on the published data, it appears that the development of type 1 diabetes leads to reduction of blood VA level in human and animals, and increase of hepatic VA store in experimental animals. On the other hand, the mutual impacts of type 2 diabetes and VA intake and blood VA level on each other appear to be uncertain. Retinoic acid, the active metabolite of VA, has been studied extensively for the treatment of diabetic complications. The current data appear to indicate that the development of diabetes is associated with changes of VA metabolism. More carefully designed clinical and laboratory experiments are needed to reveal the impacts of diabetes on VA metabolism and the role of VA in the development and treatment of diabetes.
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Affiliation(s)
- Yan Zhang
- Department of Gastroenterology, Affiliated Puren Hospital of Wuhan University of Science and Technology, Wuhan, China
| | - Tiannan Wang
- Department of Nutrition, University of Tennessee at Knoxville, Knoxville, Tennessee, USA
| | - Xinge Hu
- Department of Nutrition, University of Tennessee at Knoxville, Knoxville, Tennessee, USA
| | - Guoxun Chen
- Department of Nutrition, University of Tennessee at Knoxville, Knoxville, Tennessee, USA
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Varghese M, Antony J. Assessment of Macular Pigment Optical Density Using Fundus Reflectometry in Diabetic Patients. Middle East Afr J Ophthalmol 2019; 26:2-6. [PMID: 31114116 PMCID: PMC6507373 DOI: 10.4103/meajo.meajo_248_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
PURPOSE: Diabetic retinopathy (DR) is a major cause of visual disability and may be associated with reduction in macular pigment (MP) density and insufficient data are available. We present MP optical density (MPOD) measured by fundus reflectometry in eyes with and without early and moderate DR. SUBJECTS AND METHODS: This was a cross-sectional study conducted in the year 2014–2015. Participants were divided into three groups: the normal individuals without diabetes constituted Group I, while diabetic patients without DR and the patients with mild-to-moderate DR constituted Group II and Group III, respectively. MPOD and maximum optical density (Max OD) were measured using a Visucam 500 fundus camera (Carl Zeiss Meditec AG, Jena, Germany). RESULTS: Fifty diabetic patients without DR, 50 with mild and moderate DR, and 50 healthy individuals underwent MPOD and Max OD measurements. The mean pigment density was the same in all the three groups (0.12). HbA1c levels were inversely correlated with MPOD (P = 0.01) and Max OD (P = 0.002). There was no relationship between MP density and age (P = 0.66), gender (P = 0.24), or duration of diabetes (P = 0.85). The duration of diabetes was compared between the two groups of diabetic patients with and without DR. CONCLUSIONS: The mean pigment density assessed by fundus reflectometry was 0.12 in each of the three groups studied. Higher HbA1c levels in diabetic patients correlated with decreased MPOD and Max OD. Better glycemic control may influence macular health in diabetic patients.
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Affiliation(s)
- Mary Varghese
- Department of Ophthalmology, St. John's Medical College, Bengaluru, Karnataka, India
| | - Joel Antony
- Department of Ophthalmology, St. John's Medical College, Bengaluru, Karnataka, India
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Malechka VV, Moiseyev G, Takahashi Y, Shin Y, Ma JX. Impaired Rhodopsin Generation in the Rat Model of Diabetic Retinopathy. THE AMERICAN JOURNAL OF PATHOLOGY 2017; 187:2222-2231. [PMID: 28734946 PMCID: PMC5809515 DOI: 10.1016/j.ajpath.2017.06.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 06/14/2017] [Accepted: 06/19/2017] [Indexed: 12/11/2022]
Abstract
Diabetic retinopathy is a common complication of diabetes mellitus. Diabetic patients experience functional deficits in dark adaptation, contrast sensitivity, and color perception before microvascular pathologies become apparent. Herein, we evaluated early changes in neural retinal function and in retinoid metabolism in the eye in diabetes. Streptozotocin-induced diabetic rats showed decreased a- and b-wave amplitudes of scotopic and photopic electroretinography responses 4 months after diabetes induction compared to nondiabetic controls. Although Western blot analysis revealed no difference in opsin expression, rhodopsin content was decreased in diabetic retinas, as shown by a difference in absorbance. Consistently, levels of 11-cis-retinal, the chromophore for visual pigments, were significantly lower in diabetic retinas compared to those in controls, suggesting a retinoid deficiency. Among visual cycle proteins, interphotoreceptor retinoid-binding protein and stimulated by retinoic acid 6 protein showed significantly lower levels in diabetic rats than those in nondiabetic controls. Similarly, serum levels of retinol-binding protein 4 and retinoids were significantly lower in diabetic rats. Overall, these results suggest that retinoid metabolism in the eye is impaired in type 1 diabetes, which leads to deficient generation of visual pigments and neural retinal dysfunction in early diabetes.
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Affiliation(s)
- Volha V Malechka
- Department of Physiology, Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Gennadiy Moiseyev
- Department of Physiology, Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
| | - Yusuke Takahashi
- Department of Medicine, Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Younghwa Shin
- Department of Physiology, Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Jian-Xing Ma
- Department of Physiology, Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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She CY, Gu H, Xu J, Yang XF, Ren XT, Liu NP. Association of macular pigment optical density with early stage of non-proliferative diabetic retinopathy in Chinese patients with type 2 diabetes mellitus. Int J Ophthalmol 2016; 9:1433-1438. [PMID: 27803860 DOI: 10.18240/ijo.2016.10.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 05/13/2016] [Indexed: 12/17/2022] Open
Abstract
AIM To detect the association between macular pigment optical density (MPOD), which reflects the antioxidant ability of retina, and diabetic retinopathy (DR) and to investigate the correlated factors of MPOD. METHODS Totally 435 subjects of urban Chinese were recruited to the study and divided into 3 groups: non-diabetes mellitus controls (NDM), diabetic patients without retinopathy (DWR), and patients with early stage of non-proliferative diabetic retinopathy (DR). Demographic and lifestyle characteristics were ascertained by questionnaire. A food-frequency questionnaire, general physical and ophthalmic examinations were completed for all participants. MPOD was measured by heterochromatic flicker photometry. Foveal thickness was measured by optical coherence tomography. The difference of MPOD among 3 groups was analyzed by analysis of covariance. The correlation analyses of MPOD with the candidate influence factors were assessed using the generalized estimating equations (GEE) model. RESULTS Of the 435 participants, 34 could not perform the MPOD measurements. Final analysis included 401 subjects, including 48 were in DR group, 134 in DWR group, and 219 in NDM group. MPOD was not significantly different among DR (0.49±0.21), DWR (0.45±0.21), and NDM (0.49±0.17) groups (P=0.24) after adjustment for fasting plasma glycemia, central foveal thickness, green vegetables, Chinese wolfberry, carotene and vitamin E. For all the 401 participants included, MPOD was positively associated with central foveal thickness (E=0.0007, P=0.001), Chinese wolfberry (E=0.0345, P=0.01), and green vegetables (E=0.0596, P<0.001) intake. CONCLUSION The data suggest that MPOD level is not statistically significantly influenced by the onset of diabetes or early stage of DR in the studied population. MPOD level is positively associated with thicker central foveal thickness and higher intake of foods containing carotenoids.
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Affiliation(s)
- Chong-Yang She
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing 100730, China
| | - Hong Gu
- Department of Ophthalmology, Ningbo Medical Treatment Center Lihuili Hospital, Ningbo 315040, Zhejiang Province, China
| | - Jun Xu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing 100730, China
| | - Xiu-Fen Yang
- Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100730, China
| | - Xue-Tao Ren
- Department of Ophthalmology, Huaxin Hospital, Tsing Hua University, Beijing 100730, China
| | - Ning-Pu Liu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing 100730, China
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Yosaee S, Akbari Fakhrabadi M, Shidfar F. Positive evidence for vitamin A role in prevention of type 1 diabetes. World J Diabetes 2016; 7:177-188. [PMID: 27162582 PMCID: PMC4856890 DOI: 10.4239/wjd.v7.i9.177] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 03/23/2016] [Accepted: 04/07/2016] [Indexed: 02/05/2023] Open
Abstract
Type 1 diabetes mellitus (T1DM) as one of the most well-known autoimmune disease, results from the destruction of β-cells in pancreas by autoimmune process. T1DM is fatal without insulin treatment. The expansion of alternative treatment to insulin is a dream to be fulfilled. Currently autoimmunity is considered as main factor in development of T1DM. So manipulation of the immune system can be considered as alternative treatment to insulin. For the past decades, vitamin A has been implicated as an essential dietary micronutrient in regulator of immune function. Despite major advantage in the knowledge of vitamin A biology, patients who present T1DM are at risk for deficiency in vitamin A and carotenoids. Applying such evidences, vitamin A treatment may be the key approach in preventing T1DM.
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Takitani K, Inoue K, Koh M, Miyazaki H, Inoue A, Kishi K, Tamai H. Altered retinol status and expression of retinol-related proteins in streptozotocin-induced type 1 diabetic model rats. J Clin Biochem Nutr 2015. [PMID: 26060349 DOI: 10.3164/jcbn.14.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Diabetes is a metabolic disorder characterized by chronic hyperglycemia. Advanced diabetes is associated with severe complications and impaired nutritional status. Here, we assessed the expression of retinol-associated proteins, including β-carotene 15,15'-monooxygenase (BCMO), lecithin:retinol acyltransferase (LRAT), aldehyde dehydrogenase (ALDH), and cytochrome P450 26A1 (CYP26A1), and measured retinol levels in the plasma and liver of streptozotocin (STZ)-induced type 1 diabetic model rats. Compared to the levels in the control rats, retinol levels in the plasma and liver of STZ rats were decreased and increased, respectively. Hepatic expression of the LRAT gene in STZ rats was lower than that in the controls. In the liver of STZ rats, the expression of ALDH1A1, a retinal metabolizing enzyme was higher, whereas ALDH1A2 expression was lower than in the controls. Hepatic CYP26A1 expression in STZ rats was significantly higher than in the control rats. BCMO expression levels in the liver and intestine of STZ rats were much lower than those of the controls. Altered BCMO expression might affect retinol status. It is considered that the metabolic availability of retinol was lessened despite the accelerated catabolism of retinol; therefore, retinol mobilization may be unbalanced in the liver of rats in the type 1 diabetic state.
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Affiliation(s)
- Kimitaka Takitani
- Department of Pediatrics, Osaka Medical College, 2-7 Daigakumachi, Takatsuki-shi, Osaka 569-8686, Japan
| | - Keisuke Inoue
- Department of Pediatrics, Hirakata City Hospital, 2-14-1 Kinyahonmachi, Hirakata-shi, Osaka 573-1013, Japan
| | - Maki Koh
- Department of Pediatrics, Osaka Medical College, 2-7 Daigakumachi, Takatsuki-shi, Osaka 569-8686, Japan
| | - Hiroshi Miyazaki
- Department of Pediatrics, Osaka Rosai Hospital, 1179-3 Nagasonecho, Kita-ku, Sakai-shi, Osaka 591-8025, Japan
| | - Akiko Inoue
- Department of Pediatrics, Osaka Medical College, 2-7 Daigakumachi, Takatsuki-shi, Osaka 569-8686, Japan
| | - Kanta Kishi
- Department of Pediatrics, Osaka Medical College, 2-7 Daigakumachi, Takatsuki-shi, Osaka 569-8686, Japan
| | - Hiroshi Tamai
- Department of Pediatrics, Osaka Medical College, 2-7 Daigakumachi, Takatsuki-shi, Osaka 569-8686, Japan
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Takitani K, Inoue K, Koh M, Miyazaki H, Inoue A, Kishi K, Tamai H. Altered retinol status and expression of retinol-related proteins in streptozotocin-induced type 1 diabetic model rats. J Clin Biochem Nutr 2015; 56:195-200. [PMID: 26060349 PMCID: PMC4454085 DOI: 10.3164/jcbn.14-113] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 10/22/2014] [Indexed: 01/08/2023] Open
Abstract
Diabetes is a metabolic disorder characterized by chronic hyperglycemia. Advanced diabetes is associated with severe complications and impaired nutritional status. Here, we assessed the expression of retinol-associated proteins, including β-carotene 15,15'-monooxygenase (BCMO), lecithin:retinol acyltransferase (LRAT), aldehyde dehydrogenase (ALDH), and cytochrome P450 26A1 (CYP26A1), and measured retinol levels in the plasma and liver of streptozotocin (STZ)-induced type 1 diabetic model rats. Compared to the levels in the control rats, retinol levels in the plasma and liver of STZ rats were decreased and increased, respectively. Hepatic expression of the LRAT gene in STZ rats was lower than that in the controls. In the liver of STZ rats, the expression of ALDH1A1, a retinal metabolizing enzyme was higher, whereas ALDH1A2 expression was lower than in the controls. Hepatic CYP26A1 expression in STZ rats was significantly higher than in the control rats. BCMO expression levels in the liver and intestine of STZ rats were much lower than those of the controls. Altered BCMO expression might affect retinol status. It is considered that the metabolic availability of retinol was lessened despite the accelerated catabolism of retinol; therefore, retinol mobilization may be unbalanced in the liver of rats in the type 1 diabetic state.
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Affiliation(s)
- Kimitaka Takitani
- Department of Pediatrics, Osaka Medical College, 2-7 Daigakumachi, Takatsuki-shi, Osaka 569-8686, Japan
| | - Keisuke Inoue
- Department of Pediatrics, Hirakata City Hospital, 2-14-1 Kinyahonmachi, Hirakata-shi, Osaka 573-1013, Japan
| | - Maki Koh
- Department of Pediatrics, Osaka Medical College, 2-7 Daigakumachi, Takatsuki-shi, Osaka 569-8686, Japan
| | - Hiroshi Miyazaki
- Department of Pediatrics, Osaka Rosai Hospital, 1179-3 Nagasonecho, Kita-ku, Sakai-shi, Osaka 591-8025, Japan
| | - Akiko Inoue
- Department of Pediatrics, Osaka Medical College, 2-7 Daigakumachi, Takatsuki-shi, Osaka 569-8686, Japan
| | - Kanta Kishi
- Department of Pediatrics, Osaka Medical College, 2-7 Daigakumachi, Takatsuki-shi, Osaka 569-8686, Japan
| | - Hiroshi Tamai
- Department of Pediatrics, Osaka Medical College, 2-7 Daigakumachi, Takatsuki-shi, Osaka 569-8686, Japan
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Atilgan R, Kuloglu T, Ozkan ZS, Kavak SB, Kumbak B, Deveci D, Simsek M, Baspinar M, Sapmaz E. Evaluation of vitamin C and vitamin E for prevention of postoperative adhesion: A rat uterine horn model study. J Obstet Gynaecol Res 2014; 41:418-23. [PMID: 25331934 DOI: 10.1111/jog.12544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 07/31/2014] [Indexed: 01/27/2023]
Affiliation(s)
- Remzi Atilgan
- Department of Obstetrics and Gynecology; School of Medicine; Fırat University; Istanbul Turkey
| | - Tuncay Kuloglu
- Department of Obstetrics and Gynecology; School of Medicine; Fırat University; Istanbul Turkey
| | - Zehra Sema Ozkan
- Department of Obstetrics and Gynecology; School of Medicine; Fırat University; Istanbul Turkey
| | - Salih Burcin Kavak
- Department of Obstetrics and Gynecology; School of Medicine; Fırat University; Istanbul Turkey
| | - Banu Kumbak
- Department of Obstetrics and Gynecology; School of Medicine; Fırat University; Istanbul Turkey
| | - Derya Deveci
- Department of Obstetrics and Gynecology; School of Medicine; Fırat University; Istanbul Turkey
| | - Mehmet Simsek
- Department of Obstetrics and Gynecology; School of Medicine; Fırat University; Istanbul Turkey
| | - Melike Baspinar
- Department of Obstetrics and Gynecology; School of Medicine; Fırat University; Istanbul Turkey
| | - Ekrem Sapmaz
- Department of Obstetrics and Gynecology; School of Medicine; Fırat University; Istanbul Turkey
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Lahbib A, Ghodbane S, Sakly M, Abdelmelek H. Vitamins and glucose metabolism: The role of static magnetic fields. Int J Radiat Biol 2014; 90:1240-5. [DOI: 10.3109/09553002.2014.930537] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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12
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The levels of copper, zinc and magnesium in type II diabetic patients complicated with foot infections. Int J Diabetes Dev Ctries 2013. [DOI: 10.1007/s13410-013-0130-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Pullakhandam R, Palika R, Ghosh S, Reddy GB. Contrasting effects of type 2 and type 1 diabetes on plasma RBP4 levels: the significance of transthyretin. IUBMB Life 2012; 64:975-82. [PMID: 23129325 DOI: 10.1002/iub.1096] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 09/12/2012] [Indexed: 12/13/2022]
Abstract
Retinol-binding protein 4 (RBP4) is the principle carrier of retinol in the human plasma, which circulates as a complex with transthyretin (TTR), a homotetrameric thyroxine transport protein. Although this complex formation is thought to prevent glomerular filtration of RBP4, it also stabilizes the quaternary structure of TTR. Recent studies indicate elevated plasma levels of RBP4 in type 2 diabetes (T2D). In contrast, reduced RBP4 levels were observed in type 1 diabetes (T1D). Herein, we critically examine the probable mechanisms involved in the regulation of RBP4 and TTR levels during T2D and T1D. The available evidences point to the involvement of pancreatic factors in regulating the expression of both RBP4 and TTR. It appears that during T1D, TTR levels are reduced and it exists predominantly as a monomer that may interfere its interaction with RBP4 resulting in its loss through glomerular filtration. However, plasma TTR levels remain high under T2D conditions and thus reducing glomerular filtration of RBP4. Therefore, the plasma TTR levels appear to be an important determinant of plasma RBP4 levels in these two diabetic conditions.
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Affiliation(s)
- Raghu Pullakhandam
- National Institute of Nutrition, Indian Council of Medical Research, Jamai-Osmania, Hyderabad 500 007, India.
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Bucheli P, Gao Q, Redgwell R, Vidal K, Wang J, Zhang W. Biomolecular and Clinical Aspects of Chinese Wolfberry. OXIDATIVE STRESS AND DISEASE 2011. [DOI: 10.1201/b10787-15] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Abstract
Diabetic retinopathy increases with duration of diabetes and may be associated with carotenoid status. Carotenoids alter the pro-oxidation/antioxidation balance, and circulating levels depend largely on dietary intake. Lower levels have been reported in diabetes and age-related macular degeneration; however, little is known of the relationship between carotenoids and diabetic complications. Consequently, the purpose of the present study was to evaluate the relationship between plasma carotenoids and diabetic retinopathy. We assessed the carotenoid-retinopathy relationship in 111 individuals with type 2 diabetes in a community-based, cross-sectional study. We photodocumented retinal status and used HPLC to measure plasma carotenoid concentrations. Data for clinical and demographic variables and risk factors for diabetic retinopathy were obtained from 24 h urine and fasting blood samples, and an interviewer-assisted lifestyle questionnaire. We found that the combined lycopene and lutein/zeaxanthin (non-pro-vitamin A (non-PVA) carotenoid) concentration when compared with the pro-vitamin A (PVA) carotenoids (alpha-carotene, beta-carotene and beta-cryptoxanthin) was significantly lower in the retinopathy than non-retinopathy group (OR 1.2 (95% CI 1.0, 1.4) v. 1.6 (95% CI 1.4, 1.7), respectively; P=0.009). A higher non-PVA:PVA ratio also predicted a lower risk of diabetic retinopathy, after adjustment for potential confounders (OR 0.33 (95% CI 0.12, 0.95); P=0.039). Finally, a higher concentration of PVA carotenoids was associated with greater odds of diabetic retinopathy, after adjustment for risk factors (P=0.049). We suggest synergies between carotenoids are implicated in diabetic retinopathy, independent of established risk factors. Importantly, our observations indicate dietary modulation of retinopathy risk may be possible by increasing intakes of lutein- and lycopene-rich foods.
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Takitani K, Miyazaki H, Takaya R, Tamai H. Expression of beta-carotene 15,15'-monooxygenase gene and retinol status in type 2 diabetic Goto-Kakizaki rats. Biofactors 2008; 33:77-83. [PMID: 19276538 DOI: 10.1002/biof.5520330107] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The vitamin A status has been studied in type 2 diabetes and it is known that plasma retinol levels of patients with type 2 diabetes are elevated. However, the details of vitamin A metabolism in type 2 diabetes are unclear. beta-Carotene exhibits biological activity as provitamin A and beta-carotene 15,15'-monooxygenase (BCM) cleaves beta-carotene to form retinal. We studied BCM gene expression in type 2 diabetic Goto-Kakizaki (GK) rats. BCM gene expression was analyzed in the liver, intestine, and testis of 8- and 13-week-old GK rats and Wistar rats (control). The plasma and liver retinol levels were measured, and plasma retinol-binding protein (RBP) was detected. BCM gene expression in the liver, intestine and testis of GK rats was increased compared with that in controls. Plasma retinol levels and RBP levels were increased in GK rats, but hepatic retinol levels did not differ between GK rats and controls. BCM gene expression in the liver and intestine might affect retinol levels in type 2 diabetes. Conversion of beta-carotene to retinal might be accelerated in the presence of insulin resistance status, so that plasma retinol levels are increased in type 2 diabetes.
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Espe K, Galler A, Raila J, Kiess W, Schweigert FJ. High-normal C-reactive protein levels do not affect the vitamin A transport complex in serum of children and adolescents with type 1 diabetes. Pediatr Res 2007; 62:741-5. [PMID: 17957146 DOI: 10.1203/pdr.0b013e318158787e] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Type 1 diabetes is associated with the presence of inflammation, which in turn affects parameters used to assess the vitamin A status. In the present study, we evaluated the influence of inflammatory status on retinol, retinol-binding protein 4 (RBP4), and transthyretin (TTR) in children and adolescents with type 1 diabetes. A total of 40 children with type 1 diabetes (median age, 14.2 y; median BMI-SDS, 0.53; median diabetes duration, 5.8 y; median HbA1c, 7.3%) and 46 healthy subjects (median age, 12.8 y; median BMI-SDS, 0.34; median HbA1c 5.4%) were recruited. Serum levels of CRP were significantly elevated (p = 0.005) and retinol concentrations were significantly lower (p = 0.02) in children and adolescents with type 1 diabetes compared with healthy subjects. Serum RBP4 and TTR showed no differences between the groups. Healthy children with CRP levels above 0.6 mg/L had significant lower levels of retinol (p = 0.03). This was not observed in children with type 1 diabetes. The results suggest that, in contrast to healthy children, minor CRP elevation does not affect vitamin A transport complex in serum of children with type 1 diabetes.
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Affiliation(s)
- Katharina Espe
- Department of Physiology and Pathophysiology, Institute of Nutritional Science, University of Potsdam, Nuthetal, 14558, Germany.
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Granado-Lorencio F, Olmedilla-Alonso B, Blanco-Navarro I, Botella-Romero F, Simal-Antón A. Assessment of carotenoid status and the relation to glycaemic control in type I diabetics: a follow-up study. Eur J Clin Nutr 2006; 60:1000-8. [PMID: 16452910 DOI: 10.1038/sj.ejcn.1602411] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To assess the carotenoid status in young type I diabetic patients and its relationship to the glycaemic control of the disease. DESIGN A follow-up study. SETTING Hospital Universitario Puerta de Hierro, Health Area VI of Madrid (Spain). SUBJECTS Forty-seven type I diabetic patients, followed for 2.5 years. INTERVENTIONS Coinciding with physical examination and laboratory tests, serum levels of carotenoids were analysed by HPLC, and dietary intake of carotenoids was evaluated by a semiquantitative food frequency questionnaire and 3-day prospective dietary records. RESULTS In type I diabetic patients, average intake, serum levels and correlations between diet and serum levels of carotenoids were comparable to those in reference non-diabetic groups. Between-subjects seasonal variations were observed for beta-cryptoxanthin intake and serum levels (higher in winter) and serum lycopene (higher in summer). Significant within-subjects seasonal changes were shown for dietary and serum beta-cryptoxanthin and serum beta-carotene. Serum carotenoids were unrelated to glycaemic control markers. Subjects with clinically acceptable glycaemic control showed lower lycopene intake than those with unacceptable control. Intake of carotenoids did not explain variance in insulin dose, fasting glycaemia, fructosamine or HbA1c. With the exception of lycopene, serum carotenoids were predicted by dietary intake, but in no case by fasting glycaemia, HbA1c or fructosamine. CONCLUSION In type I diabetic patients, serum carotenoid concentrations and their variance are determined by dietary intake patterns, and are unrelated to the glycaemic control of the disease, as assessed by biochemical markers.
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Affiliation(s)
- F Granado-Lorencio
- Servicio de Endocrinología y Nutrición. Unidad de Vitaminas, Hospital Universitario Puerta de Hierro, Madrid, Spain.
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19
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Ozcelik O, Ozkan Y, Karatas F, Kelestimur H. Exercise Training as an Adjunct to Orlistat Therapy Reduces Oxidative Stress in Obese Subjects. TOHOKU J EXP MED 2005; 206:313-8. [PMID: 15997202 DOI: 10.1620/tjem.206.313] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The anti-obesity drug orlistat promotes weight loss and improves obesity-related risk factors, but its effect on oxidative stress is not clear yet. Orlistat reduces dietary fat absorption, which may have effects on fat soluble vitamins especially the antioxidant vitamins A and E. The aim of this study was to determine and compare the effects of weight loss achieved by orlistat therapy and a combination of orlistat with aerobic exercise training on lipid peroxidation and antioxidative defense in obese subjects. Total of 24 obese subjects were randomly assigned to receive 12-week treatment with hypocaloric diet-orlistat (120 mg three times daily) (DO group) or diet-orlistat-exercise (DOE group). Serum levels of malondialdehyde (MDA), a marker for lipid peroxidation, and vitamins A and E were measured by high performance liquid chromatography at baseline and at the end of the treatment. Body weight and fat mass were significantly reduced in the two groups (p < 0.001). In the DO group, the MDA levels remained unchanged (p = 0.59), while vitamins A (p < 0.01) and E (p < 0.001) were significantly decreased. In contrast, the subjects treated with DOE exhibited marked decreases in MDA (p = 0.002) and a small but significant decrease in vitamins A (p = 0.003) and E (p = 0.003). Thus, orlistat therapy alone caused a significant reduction in antioxidative capacity without affecting oxidative stress, whereas orlistat in combination with exercise training provided a significant decrease in MDA levels. The beneficial effect of aerobic exercise as an adjunct to the orlistat therapy is of importance with regard to the obesity-associated risk factors.
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Affiliation(s)
- Oguz Ozcelik
- Department of Physiology, Firat University Faculty of Medicine, Elazig, Turkey.
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20
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The effect of dietary supplementation of β-carotene on lipid metabolism in streptozotocin-induced diabetic rats. Nutr Res 2004. [DOI: 10.1016/j.nutres.2004.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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21
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Granado F, Olmedilla B, Blanco I. Carotenoid Depletion in Serum of Young Type-1 Diabetics Fed Low-Carotenoid Diets. ANNALS OF NUTRITION AND METABOLISM 2004; 48:251-8. [PMID: 15331884 DOI: 10.1159/000080459] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2004] [Accepted: 04/23/2004] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Type-1 diabetics have been considered to be at risk for increased oxidative stress which has been implicated in the development of long-term diabetes complications. Evidence suggests that antioxidant activity may be an important mechanism by which carotenoids could confer protection in human health. Our aim was to compare the serum carotenoid depletion rate in type-1 diabetics and control subjects consuming low-carotenoid diets. METHODS Ten type-1 diabetics and 8 controls followed a very low-carotenoid diet for 21 days. Dietary intake was recorded daily and fasting blood samples collected at baseline and after 1, 2, 3, 6, 11, 15, 16, 17, and 21 days. Individual carotenoids in serum were analyzed by a validated HPLC method. RESULTS In both groups, carotenoid intake was less than 5% of the season-adjusted carotenoid reference intake. These diets resulted in decreased serum carotenoid levels in both groups, although depletion curves, final mean concentrations and the estimated half-life of carotenoids in serum revealed no differences between type-1 diabetics and controls. Levels of other minor serum carotenoids, cis-isomers and keto-carotenoids, also decreased whereas serum retinol and alpha- and gamma-tocopherol did not change during the study. CONCLUSION Upon a low-carotenoid intake, the depletion rate of carotenoids in serum in young type-1 diabetics does not differ from that observed in matched related controls.
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Affiliation(s)
- F Granado
- Unidad de Vitaminas, Servicio de Endocrinología y Nutrición, Hospital Universitario Puerta de Hierro, Madrid, Spain
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22
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Vega-López S, Devaraj S, Jialal I. Oxidative Stress and Antioxidant Supplementation in the Management of Diabetic Cardiovascular Disease. J Investig Med 2004. [DOI: 10.1177/108155890405200123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The diabetic state confers an increased propensity to accelerated atherogenesis. In addition to the established risk factors, there is evidence for increased oxidative stress in diabetes. Increased oxidative stress is manifested by increased lipid peroxidation, increased F2-isoprostanes, increased nitrotyrosine, and increased DNA damage. Also, in diabetics, there is increased superoxide release. With regard to diabetes, antioxidants such as α-tocopherol, α-lipoate, and ascorbic acid supplementation have been shown to be beneficial. Most importantly, α-tocopherol therapy, especially at high doses, clearly shows a benefit with regard to low-density lipoprotein oxidation, isoprostanes, and monocyte superoxide release. Thus, it appears that, in diabetes, antioxidant therapy could alleviate the increased attendant oxidative stress and emerge as an additional therapeutic modality.
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Affiliation(s)
- Sonia Vega-López
- Laboratory for Atherosclerosis and Metabolic Research, University of California, Davis Medical Center, Sacramento, CA
| | - Sridevi Devaraj
- Laboratory for Atherosclerosis and Metabolic Research, University of California, Davis Medical Center, Sacramento, CA
| | - Ishwarlal Jialal
- Laboratory for Atherosclerosis and Metabolic Research, University of California, Davis Medical Center, Sacramento, CA
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23
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Affiliation(s)
- M Donaldson
- Department of Ophthalmology, Birmingham Heartlands Hospital, Birmingham, UK
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24
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Granado F, Olmedilla B, Botella F, Simal A, Blanco I. Retinol and alpha-tocopherol in serum of type 1 diabetic patients with intensive insulin therapy: a long term follow-up study. Nutrition 2003; 19:128-32. [PMID: 12591543 DOI: 10.1016/s0899-9007(02)00908-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE We evaluated the effect of intensive insulin therapy and glycemic control in patients with type 1 diabetes on biochemical markers of vitamin A and E. METHODS Fifty-seven patients with type 1 diabetes were enrolled in a follow-up study for 3 to 33 mo. At entrance, all patients were on conventional insulin therapy or recently had been diagnosed with the disease. Intensive insulin therapy (multiple daily glycemia records and at least three insulin doses daily) was established, and every 3 to 6 mo patients were screened for clinical, biochemical, and hematologic indexes. Biochemical markers of vitamin A and E nutrition status were measured at each visit by a quality-controlled high-performance liquid chromatography. RESULTS At entrance, serum retinol concentrations, but not the ratio of alpha-tocopherol to cholesterol, showed a negative correlation with increasing values of HbA1c and insulin dose, neither of which was significant in multiple regression models. With intensive insulin therapy, a trend to normalize parameters of glycemic control (HbA1c and fructosamine) was observed within subjects and on a group level. However, no significant changes were observed in serum retinol or alpha-tocopherol:cholesterol ratio according to the metabolic control of the disease. CONCLUSIONS Patients with type 1 diabetes under intensive insulin therapy tend to normalize the clinical parameters of glycemic control, although this improvement does not significantly affect biochemical markers of vitamin A and E status.
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Affiliation(s)
- F Granado
- Unidad de Vitaminas, Sección de Nutrición, Clínica Puerta de Hierro, Madrid, Spain
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Abstract
OBJECTIVES To test the hypothesis that type 1 diabetes is associated with increased oxidative stress and/or antioxidant status by investigating concentrations of 8-iso-prostaglandin F2alpha (8-iso-PGF2alpha) in urine and plasma and malondialdehyde (MDA) in plasma as indicators of lipid peroxidation in vivo, and antioxidant status in diabetic subjects compared with healthy control subjects. DESIGN AND SUBJECTS Thirty-eight subjects with type 1 diabetes mellitus and 41 healthy age- and sex-matched control subjects were included in the study. Blood and urine samples were obtained and analysed for 8-iso-PGF2alpha with a newly developed radioimmunoassay, as well as for MDA, total antioxidant capacity (TAOC) and serum tocopherol levels. RESULTS None of the variables of lipid peroxidation showed any significant difference between the two groups. Similarly, there were no significant correlations between the levels of 8-iso-PGF2alpha or MDA, and degree of glycemic control (HbA1c). Total antioxidant capacity in plasma was 16% lower amongst the subjects with type 1 diabetes than in the control group (P < 0.0005). Lipid corrected levels of alpha-tocopherol in serum were significantly increased in type 1 diabetic subjects (P < 0.05), as were gamma-tocopherol levels (P < 0.005). CONCLUSIONS In spite of lower total antioxidant defence, our results do not support the oxidative stress hypothesis for type 1 diabetes mellitus. The higher tocopherol levels suggest that no vitamin E supplementation is necessary for subjects with type 1 diabetes mellitus.
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Affiliation(s)
- J Vessby
- Section for Clinical Nutrition Research, Department of Public and Caring Sciences, Uppsala University, Uppsala, Sweden.
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26
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Lu J, Dixon WT, Tsin AT, Basu TK. The metabolic availability of vitamin A is decreased at the onset of diabetes in BB rats. J Nutr 2000; 130:1958-62. [PMID: 10917908 DOI: 10.1093/jn/130.8.1958] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Streptozotocin (STZ)-induced diabetic rats have been associated with an impaired metabolic availability of vitamin A (retinol). This study was undertaken to investigate whether Biobreeding (BB) rats, in which diabetes mellitus resembling human type I diabetes develops spontaneously, respond the same way at the onset of diabetes. Weaning diabetes-prone (BBdp) and normal (BBn) BB rats consumed NIH-07 nonpurified diet ad libitum until 120 d of age. Plasma and hepatic concentrations of retinol and its carriers, retinol-binding protein (RBP) and transthyretin (TTR) were lower in diabetic BB (BBd) rats than in BBn rats. In parallel with RBP, the abundance of mRNA was lower in the liver of BBd rats. Furthermore, the status of zinc, an important factor for the synthesis of RBP, was also disturbed in BBd rats, as indicated by lower circulatory levels and greater urinary excretion. To determine whether the biochemical evidence of vitamin A deficiency in BBd rats could be reversed, BBdp rats were fed a diet supplemented with vitamin A either alone or in combination with zinc. None of these treatments increased plasma vitamin A concentration. The hepatic abundance of RBP mRNA was significantly greater, whereas circulatory RBP concentrations were unaffected by vitamin A plus zinc supplementation. Overall, these results suggest that impaired metabolic availability of vitamin A, possibly caused by its decreased transport from hepatic stores, is another metabolic derangement associated with type I diabetes.
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Affiliation(s)
- J Lu
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada
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27
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Polidori MC, Mecocci P, Stahl W, Parente B, Cecchetti R, Cherubini A, Cao P, Sies H, Senin U. Plasma levels of lipophilic antioxidants in very old patients with type 2 diabetes. Diabetes Metab Res Rev 2000; 16:15-9. [PMID: 10707034 DOI: 10.1002/(sici)1520-7560(200001/02)16:1<15::aid-dmrr71>3.0.co;2-b] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Experimental research indicates that oxidative stress is implicated in aging and in the pathogenesis of diabetes and its complications. This evidence is limited in elderly patients with non-insulin dependent diabetes, in which age- and disease-related production of reactive oxygen species might exert synergistic damaging effects on tissues and organs. METHODS Plasma levels of lipid-soluble compounds with antioxidant properties including vitamin A, vitamin E and carotenoids (lutein, zeaxanthin, beta-cryptoxanthin, lycopene, alpha- and beta-carotene) were measured by HPLC in 72 elderly patients with non-insulin dependent diabetes (75.7+/-0.8 years, 40 F, 32 M) and in 75 age-matched controls (77.2+/-1.2 years, 48 F, 27 M). RESULTS All compounds measured were significantly lower in plasma from diabetic patients as compared to controls (p<0.0001). Plasma levels of vitamins A and E and of carotenoids did not significantly correlate with dietary intake and lipid profile in both groups. In patients, significant inverse correlations were found between age and levels of vitamin E, beta-cryptoxanthin, lycopene and beta-carotene. CONCLUSIONS We conclude that patients of very old age with Type 2 diabetes show a poor plasma status of vitamins A and E and carotenoids, which negatively correlates with age. Further studies are needed to explore the possible therapeutic role of lipid-soluble vitamin supplements in elderly diabetic subjects.
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Affiliation(s)
- M C Polidori
- Institute of Gerontology and Geriatrics, Perugia University Hospital, Perugia, Italy.
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