Plasma Vitamin E and the Risk of First Stroke in Hypertensive Patients: A Nested Case-Control Study

Background: The association between plasma vitamin E levels and first stroke risk in men and women remains unclear.Objective: We aimed to examine the prospective association between plasma vitamin E and first stroke, and evaluate the effect modifiers for the association, among hypertensive patients.Design: The study sample was drawn from the China Stroke Primary Prevention Trial (CSPPT), which randomized a total of 20,702 hypertensive patients to a double-blind, daily treatment with either 10 mg enalapril and 0.8 mg folic acid or 10 mg enalapril alone. This nested case-control study, including 618 first stroke cases and 618 controls matched for age, sex, treatment group, and study site, was conducted after the completion of the CSPPT.Results: The median follow-up duration was 4.5 years. Among men, a significantly higher risk of first stroke (adjusted OR, 1.67; 95%CI: 1.01, 2.77) was found for those with plasma vitamin E ≥7.1 μg/mL (≥quartile 1) compared with those with plasma vitamin E < 7.1 μg/mL. Subgroup analyses further showed that the association between vitamin E (≥7.1 vs. <7.1 μg/mL) and first stroke in men was significantly stronger in non-drinkers (adjusted OR, 2.64; 95%CI: 1.41, 4.96), compared to current drinkers (adjusted OR, 0.84; 95% CI: 0.43, 1.66, P-interaction = 0.008). However, there was no significant association between plasma vitamin E and first stroke in women (P-interaction between sex and plasma vitamin E = 0.048).Conclusions: Among Chinese hypertensive patients, there was a statistically significant positive association between baseline plasma vitamin E and the risk of first stroke in men, but not in women.Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT00794885, Identifier: NCT00794885.

Biochemical and Clinical Effects of Vitamin E Supplementation in Hungarian Smith-Lemli-Opitz Syndrome Patients

Smith-Lemli-Opitz syndrome (SLOS) is a severe monogenic disorder resulting in low cholesterol and high 7-dehydrocholesterol (7-DHC) levels. 7-DHC-derived oxysterols likely contribute to disease pathophysiology, and thus antioxidant treatment might be beneficial because of high oxidative stress. In a three-year prospective study, we investigated the effects of vitamin E supplementation in six SLOS patients already receiving dietary cholesterol treatment. Plasma vitamin A and E concentrations were determined by the high-performance liquid chromatography (HPLC) method. At baseline, plasma 7-DHC, 8-dehydrocholesterol (8-DHC) and cholesterol levels were determined by liquid chromatography–tandem mass spectrometry (LC-MS/MS) method. The clinical effect of the supplementation was assessed by performing structured parental interviews. At baseline, patients were characterized by low or low–normal plasma vitamin E concentrations (7.19–15.68 μmol/L), while vitamin A concentrations were found to be normal or high (1.26–2.68 μmol/L). Vitamin E supplementation resulted in correction or significant elevation of plasma vitamin E concentration in all patients. We observed reduced aggression, self-injury, irritability, hyperactivity, attention deficit, repetitive behavior, sleep disturbance, skin photosensitivity and/or eczema in 3/6 patients, with notable individual variability. Clinical response to therapy was associated with a low baseline 7-DHC + 8-DHC/cholesterol ratio (0.2–0.4). We suggest that determination of vitamin E status is important in SLOS patients. Supplementation of vitamin E should be considered and might be beneficial.

PSIII-20 Oil source and peroxidation affects performance and vitamin E status in nursery pigs

Oil source and peroxidation are known to impact performance and oxidative status in young pigs. The objectives of this trial were to evaluate the effect of oil source and peroxidation status on pig performance and plasma vitamin E. Pigs (initial BW 6.07 ± 0.12 kg) were allotted to 96 pens containing 3 pigs/pen in a completely randomized design and fed for 21 d. The 4 × 2 factorial arrangement of treatments included 4 oil sources (palm, poultry fat, soybean, and canola oil) and either fresh (FO) or peroxidized oil (PO). Peroxidation was achieved by heating oils at 90oC for 72 h with air flow rate of 12L/min. Both FO and PO were analyzed for peroxide value and anisidine value, each of which increased with peroxidation compared to FO, while peroxidation reduced total tocopherols. Blood was also collected from one randomly selected pig/pen from 9 replications per treatment on d 12 for plasma vitamin E analysis. PO decreased both ADFI (318 vs. 338 g, P < 0.05) and ADG (267 vs. 289 g, P < 0.05) compared to FO. No difference in ADG and ADFI was detected for the main effect of oil source. An interaction tended to occur (P = 0.10) for ADFI where pigs fed PO palm, soybean, and canola oil had reduced ADFI compared to pigs fed peroxidized poultry fat, with the greatest reduction in ADFI noted for pigs fed peroxidized soybean and canola oil. Changes in ADG were directionally similar. Plasma vitamin E was reduced in pigs fed PO (P < 0.01), with the largest difference in pigs fed peroxidized soybean (-67%) and canola oil (-40%) compared to fresh soybean and canola oil. Based on changes in peroxidation status, performance and plasma vitamin E were reduced most in pigs fed soybean and canola oils and less in pigs fed palm oil and poultry fat.

MODERN POSSIBILITIES OF RATIONAL VITAMIN THERAPY IN PREGNANT WOMEN

Insufficient nutrition is an urgent problem of modern healthcare. According to WHO, more than 2 billion people suffer from essential vitamin and mineral deficiencies, in particular vitamin A, iodine, iron and zinc [1]. The hypovitaminosis, as well as hypoelementosis pose the greatest threat to pregnancy and lactation, contributing to the development of miscarriages, intrauterine growth restriction, maternal mortality, labor complications, infectious pathology and adverse course of the neonatal period.Objective of the study: evaluation of the efficacy of the vitamin and mineral complex in correcting the nutritional status of patients during gestation.Materials and methods of the study: 33 pregnant women with threatened miscarriage of various genesis, who were admitted to the department of gynaecology, underwent a clinical and laboratory examination and treatment. In addition to the general clinical examination, all patients were assessed for plasma vitamin E and folic acid concentrations, which play a key role in embryogenesis. In addition to therapy aimed at prolonging pregnancy, all pregnant women received nutritional support in the form of a multivitamin drug.Results of the study: During the observation period, the condition of pregnant women improved significantly: signs of threatened miscarriage were eliminated, complaints of weakness, fatigue and sleep disturbance disappeared. All patients showed significantly higher plasma vitamin E and folic acid concentrations after the treatment.