Alpha-Tocopherol Distribution in Lipoproteins and Anti-Inflammatory Effects Differ between CHD-Patients and Healthy Subjects

Abstract

Objective: The purpose of this study was to investigate the dose-dependent effects of RRR-α-tocopherol supplementation in coronary heart disease (CHD) patients and healthy subjects on plasma α-tocopherol levels, plasma lipoprotein distribution, LDL oxidation, and inflammatory plasma markers.Methods: 12 patients with coronary heart disease and 12 healthy subjects were supplemented with increasing dosages of RRR-α-tocopherol at 100, 200 and 400 mg/day for a period of 3 weeks per dose. Lipoproteins were separated by FPLC and ultracentrifugation. α-Tocopherol was measured by HPLC. Resistance of LDL to oxidation was determined by reading the absorption at 234 nm after CuCl2-induced oxidation. Clinical chemistry and inflammatory markers were measured on automated analysis systems.Results: Plasma α-tocopherol concentrations at baseline were comparable between CHD-patients and healthy subjects (21.7 ± 4.7 μmol/L and 25.8 ± 7.6 μmol/L, respectively). CHD-patients showed a significant increase (59%) of plasma α-tocopherol concentrations to 34.6 ± 9.8 μmol/L at a dosage of 100 mg/day RRR-α-tocopherol, whereas healthy subjects showed a significant (54%) increase to 39.7 ± 6.1 μmol/L only with 400 mg/day RRR-α-tocopherol. In addition, CHD-patients showed a significantly increased enrichment of α-tocopherol in VLDL. Supplementation (200 mg/day) caused a significant decrease of the acute phase plasma proteins C-reactive protein (CRP) (−65%) and fibrinogen (−24%).Conclusion: Our data demonstrate that CHD-patients require lower dosages of α-tocopherol supplementation than healthy subjects to exert biological effects on plasma lipoproteins and acute phase response.