Abstract
Background: Accelerated atherosclerosis is common in patients with diabetes mellitus which may be linked to increased lipid peroxidation. Therefore, we compared the oxidation of LDL derived from patients with diabetes to normoglycemic controls and followed-up the effect of dietary β-carotene supplementation on LDL oxidation. Methods: Twenty patients with long-standing non-insulin-dependent diabetes mellitus were studied in comparison with age- and sex-matched control subjects. Dunaliella bardawil-derived β-carotene was supplemented to the patients for 3 weeks, 60 mg daily dose. LDL oxidation was analyzed by measuring malondialdehyde (MDA), lipid peroxides (PD), and conjugated dienes (CD) generation in response to CuSO<sub>4</sub>-induced oxidation. LDL lipid composition and the LDL associated vitamins A, E and carotenoids were also measured. Results: LDL susceptibility to oxidation by CuSO<sub>4</sub> was increased in the patients by 40% with a 35% shorter lag time required for the initiation of LDL oxidation, i.e. 56 ± 6 min in patients vs. 85 ± 9 min in controls (p <0.01). Patients showed increased cholesterol/phospholipid and polyunsaturated/saturated ratios, as well as reduced content of LDL associated vitamins. Upon β-carotene supplementation, there was a significant elevation in plasma and in LDL all-trans β-carotene [from 0.296 ± 0.020 to 0.968 ± 0.133 μg/mg LDL protein (p < 0.01)] paralleled by a significant reduction in LDL susceptibility to oxidation, as exhibited by increased lag time up to 115 ± 10 min (p < 0.01) and reduction in MDA and PD generation (by 25 and 40%), respectively (p < 0.01). Conclusions: Increased susceptibility to oxidation of LDL derived from patients with diabetes mellitus is associated with abnormal LDL lipid composition and antioxidant content. Natural β-carotene dietary supplementation normalizes the enhanced LDL oxidation and consequently may be of importance in delaying accelerated development of atherosclerosis in these patients.
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