Effect of Antioxidant Vitamins C and E Supplementation on its Plasma Levels and on Lipid Profile in Pulmonary Tuberculosis Patients26

Abstract

Problem statement: Patients with active pulmonary Tuberculosis (TB) ar e malnourished as indicated by reductions in lean mass, anthropometri c indices and micronutrient status. Supplementation with vitamins may prove to be beneficial. Limited i nformation is available on the supplementation of vitamin C and E in pulmonary TB patients. Hence, the present study was undertaken to address the question whether any benefit could be demonstrated with supplementation of antioxidant vitamins C and E and in combination in pulmonary TB patients. Approach: A five arm study was carried out for a period of 6 months in which the normal healthy volunteers served as control group and the sputum positive category I pulmonary TB patients served as the treatment group. Three out of the four patient groups received the antioxidant vitamin supplementa tion of either vitamin C, vitamin E or in combination along with ATT, whereas fourth group received ATT alone. Plasma concentrations of vitamin C and E were analyzed pre, during and post Anti-Tuberculosis Therapy (ATT) to establish the role of oral supplementation of these vitamins. Spu tum culture was also done at all the three times points for Mycobacterium tuberculosis . To study the possible interaction and influence o f the supplemented vitamins on LDL-C and HDL-C and other lipid parameters a lipid profile was carried out. Results: (1) All the patients in the treatment groups turne d sputum at the end of 2 months of treatment. (2) There was a significant improvement in the body weights of the patients upon supplementation with antioxidant vitamins. (3) Ther e was a significant increase in the of plasma ascorbic acid and α-tocopherol levels after 6 months of treatment in t he vitamin C and vitamin E supplemented groups. (4) The HDL-C levels increased significantly in the antioxidant vitamin supplemented groups. (5) Lower levels of LDL-C were observed in the antioxidant vitamin supplemented groups when compared to the un-supplemented group. Conclusion: The plasma concentrations of ascorbic acid and α-tocopherol increased significantly after their die tary supplementation. The increase could also be due to the synergy exhibited by both the vitamins. Vitamin C and vitamin E supplementation influenced the lipid profile by increasing the serum HDL-C, improving the total cholesterol levels and decreasi ng the LDL-C concentration in the antioxidant vitamin supplemented groups.