Abstract
BackgroundObesity and related morbidities are reaching epidemic proportions in the Arab populations. Possible mechanisms that link obesity/visceral fat to diabetes and cardiovascular (CVD) complications include inflammation and increased oxidative stress. The aim of this study is to test whether supplementary antioxidants with B-group vitamins enhance antioxidant capacity and/or mitigate oxidative damage and subclinical inflammation in obese diabetic patients.MethodsHundred diabetic patients were randomly assigned to receive either oral dose of daily B-group vitamins (1.67 mg folic acid, 1.67 mg vitamin B-2, 20 mg vitamin B-6, 0.134 mg vitamin B-12) and antioxidant vitamins (221 mg of α-tocopherol and 167 mg of vitamin C) [n = 50], or an identical placebo [n = 50] daily for 90 days. Blood was obtained before treatment, and after 90 days for measurements of plasma antioxidant vitamins status, markers of oxidative damage [malondialdehyde (MDA) and protein carbonyls] and inflammation (C-Reactive Proteins [CRP], IL6 & TNFα).ResultsSupplementation with antioxidant and B-group vitamins increased plasma concentration of vitamin E and folate and reduced homocysteine in the intervention groups compared with the placebo group. Vitamin B12 improved in the supplement group compared with the decline seen in the placebo group however, this did not reach statistical significance. Vitamin C declined in both groups but more so in the intervention group. Both MDA and Protein carbonyls increased in both the supplement and the placebo group. IL6 concentration increased in both groups but less so in the supplement group (p = 0.023). TNF showed more pronounced decline in the supplement group compared with the placebo group but the difference between cumulative changes did not reach statistical significance (p = 0.204). CRP concentrations declined in the supplement group in contrast to the rise seen in the placebo group however, the difference between cumulative changes was not statistically significant (p = 0.205).ConclusionsAntioxidants supplementation with B-group vitamins enhances antioxidant capacity, and may have an anti-inflammatory effect in obese diabetic patients.
Highlights
The Middle Eastern countries including the United Arab Emirates (UAE) have been through rapid socioeconomic and social changes with urbanization over the last 40 years
In obese patients subclinical inflammation has been found to correlate with markers of oxidative stress in adipose tissue and this may be the mechanism for obesity-related metabolic syndrome, insulin resistance and diabetes mellitus
We have previously shown that B-group vitamins have antioxidant effects independent of their homocysteine-lowering effects and that antioxidant with B-group vitamin supplement in cardiovascular disease (CVD) patients significantly reduced markers of inflammation [7]
Summary
The Middle Eastern countries including the United Arab Emirates (UAE) have been through rapid socioeconomic and social changes with urbanization over the last 40 years. Possible mechanisms that relate obesity and diabetes to increased CVD risk include inflammation, oxidative damage, and related insulin resistance. In obese patients subclinical inflammation has been found to correlate with markers of oxidative stress in adipose tissue and this may be the mechanism for obesity-related metabolic syndrome, insulin resistance and diabetes mellitus. Both oxidative stress and low-grade inflammation may be causatively linked to the development, progression and complications of diabetes in obese patients [2]. Emerging experimental and clinical evidence is supporting the presence of increased oxidative stress and inflammation in patients with obesity and type 2 diabetes. Possible mechanisms that link obesity/visceral fat to diabetes and cardiovascular (CVD) complications include inflammation and increased oxidative stress. The aim of this study is to test whether supplementary antioxidants with B-group vitamins enhance antioxidant capacity and/or mitigate oxidative damage and subclinical inflammation in obese diabetic patients
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