Serum Tocopherol Levels Research Articles

Associations Between Maternal Tocopherol Levels and Pregnancy-Induced Blood Pressure Changes

Abstract Objectives Vitamin E plays different roles in health based on its three isoforms: alpha (α)-tocopherol is anti-inflammatory, gamma (γ)-tocopherol is pro-inflammatory, delta (δ)-tocopherol remains unknown. As inflammation may promote hypertension, the objective of this study is to examine relationships between maternal serum tocopherol levels at time of delivery and pregnancy-related blood pressure (BP) changes. Hypothesis is that increased level of α-tocopherol has favorable effects and γ-tocopherol has adverse effects on maternal BP. Methods An IRB-approved cross-sectional study enrolled mother-infant dyads (n = 342) at time of delivery (Omaha, NE, USA) for collection of electronic health data and maternal blood. High-performance liquid chromatography analyzed serum tocopherol levels. Maternal BP values were collected from 1st and 3rd trimester clinic/hospital visits with changes calculated in systolic BP and mean arterial pressure (MAP = diastolic BP + 1/3(systolic BP – diastolic BP). Mothers were classified as hypertensive if: systolic BP ≥140, diastolic BP ≥ 90, or diagnosis of preeclampsia. Two-sample t-test and Pearson correlation coefficients compared relationships between serum tocopherol levels and BP data. P-value < 0.05 was significant. Results Mean maternal age was 28.5 years, majority (61.4%) Caucasian, 10.4% (n = 29) with hypertension. Mean serum levels: α-tocopherol 15,229 + 5849 mcg/L, γ-tocopherol 1642 + 868 mcg/L, δ-tocopherol 226 + 164 mcg/L, with α: γ ratio 11.5 + 8.7. Mean serum α-tocopherol level was higher in normotensive vs. hypertensive mothers (15,751 vs. 13,819 mcg/L; P = 0.06). Ratio of α: γ demonstrated an inverse correlation with change in maternal systolic BP (r = −0.128; P = 0.03). No other relationships were significant. Conclusions Increasing maternal α-tocopherol and α: γ ratio has favorable association with maintaining normal BP during pregnancy. More research is needed to specifically identify serum thresholds and tocopherol isoform ratios for favorably reducing risk of pregnancy-related hypertension. Funding Sources Department of Pediatrics and the Child Health Research Institute at the University of Nebraska Medical Center and Children's Hospital & Medical Center (Omaha, NE).

Effects of Vitamin E in Neonates and Young Infants

Vitamin E (alpha-tocopherol) is a potent and natural antioxidant. Vitamin E is concentrated from soybean oil. The Committee on Fetus and Newborn of the Academy of the American of Pediatrics endorsed 1 to 2 mg/dl as the normal range of serum tocopherol level. Human infants are born with low stores of vitamin E, thus they require an adequate intake of vitamin E soon after birth. The optimum intravenous dose of vitamin E is 2.8 mg/kg per day (maximum 7 mg/kg per day). Treating very-low-birth-weight infants with 100 mg/kg vitamin E for >1 week results in levels >3.5 mg/dl and significantly reduces the risks of severe retinopathy, intracranial hemorrhage, hemolytic anemia, chronic lung disease, retrolental fibroplasia and incidence and severity of intraventricular hemorrhage, but increases the risks of sepsis, necrotizing enterocolitis and can cause retinal hemorrhage in very-low-birth-weight infants. Vitamin E supplementation prevents the isolated vitamin E deficiency that causes spinocerebellar symptoms. The major benefits arising from elevated dosages of vitamin E have been the relief of symptoms of vitamin E deficiency in infants with abetalipoproteinamia and chronic cholestasis. Excessive doses of vitamin E may result in side effects and careful monitoring of vitamin E is thus essential. Neonates born to mothers treated with high doses of vitamin E have significantly lower birth weight compared to neonates born to untreated mothers. Vitamin E is not teratogenic. The aim of this study was to review the effects of vitamin E in neonates and young infants.

Serum tocopherol levels and vitamin E intake are associated with lung function in the normative aging study

The results of studies assessing relationships between vitamin E intake and status and lung function are conflicting. This study aimed to evaluate the effect of vitamin E intake and serum levels of tocopherol isoforms on lung function in a cross-sectional sample of 580 men from the Normative Aging Study, a longitudinal aging study. Regression models were used to look at associations of serum tocopherol isoform levels and vitamin E intake with lung function parameters after adjustment for confounders. Vitamin E intake was measured using a food frequency questionnaire and serum levels of γ, α, and δ-tocopherol levels were measured using high-performance liquid chromatography. After adjustment for potential confounders, serum γ-tocopherol had a significant inverse association with forced vital capacity (β=-0.10, p=0.05). Alpha and δ-tocopherol were not associated with any lung function parameter. After classifying COPD status according to Global Initiative for Obstructive Lung Disease (GOLD) stage criteria, serum levels of δ-tocopherol were lower in participants with more severe COPD (p=0.01). Serum levels of δ-tocopherol were also lower in participants with greater levels of smoking (p=0.02). Both vitamin E intake (β=0.03, p=0.02; β=0.03, p=0.01) and use of vitamin E supplements (β=0.05, p=0.03; β=0.06. p=0.02) were positively associated with FEV1 and FVC, after adjusting for confounders. Subjects who took vitamin E supplements had significantly higher α-tocopherol levels (p<0.0001) and lower γ-tocopherol levels (p<0.0001) than non-users. In this study, there is a positive association between dietary vitamin E intake and lung function, and evidence of an inverse relationship between serum levels of γ-tocopherol and lung function.

Vitamin E and risk of age-related cataract: a meta-analysis.

We conducted a meta-analysis to evaluate the relationship between vitamin E and age-related cataract (ARC). The fixed- or random-effect model was selected based on heterogeneity. Meta-regression was used to explore potential sources of between-study heterogeneity. Publication bias was evaluated using Begg's test. The dose-response relationship was assessed by a restricted cubic spline model. Relevant studies were identified by a search of PubMed and the Cochrane Library to May 2014, without language restrictions. Studies involved samples of people of all ages. Dietary vitamin E intake, dietary and supplemental vitamin E intake, and high serum tocopherol levels were significantly associated with decreased risk of ARC, the pooled relative risk was 0·73 (95% CI 0·58, 0·92), 0·86 (95% CI 0·75, 0·99) and 0·77 (95% CI 0·66, 0·91), respectively. Supplemental vitamin E intake was non-significantly associated with ARC risk (relative risk=0·92; 95% CI 0·78, 1·07). The findings from dose-response analysis showed evidence of a non-linear association between dietary vitamin E intake and ARC. The risk of ARC decreased with dietary vitamin E intake from 7 mg/d (relative risk=0·94; 95% CI 0·90, 0·97). The findings of the meta-analysis indicated that dietary vitamin E intake, dietary and supplemental vitamin E intake, and high level of serum tocopherol might be significantly associated with reduced ARC risk.

Serum tocopherol levels in very preterm infants after a single dose of vitamin E at birth.

Our aim was to examine the impact of a single enteral dose of vitamin E on serum tocopherol levels. The study was undertaken to see whether a single dose of vitamin E soon after birth can rapidly increase the low α-tocopherol levels seen in very preterm infants. If so, this intervention could be tested as a means of reducing the risk of intracranial hemorrhage. Ninety-three infants <27 weeks' gestation and <1000 g were randomly assigned to receive a single dose of vitamin E or placebo by gastric tube within 4 hours of birth. The vitamin E group received 50 IU/kg of vitamin E as dl-α-tocopheryl acetate (Aquasol E). The placebo group received sterile water. Blood samples were taken for measurement of serum tocopherol levels by high-performance liquid chromatography before dosing and 24 hours and 7 days after dosing. Eighty-eight infants received the study drug and were included in the analyses. The α-tocopherol levels were similar between the groups at baseline but higher in the vitamin E group at 24 hours (median 0.63 mg/dL vs. 0.42 mg/dL, P = .003) and 7 days (2.21 mg/dL vs 1.86 mg/dL, P = .04). There were no differences between groups in γ-tocopherol levels. At 24 hours, 30% of vitamin E infants and 62% of placebo infants had α-tocopherol levels <0.5 mg/dL. A 50-IU/kg dose of vitamin E raised serum α-tocopherol levels, but to consistently achieve α-tocopherol levels >0.5 mg/dL, a higher dose or several doses of vitamin E may be needed.

Prediagnostic serum tocopherol levels and the risk of non-hodgkin lymphoma: the multiethnic cohort.

Compromised immunity and chronic inflammation are thought to contribute to the development of non-Hodgkin lymphoma (NHL). Because tocopherols protect cells through antioxidant mechanisms, they may play a role in NHL etiology. This nested case-control study within the Multiethnic Cohort examined the association of prediagnostic serum tocopherols levels measured in 271 NHL cases and 538 matched controls by high-pressure liquid chromatography/photodiode array detection with NHL risk. Conditional logistic regression was used to calculate ORs and 95% confidence intervals (CI). We observed U-shaped associations with NHL for total and α-tocopherols [Ptrend < 0.01 for polynomial terms (3 df)]. The ORs (95% CI) for total tocopherols, which consisted primarily of α-tocopherol, were 0.41 (0.25-0.68), 0.52 (0.32-0.85), 0.39 (0.23-0.65), and 0.78 (0.47-1.29) for the second to fifth quintiles as compared with the first. The risk estimates were similar for α-tocopherol but nonsignificant for β- and γ-tocopherol combined and for γ-tocopherol. Adjustment for serum lipids strengthened the nonlinear associations for total and α-tocopherols. Serum total tocopherol levels were higher for vitamin E supplement users at cohort entry than nonusers (21.32 ± 9.04 vs. 17.72 ± 7.43 μg/mL; P < 0.0001), but supplement use was not associated with NHL risk. No heterogeneity in risk estimates was detected by sex, ethnicity, vitamin E supplement use, or NHL subtype. Circulating tocopherols, at levels likely reflecting adequate dietary intakes, may be protective against NHL, whereas higher intakes from supplementation may not be beneficial. The association between serum tocopherol levels and NHL risk provides possible new insights into the etiology of NHL.

Relation of Serum ^|^alpha;- and ^|^gamma;-Tocopherol Levels to Cardiovascular Disease-Related Mortality Among Japanese Men and Women

BackgroundThere is limited evidence regarding the relationship between serum tocopherol levels and cardiovascular disease.MethodsWe conducted a nested case-control study as part of the Japan Collaborative Cohort Study for evaluation of cancer risk (JACC Study). Baseline serum samples were collected from 39 242 participants (age range, 40–79 years) between 1988 and 1990. During the 13-year follow-up, there were 530 stroke deaths (302 ischemic strokes and 210 hemorrhagic strokes) and 211 deaths from coronary heart disease. Controls were matched for sex, age, and area of residence.ResultsSerum α-tocopherol level was not associated with any type of cardiovascular death in men; however, in women, it was inversely associated with total stroke mortality and hemorrhagic stroke mortality. The multivariate odds ratio (95% CI) for the highest versus the lowest quintile of serum α-tocopherol levels among women was 0.35 (0.16–0.77; P for trend = 0.009) for total stroke and 0.26 (0.07–0.97; P for trend = 0.048) for hemorrhagic stroke. Serum γ-tocopherol was inversely associated with ischemic stroke mortality in men but positively associated with hemorrhagic stroke mortality in women. The respective multivariate odds ratios (95% CI) for the highest versus the lowest quintile and for a 1-standard deviation increment in γ-tocopherol level were 0.48 (0.22–1.06; P for trend = 0.07) and 0.77 (0.58–1.02), respectively, for ischemic stroke in men and 3.10 (0.95–10.12; P for trend = 0.052) and 1.49 (1.04–2.13) for hemorrhagic stroke in women.ConclusionsAmong women, hemorrhagic stroke mortality was inversely associated with serum α-tocopherol and positively associated with serum γ-tocopherol. These findings are due in part to the antioxidative and antithrombotic activities of these tocopherols.

Analysis of Serum Antioxidant Materials Concentration and Their Relation with Blood Lipids and Anthropometric Indices in Middle-Aged Adults in Korea

The serum levels of antioxidant materials (α-carotene, β-carotene, β-cryptoxanthin, lutein, lycopene, α-tocopherol, γ-tocopherol, retinol) of the healthy Korean middle-aged adults (n = 373) were measured and their relationships with the serum lipids and anthropometric indices were analyzed. The serum levels of β-cryptoxanthin, β-carotene, lutein were higher than those of lycopene and α-carotene. The levels of all measured carotenoids except lutein were significantly higher in females than in males, but retinol level was vice versa. There was a tendency of increase in serum levels of antioxidant vitamins with increasing age. The serum carotenoid levels had a positive correlation with serum cholesterol and a negative correlation with serum triglyceride. The serum levels of tocopherols or retinol showed a significantly positive relationship with blood cholesterol or triglyceride. In overall, anthropometric indices showed negative relations with serum carotenoids levels, but vice versa with serum tocopherol or retinol levels. Particularly, β-carotene and lutein levels showed a significantly negative relation with blood pressure in male subjects. The serum levels of α-carotene, β-carotene and β-cryptoxanthin had significantly negative relations with body fat-related indices in female subjects. The results demonstrated that blood antioxidants levels differed by sex and age, and had significant relations with blood lipid levels and anthropometric indices. Therefore, the rationale and significance of the relationships need to be elucidated in the future study related to dietary intakes and life style. (Korean J Nutr 2009; 42(5): 464 ~ 473)

Vitamin Supplements and Cancer Prevention: Where Do Randomized Controlled Trials Stand?

Vitamin Supplements and Cancer Prevention: Where Do Randomized Controlled Trials Stand?

The effect of walnut intake on factors related to prostate and vascular health in men at increased risk for prostate cancer

Tocopherols may protect against prostate cancer. We conducted a free-living feeding study to assess the effect of walnuts, a tocopherol-rich food, on markers of prostate and vascular health in men at risk for prostate cancer. We examined serum tocopherol levels, lipids, selected hormones, PSA, food records and urinary symptoms data. Subjects (n=21) were randomized to an 8-week walnut diet (75 g/d) or their usual diet (control) and switched to the other diet for the second 8-week period following a 2-week washout. Fasted subjects had blood drawn at baseline and at the end of each diet period. All analyses were adjusted for weight, and the tocopherol analyses were also adjusted for age and lipids. No sequence effects were detected. At baseline, average serum concentrations were 193 mg/dl (SD=28.2) for total cholesterol, 102 mg/dl (SD=48.5) for triglycerides, 19.2 % (SD=8.53) for percent free PSA (PFP), 139 ng/ml (SD=40.5) for IGF-1, 29.3 μM (SD=10.0) for α-tocopherol (αT), 4.14 μM (SD=1.99) for γ-tocopherol (γ T) and 11.0 (SD=9.91) for the tocopherol ratio (αT: γ T). A change score was used to measure differences in concentrations between baseline and the diet periods. During the walnut diet, decreasing trends were seen in the mean serum concentrations of several variables, including αT: γ T (Δ =−3.46), total cholesterol (Δ =−6.00), triglycerides (Δ =−6.00) and PFP (Δ =−0.40%). In addition, a decreasing trend in mean serum IGF-1 was seen when comparing the diets (Δ =−8.00). Walnut consumption may thus improve markers associated with prostate cancer and cardiovascular disease risks. Funded by the California Walnut Commission.

Effect of Supplementation of Vitamin C Antioxidant on the Nutritional Profile of Male Smokers

Smoking is a uniquely common habit and has been identified as a major risk factor for coronary heart disease and number of other diseases. With the hypothesis that dietary antioxidant may help to prevent the development of atherosclerosis and other associated problems. Twenty five male smokers in the age group of 25-40 years with similar smoking habits and physical activity pattern were selected from Ludhiana. The effect of supplementation of vitamin C by food as their dietary blood lipid antioxidant profile and anthropometry was studied among smokers. Supplementation with vitamin C the consumption of cereals GLV and fruit intake increased significantly (p < 0.05) and that of roots and tubers fats and oil and sugar and jaggery decreased significantly (p < 0.05). The energy carbohydrate total and visible fat intake decreased significantly (p < 0.05) after vitamin C supplementation. Total cholesterol and LDL cholesterol decreased significantly. Serum s carotene and serum ascorbic acid increased significantly (p < 0.05). The serum tocopherol level did not alter much with supplementation of vitamin C. The anthropometric parameters of smokers did not vary significantly after supplementation of vitamin C. The decrease in blood pressure of smokers was also non-significant after supplementation of vitamin C. It was concluded that supplementation of vitamin C improved the status of vitamin C in body. Consumption of vitamin C lowers the blood cholesterol and changes other parameters on better side. So smokers are advised to consume foods rich in vitamin C. (authors)

Serum Alpha- and Gamma-Tocopherol Levels in Atopic Mothers and Their Infants Are Correlated

Background: Vitamin E may have immunomodulatory properties beyond its antioxidant function. The objective here was to assess the α- and γ-tocopherol status and its correlation between atopic mothers and their infants. Methods: Mothers with atopic disease were recruited at the end of gestation and their infants were followed up. Serum samples from mothers and infants were collected at the infants’ age of 1 month. Atopic dermatitis was diagnosed during the 1st year of life and skin prick tests were performed at 1 year. Results: Infants’ serum γ- and α-tocopherol to fat ratios were significantly correlated with maternal serum ratios (r = 0.70, p < 0.0001 and r = 0.52, p = 0.004, respectively). In infants the serum α-tocopherol/fat was higher and the γ-tocopherol/fat ratio lower than in mothers. Serum tocopherol levels were not associated with skin prick test reactions or atopic dermatitis in the infants. Conclusions: Maternal tocopherol status determines that of the infant. Different tocopherol forms may have different serum levels and roles in the regulation of inflammatory diseases.

Is low serum tocopherol in Wilson's disease a significant symptom?

Background Free radical mediated injury is increasingly recognized in many metabolic diseases including Wilson's disease (WD). Use of antioxidants as an adjunctive therapy in WD may have therapeutic significance. Aim The aim of the study was to correlate serum levels of tocopherols with serum copper and ceruloplasmin and clinical status of these patients. Methods Serum levels of tocopherol of were measured spectrophotometrically using the Emmerie–Engel reaction in 34 patients from a large cohort of WD being followed up at a tertiary care center. Results Majority of patients were male (M/F=23:11). The mean serum copper was 43.6±26.2 μg/dl (range=10–121 μg/dl) and serum ceruloplasmin was 5.6±5.5 mg/dl (range=0–30 mg/dl). The mean serum tocopherol level was 0.68±0.18 mg/dl (range=0.23–1.14 mg/dl) and compared to the control (1.07±0.17 mg/dl), nearly 59% of patients had decreased levels ( p<0.001). No significant correlation was noted between low serum tocopherol levels and serum copper levels, Mini Mental Status Examination (MMSE) scores and CHU staging. However, serum tocopherol levels were lower in patients with relatively short duration of treatment (7.8 years vs. 12.4 years). Conclusion Decreased levels of serum tocopherol were detected in 59% of patients compared to controls. However, low tocopherol levels did not correlate with clinical status or biochemical parameters of WD, except for relatively shorter duration of treatment. Further studies, especially in newly diagnosed patients, need to be done to validate the role of low tocopherol levels in Wilson's disease.

Variability in the Dose of Intravenous Vitamin E Given to Very Low Birth Weight Infants

Vitamin E is required by very low birth weight (VLBW) infants to prevent vitamin E deficiency. However, prolonged intravenous intakes of vitamin E >4 international units (IU)/kg/day often yield potentially toxic serum tocopherol levels. This study was designed to assess the frequency of potentially inadequate or excessive doses of intravenous vitamin E in parenteral nutrition for VLBW infants in the US. A questionnaire was sent to the 100 neonatal-perinatal training program centers listed in the 2003 directory (American Academy of Pediatrics (AAP)). Using the information provided for each neonatal unit, we calculated the doses of vitamin E (IU/kg/day) that would have been given to infants with body weights of 0.5, 1.0 and 1.5 kg in that unit. The doses were then recoded as inadequate if less than recommended (2.8 IU/kg/day, maximum 7 IU/day) by the American Society for Clinical Nutrition and the AAP, and excessive if >4 IU/kg/day, and frequencies were compared using chi2 analysis. The 65 centers that responded were predominantly among those that offered the highest level of subspecialty neonatal intensive care (level IIID). The predicted dose of vitamin E had a median value of 2.8 IU/kg/day for all three weights, and was no significantly different among the three weights. VLBW infants with weights of 0.5, 1.0 and 1.5 kg were predicted to receive doses <2.8 IU/kg/day in 12, 12 and 19% of the neonatal intensive care units (NICUs), respectively, and doses >4 IU/kg/day in 40, 31 and 10% of the NICUs, respectively. Excessive doses were significantly associated with body weight, with more frequent excessive doses at lower weight (p=0.0008). This survey showed a lack of uniformity of dosing of intravenous vitamin E in VLBW infants. The smallest infants (<1.0 kg) were receiving excessive, potentially toxic doses of vitamin E in a significant number of NICUs in the US in 2003.

What is the appropriate intravenous dose of vitamin E for very-low-birth-weight infants?

The Committee on Fetus and Newborn of the American Academy of Pediatrics (AAP) has endorsed 1 to 2 mg/dl as the normal range of serum tocopherol level. Our Cochrane review has shown that vitamin E supplementation resulting in levels >3.5 mg/dl, but not < or =3.5 mg/dl, significantly reduces the risk for severe retinopathy among very-low-birth-weight (VLBW) infants examined but increases the risks of sepsis and of necrotizing enterocolitis among infants treated for >1 week. As a fixed daily intravenous dose of vitamin E results in an inverse relationship between serum level and birth weight and is a risk for both low and high serum tocopherol levels, a dose adjusted for current weight appears more judicious than a fixed dose per day. Based on currently available data the AAP and the American Society for Clinical Nutrition currently recommend a routine intake of 2 ml/kg/day of MVI Pediatric (2.8 IU/kg/day) in VLBW infants (maximum of 5 ml/day or 7 IU/day).

Vitamin E supplementation for prevention of morbidity and mortality in preterm infants.

Treating very low birth weight (VLBW) infants with pharmacologic doses of vitamin E as an antioxidant agent has been proposed for preventing or limiting retinopathy of prematurity, intracranial hemorrhage, hemolytic anemia, and chronic lung disease. However, excessive doses of vitamin E may result in side effects. The aim of this systematic review was to assess the effects of vitamin E supplementation on morbidity and mortality in preterm infants. We searched MEDLINE (October 2002), EMBASE (March 2002), the Cochrane Controlled Trials Register (CCTR) from the Cochrane Library, 2003, Issue 1, and personal files for clinical trials assessing vitamin E in preterm infants. We selected trials analyzing primary outcomes (mortality or combined long-term morbidity) or secondary outcomes (other morbidity) in infants with gestational age less than 37 weeks or birth weight less than 2500 grams. The intervention was allocation to routine supplementation with vitamin E in the treatment group versus placebo, no treatment or another type, dose or route of administration of vitamin E. We used standard methods of the Cochrane Collaboration and of the Cochrane Neonatal Review Group. Twenty-six randomized clinical trials fulfilled entry criteria. No study assessed combined long-term morbidity. Routine vitamin E supplementation significantly reduced the risk of germinal/intraventricular hemorrhage (typical relative risk [RR] 0.85, 95% confidence interval [CI] 0.73, 0.99), increased the risk of sepsis (typical RR 1.52, CI 1.13, 2.04) and increased hemoglobin concentration by a small amount, but did not significantly affect mortality and other morbidity. In VLBW infants, vitamin E supplementation increased the risk of sepsis, and reduced the risk of severe retinopathy and blindness among those examined. Subgroup analyses in VLBW infants showed (1) an association between serum tocopherol levels greater than 3.5 mg/dl and increased risk of sepsis and reduced risk for severe retinopathy among those examined; and (2) an association between intravenous, high-dose administration of vitamin E and increased risk of sepsis. Vitamin E supplementation in preterm infants reduced the risk of intracranial hemorrhage but increased the risk of sepsis. In very low birth weight infants it increased the risk of sepsis, and reduced the risk of severe retinopathy and blindness among those examined. Evidence does not support the routine use of vitamin E supplementation by intravenous route at high doses, or aiming at serum tocopherol levels greater than 3.5 mg/dl.

Oxidative stress and antioxidant status in type 1 diabetes mellitus.

To test the hypothesis that type 1 diabetes is associated with increased oxidative stress and/or antioxidant status by investigating concentrations of 8-iso-prostaglandin F2alpha (8-iso-PGF2alpha) in urine and plasma and malondialdehyde (MDA) in plasma as indicators of lipid peroxidation in vivo, and antioxidant status in diabetic subjects compared with healthy control subjects. Thirty-eight subjects with type 1 diabetes mellitus and 41 healthy age- and sex-matched control subjects were included in the study. Blood and urine samples were obtained and analysed for 8-iso-PGF2alpha with a newly developed radioimmunoassay, as well as for MDA, total antioxidant capacity (TAOC) and serum tocopherol levels. None of the variables of lipid peroxidation showed any significant difference between the two groups. Similarly, there were no significant correlations between the levels of 8-iso-PGF2alpha or MDA, and degree of glycemic control (HbA1c). Total antioxidant capacity in plasma was 16% lower amongst the subjects with type 1 diabetes than in the control group (P < 0.0005). Lipid corrected levels of alpha-tocopherol in serum were significantly increased in type 1 diabetic subjects (P < 0.05), as were gamma-tocopherol levels (P < 0.005). In spite of lower total antioxidant defence, our results do not support the oxidative stress hypothesis for type 1 diabetes mellitus. The higher tocopherol levels suggest that no vitamin E supplementation is necessary for subjects with type 1 diabetes mellitus.

Correlates of Serum α- and γ-Tocopherol in the Women's Health Initiative

PURPOSE: There is increasing evidence that vitamin E (primarily α- and γ-tocopherol) may reduce the risk of cardiovascular disease and some cancers, therefore it is important to understand factors that influence blood levels. METHODS: The correlates of serum α- and γ-tocopherol were investigated among participants in the Women's Health Initiative (WHI), a 40-site disease prevention trial. Subjects were 1047 postmenopausal women aged 50–79 years, who provided fasting blood specimens and detailed information on diet, supplement use, and other factors at entry to the study (1994–96). RESULTS: Total serum cholesterol and triglycerides were highly correlated with serum α- and γ-tocopherol concentrations and were controlled for in all analyses along with age, ethnicity and body mass index (BMI). Alpha and γ-tocopherol were strongly negatively correlated (partial r = −0.69). The strongest predictor of serum tocopherols was average daily intake of vitamin E from supplements (partial r = 0.60 for α, r = −0.54 for γ). Other factors associated with increased α- and/or decreased γ-tocopherol concentrations were serum retinol and carotenoids, supplemental vitamin C, α-tocopherol intake from food, dietary fiber, and Hispanic ethnicity. Factors associated with lower α- and/or higher γ-tocopherol concentrations included γ-tocopherol intake from food, total fat intake, and BMI. Age, income, hormone use, and geographic location were “spuriously” associated with serum tocopherol levels through their association with supplement use, i.e., there was no such association among the subset of women not taking supplements. CONCLUSIONS: Vitamin E intake from supplements and BMI are the major independent predictors of serum tocopherol levels in women, whereas dietary factors only play a small role.

Maternal vitamin E status during the third trimester of pregnancy in Spanish women: Influence on breast milk vitamin E concentration

A prospective, observational study was made into the effects of vitamin E intake on serum levels of the same during the third trimester of pregnancy, and on breast milk vitamin E levels. The study subjects were a group of 57 healthy, lactating mothers between 18 and 35 years of age. Vitamin E intake was determined during the third trimester of pregnancy using a 5-day dietary record (including a Sunday) and by recording the quantities provided by supplements. HPLC was used to determine vitamin E concentrations in maternal serum, transitional milk (days 13–14 of lactation) and mature milk (day 40 of lactation). Only 3.5% of subjects took vitamin E supplements during pregnancy. The addition of this intake to that provided by the diet produced no notable change in the results. 68.4% of third trimester subjects took < 75% of the recommended intake of vitamin E (including both dietary intake and supplements) (n=39) (Group L). The newborn of these subjects had poorer 5th minute Apgar scores than did those of subjects who took greater amounts of vitamin E (Group H). Mean serum tocopherol levels were somewhat greater in pregnant subjects with vitamin E intakes ≥ 75% of recommended, though this difference was not significant. However, transition milk vitamin E levels were significantly better in H subjects. Subjects with vitamin E/PUFA ratios <1 (75th percentile) showed lower mature milk vitamin E concentrations (2.16±0.70 μmol/L compared to 3.90±1.02 μmol/L in subjects with ratios ≥1). The results obtained seem to support the idea that vitamin E and PUFA intakes in pregnancy conditioned levels of vitamin E in transitional breast milk.

A community based study of vitamin A and vitamin E status of adolescent girls living in the Shire Valley, Southern Malawi.

To assess vitamin A and E status and anaemia in non-pregnant Malawian adolescent girls. A cross-sectional study in rural village communities in the Shire Valley, Southern Malawi. Adolescent girls, n = 118, aged between 10 and 19 y, 112 of whom were unmarried. Socio-demographic information was collected by questionnaire, heights and weights were measured. Vitamin A was assessed by the Modified Relative Dose Response (MRDR) test, in addition to serum retinol values. Blood samples were collected 4-5 h after administration of 3,4-didehydroretinyl acetate. Retinol and alpha-tocopherol levels were measured by HPLC. Serum retinol results for non-pregnant girls were compared with values for 43 adolescent pregnant girls which were available from a previous study. 26.6% of non-pregnant girls had serum retinol values < 0.70 micromol/L; 40.2% had an MRDR ratio > 0.060. In 59.3%, serum tocopherol levels were < 11.5 micromol/L and the tocopherol/cholesterol ratio was < 2.2 in 23.9%. 11.3% had a haemoglobin > or = 12 g/dl. Vitamin A levels were significantly related to age, and younger girls were more likely to be deficient. Significant correlations were found between serum retinol, MRDR values and serum tocopherol. Girls with a low body mass index for age had tocopherol cholesterol ratios < 2.2. Low serum retinol values occurred significantly more often in stunted girls (P=0.01). Serum retinol values of adolescent pregnant girls were significantly lower than those of non-pregnant adolescents (P=0.002). Vitamin A and E deficiency and anaemia were common in adolescent non-pregnant girls, and thought to partly result from increased growth requirements. Girls who become pregnant at an early age are at risk of depletion of their nutritional reserves. Measures to reduce nutritional deficiencies before the first pregnancy are needed.