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Vitamin E compared with other potential risk factor concentrations in patients with and without coronary artery
F Van Lente1, R Daher, J A Waletzky
1Section of Biochemistry, Cleveland Clinic Foundation, Ohio.
Insights
Higher vitamin E (alpha-tocopherol) levels were found in patients with coronary artery disease. However, this antioxidant was not a reliable indicator of coronary artery disease risk when adjusted for cholesterol levels.
Area of Science:
- Cardiovascular Medicine
- Nutritional Biochemistry
Background:
- Coronary artery disease (CAD) is a leading cause of mortality worldwide.
- Lipid profiles and certain antioxidants are implicated in CAD pathogenesis.
- The role of vitamin E (alpha-tocopherol) in CAD remains debated.
Purpose of the Study:
- To investigate serum concentrations of vitamin E and various lipid markers in individuals with and without coronary atherosclerosis.
- To determine if alpha-tocopherol levels can serve as an independent risk factor for CAD.
Main Methods:
- A case-control study involving 36 patients with angiographically confirmed CAD and 36 matched controls.
- Serum levels of vitamin E (alpha-tocopherol), total cholesterol, triacylglycerols, HDL-C, LDL-C, ApoA-I, and ApoB were measured.
- Statistical analyses, including logistic regression, were performed to assess associations.
Main Results:
- Patients with CAD exhibited significantly higher concentrations of ApoB, LDL-C, and total cholesterol.
- Triacylglycerol levels were marginally higher in the CAD group.
- Serum alpha-tocopherol concentrations were significantly higher in patients with atherosclerosis (35.1 ± 17.0 μmol/l) compared to controls (29.0 ± 13.2 μmol/l).
- Alpha-tocopherol levels strongly correlated with lipid concentrations; ratios normalized to total cholesterol were not significantly different between groups.
- Logistic regression indicated total cholesterol as the primary determinant of coronary stenosis.
Conclusions:
- Elevated serum alpha-tocopherol concentrations are associated with coronary atherosclerosis in this cohort.
- However, alpha-tocopherol is not an independent predictor of CAD risk when adjusted for lipid profiles, particularly total cholesterol.
- The findings suggest that higher vitamin E levels in CAD patients may reflect altered lipid metabolism rather than a protective effect.
Abstract:
Thirty six individuals with angiographic evidence of coronary atherosclerosis and thirty six individuals without coronary disease, matched for a variety of cardiovascular risk factors including age, sex, smoking, hypertension, diabetes and family history, were evaluated for their serum concentrations of vitamin E, total cholesterol, triacylglycerols, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, apolipoprotein A-I, and apolipoprotein B. Apolipoprotein B, low density lipoprotein-cholesterol and total cholesterol concentrations were unequivocally higher in patients with coronary artery disease. Triacylglycerols were marginally higher in patients with disease. The antioxidant vitamin E (alpha-tocopherol) was significantly higher in patients with atherosclerosis when compared with controls (35.1 +/- 17.0 mumol/l vs. 29.0 +/- 13.2 mumol/l, p = 0.017). However, alpha-tocopherol concentrations were strongly associated with lipid concentrations and normalization to the total cholesterol concentrations produced ratios which were not significantly different in the two groups. Logistic regression analysis revealed that the association of lipid risk factors with coronary stenosis was determined primarily by the difference in total cholesterol values. This study demonstrated that in this group of patients referred for angiography and matched for other risk factors, higher alpha-tocopherol concentrations were associated with patients with coronary disease and were not useful for assessing risk of coronary artery disease.