open access

Vol 24, No 1 (2018)
Artykuły
Published online: 2018-04-12
Get Citation

Systemic oxidoreductive balance in patients without clinical manifestation of atherosclerosis

Marcin Majer, Daniel Gackowski, Rafał Różalski, Agnieszka Siomek-Górecka, Ryszard Oliński, Jacek Budzyński
DOI: 10.5603/AA.2018.0001
·
Acta Angiologica 2018;24(1):1-8.

open access

Vol 24, No 1 (2018)
Artykuły
Published online: 2018-04-12

Abstract

Introduction. Oxidative stress plays an important role in atherosclerosis, but numerous clinical trials have not confirmed a favourable effect of antioxidant supplementation. We aimed to determine the oxidative stress parameters in patients without clinical manifestation of vascular disease. Material and methods. Forty-eight patients were divided into two groups in relation to the presence or absence of clinically silent signs of atherosclerosis (ankle-brachial index < 0.9, intima-media thickness ≥ 0.9 mm, the presence of carotid atherosclerotic plaques, silent ischaemia in a treadmill stress test or focal myocardial contractility found in echocardiography). Plasma concentrations of: retinol, ascorbic acid, alpha-tocopherol and uric acid, as well as the products of oxidative DNA damage repair: 8-oxo-7,8-dihydro-2’-deoxyguanosine (8-oxodG) in blood leucocytes and urine, and 8-oxo-7,8-dihydroguanine (8-oxo-Gua) in urine. Results. Patients with signs of subclinical atherosclerosis had lower blood concentration of alpha- tocopherol, and a non-significantly greater urine concentration of 8-oxoGua. Women had significantly greater blood concentration of ascorbic acid and alpha-tocopherol, as well as lower level of retinol and uric acid. They also had greater leucocyte concentration of 8-oxodG. Plasma concentration of alpha-tocopherol 30.34 μM distinguished patients with and without signs of subclinical atherosclerosis. Conclusions. Oxidative stress has clinical importance in the early stages of atherosclerosis and may be helpful in predicting its subclinical stage. Women had higher level of antioxidant defence, which explains their natural protection against early atherosclerosis development. Further studies are needed to determine the usefulness of tocopherol determination as a biomarker for atherosclerosis risk evaluation.

Abstract

Introduction. Oxidative stress plays an important role in atherosclerosis, but numerous clinical trials have not confirmed a favourable effect of antioxidant supplementation. We aimed to determine the oxidative stress parameters in patients without clinical manifestation of vascular disease. Material and methods. Forty-eight patients were divided into two groups in relation to the presence or absence of clinically silent signs of atherosclerosis (ankle-brachial index < 0.9, intima-media thickness ≥ 0.9 mm, the presence of carotid atherosclerotic plaques, silent ischaemia in a treadmill stress test or focal myocardial contractility found in echocardiography). Plasma concentrations of: retinol, ascorbic acid, alpha-tocopherol and uric acid, as well as the products of oxidative DNA damage repair: 8-oxo-7,8-dihydro-2’-deoxyguanosine (8-oxodG) in blood leucocytes and urine, and 8-oxo-7,8-dihydroguanine (8-oxo-Gua) in urine. Results. Patients with signs of subclinical atherosclerosis had lower blood concentration of alpha- tocopherol, and a non-significantly greater urine concentration of 8-oxoGua. Women had significantly greater blood concentration of ascorbic acid and alpha-tocopherol, as well as lower level of retinol and uric acid. They also had greater leucocyte concentration of 8-oxodG. Plasma concentration of alpha-tocopherol 30.34 μM distinguished patients with and without signs of subclinical atherosclerosis. Conclusions. Oxidative stress has clinical importance in the early stages of atherosclerosis and may be helpful in predicting its subclinical stage. Women had higher level of antioxidant defence, which explains their natural protection against early atherosclerosis development. Further studies are needed to determine the usefulness of tocopherol determination as a biomarker for atherosclerosis risk evaluation.

Get Citation

Keywords

oxidative stress, biomarkers, atherosclerosis, intima-media thickness, vitamin E

About this article
Title

Systemic oxidoreductive balance in patients without clinical manifestation of atherosclerosis

Journal

Acta Angiologica

Issue

Vol 24, No 1 (2018)

Pages

1-8

Published online

2018-04-12

DOI

10.5603/AA.2018.0001

Bibliographic record

Acta Angiologica 2018;24(1):1-8.

Keywords

oxidative stress
biomarkers
atherosclerosis
intima-media thickness
vitamin E

Authors

Marcin Majer
Daniel Gackowski
Rafał Różalski
Agnieszka Siomek-Górecka
Ryszard Oliński
Jacek Budzyński

References (44)
  1. Santilli F, D'Ardes D, Davì G. Oxidative stress in chronic vascular disease: From prediction to prevention. Vascul Pharmacol. 2015; 74: 23–37.
  2. Ozkanlar S, Akcay F. Antioxidant vitamins in atherosclerosis--animal experiments and clinical studies. Adv Clin Exp Med. 2012; 21(1): 115–123.
  3. Farbstein D, Kozak-Blickstein A, Levy AP. Antioxidant vitamins and their use in preventing cardiovascular disease. Molecules. 2010; 15(11): 8098–8110.
  4. Rasmussen ST, Andersen JT, Nielsen TK, et al. Simvastatin and oxidative stress in humans: A randomized, double-blinded, placebo-controlled clinical trial. Redox Biol. 2016; 9: 32–38.
  5. Steven S, Daiber A, Dopheide JF, et al. Peripheral artery disease, redox signaling, oxidative stress - Basic and clinical aspects. Redox Biol. 2017; 12: 787–797.
  6. Hamishehkar H, Ranjdoost F, Asgharian P, et al. Vitamins, Are They Safe? Adv Pharm Bull. 2016; 6(4): 467–477.
  7. Hemilä H, Suonsyrjä T. Vitamin C for preventing atrial fibrillation in high risk patients: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2017; 17(1): 49.
  8. Ashor AW, Siervo M, Lara J, et al. Effect of vitamin C on endothelial function in health and disease: a systematic review and meta-analysis of randomised controlled trials. Atherosclerosis. 2014; 235(1): 9–20.
  9. Ashor AW, Siervo M, Lara J, et al. Effect of vitamin C and vitamin E supplementation on endothelial function: a systematic review and meta-analysis of randomised controlled trials. Br J Nutr. 2015; 113(8): 1182–1194.
  10. Bjelakovic G, Gluud LL, Nikolova D, et al. Vitamin D supplementation for prevention of mortality in adults. Cochrane Database Syst Rev. 2014(1): CD007470.
  11. Bjelakovic G, Nikolova D, Gluud C. Meta-regression analyses, meta-analyses, and trial sequential analyses of the effects of supplementation with beta-carotene, vitamin A, and vitamin E singly or in different combinations on all-cause mortality: do we have evidence for lack of harm? PLoS One. 2013; 8(9): e74558.
  12. Schwingshackl L, Boeing H, Stelmach-Mardas M, et al. Dietary supplements and risk of cause-specific death, cardiovascular disease, and cancer: a protocol for a systematic review and network meta-analysis of primary prevention trials. Syst Rev. 2015; 4(1): 34–39.
  13. Paganini-Hill A, Kawas CH, Corrada MM. Antioxidant vitamin intake and mortality: the Leisure World Cohort Study. Am J Epidemiol. 2015; 181(2): 120–126.
  14. Stepaniak U, Micek A, Grosso G, et al. Antioxidant vitamin intake and mortality in three Central and Eastern European urban populations: the HAPIEE study. Eur J Nutr. 2016; 55(2): 547–560.
  15. Mottaghi A, Ebrahimof S, Angoorani P, et al. Vitamin A supplementation reduces IL-17 and RORc gene expression in atherosclerotic patients. Scand J Immunol. 2014; 80(2): 151–157.
  16. Hosseini B, Saedisomeolia A, Skilton MR. Association between Micronutrients Intake/Status and Carotid Intima Media Thickness: A Systematic Review. J Acad Nutr Diet. 2017; 117(1): 69–82.
  17. Vardi M, Levy NS, Levy AP. Vitamin E in the prevention of cardiovascular disease: the importance of proper patient selection. J Lipid Res. 2013; 54(9): 2307–2314.
  18. Levy Y, Blum S, Levy AP. Antioxidants in the prevention of atherosclerosis: the importance of proper patient selection. Clin Nutr. 2009; 28(5): 581–582.
  19. Rozalski R, Migdalski A, Gackowski D, et al. Does morphology of carotid plaque depend on patient's oxidative stress? Clin Biochem. 2013; 46(12): 1030–1035.
  20. Foksinski M, Gackowski D, Rozalski R, et al. Effects of basal level of antioxidants on oxidative DNA damage in humans. Eur J Nutr. 2007; 46(3): 174–180.
  21. Gackowski D, Rozalski R, Roszkowski K, et al. 8-Oxo-7,8-dihydroguanine and 8-oxo-7,8-dihydro-2'-deoxyguanosine levels in human urine do not depend on diet. Free Radic Res. 2001; 35(6): 825–832.
  22. Siomek A, Gackowski D, Rozalski R, et al. Higher leukocyte 8-oxo-7,8-dihydro-2'-deoxyguanosine and lower plasma ascorbate in aging humans? Antioxid Redox Signal. 2007; 9(1): 143–150.
  23. Malayappan B, Garrett TJ, Segal M, et al. Urinary analysis of 8-oxoguanine, 8-oxoguanosine, fapy-guanine and 8-oxo-2'-deoxyguanosine by high-performance liquid chromatography-electrospray tandem mass spectrometry as a measure of oxidative stress. J Chromatogr A. 2007; 1167(1): 54–62.
  24. Martinet W, Knaapen MWM, De Meyer GRY, et al. Elevated levels of oxidative DNA damage and DNA repair enzymes in human atherosclerotic plaques. Circulation. 2002; 106(8): 927–932.
  25. Sigala F, Kotsinas A, Savari P, et al. Oxidized LDL in human carotid plaques is related to symptomatic carotid disease and lesion instability. J Vasc Surg. 2010; 52(3): 704–713.
  26. Norgren L, Hiatt WR, Dormandy JA, et al. TASC II Working Group. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg. 2007; 45 Suppl S: S5–67.
  27. Piepoli MF, Hoes AW, Agewall S, et al. Authors/Task Force Members:, Authors/Task Force Members, Additional Contributor: Simone Binno (Italy), Document Reviewers:, ESC Scientific Document Group. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016; 37(29): 2315–2381.
  28. Li G, Li Y, Chen X, et al. Circulating tocopherols and risk of coronary artery disease: A systematic review and meta-analysis. Eur J Prev Cardiol. 2016; 23(7): 748–757.
  29. Riccioni G, D'Orazio N, Palumbo N, et al. Relationship between plasma antioxidant concentrations and carotid intima-media thickness: the Asymptomatic Carotid Atherosclerotic Disease In Manfredonia Study. Eur J Cardiovasc Prev Rehabil. 2009; 16(3): 351–357.
  30. Yakoot M. Vitamin e and omega-3: what to believe: observational studies or randomized controlled trials? Heart Views. 2012; 13(2): 66–68.
  31. Stephens NG, Parsons A, Schofield PM, et al. Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study (CHAOS). Lancet. 1996; 347(9004): 781–786.
  32. Loffredo L, Perri L, Di Castelnuovo A, et al. Supplementation with vitamin E alone is associated with reduced myocardial infarction: a meta-analysis. Nutr Metab Cardiovasc Dis. 2015; 25(4): 354–363.
  33. Jha P, Flather M, Lonn E, et al. The antioxidant vitamins and cardiovascular disease. A critical review of epidemiologic and clinical trial data. Ann Intern Med. 1995; 123(11): 860–872.
  34. Yusuf S, Dagenais G, Pogue J, et al. Heart Outcomes Prevention Evaluation Study Investigators. Vitamin E supplementation and cardiovascular events in high-risk patients. N Engl J Med. 2000; 342(3): 154–160.
  35. Shekelle PG, Morton SC, Jungvig LK, et al. Effect of supplemental vitamin E for the prevention and treatment of cardiovascular disease. J Gen Intern Med. 2004; 19(4): 380–389.
  36. Bjelakovic G, Nikolova D, Gluud LL, et al. Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. Cochrane Database Syst Rev. 2012(3): CD007176.
  37. Ye Y, Li J, Yuan Z. Effect of antioxidant vitamin supplementation on cardiovascular outcomes: a meta-analysis of randomized controlled trials. PLoS One. 2013; 8(2): e56803.
  38. Myung SK, Ju W, Cho B, et al. Korean Meta-Analysis Study Group. Efficacy of vitamin and antioxidant supplements in prevention of cardiovascular disease: systematic review and meta-analysis of randomised controlled trials. BMJ. 2013; 346: f10.
  39. Miller ER, Pastor-Barriuso R, Dalal D, et al. Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern Med. 2005; 142(1): 37–46.
  40. Sun Ye, Koh HWL, Choi H, et al. Plasma carotenoids and risk of acute myocardial infarction in the Singapore Chinese Health Study. Nutr Metab Cardiovasc Dis. 2011; 21(9): 685–690.
  41. Gey KF, Ducimetière P, Evans A, et al. Low plasma retinol predicts coronary events in healthy middle-aged men: the PRIME Study. Atherosclerosis. 2010; 208(1): 270–274.
  42. Joris PJ, Mensink RP. Effects of supplementation with the fat-soluble vitamins E and D on fasting flow-mediated vasodilation in adults: a meta-analysis of randomized controlled trials. Nutrients. 2015; 7(3): 1728–1743.
  43. Mathur P, Ding Z, Saldeen T, et al. Tocopherols in the Prevention and Treatment of Atherosclerosis and Related Cardiovascular Disease. Clin Cardiol. 2015; 38(9): 570–576.
  44. Zhang PY, Xu X, Li XC. Cardiovascular diseases: oxidative damage and antioxidant protection. Eur Rev Med Pharmacol Sci. 2014; 18(20): 3091–3096.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl