Ali Keshavarz

Comparison of the Effects of Simultaneous Administration of Vitamin C and Omega-3 Fatty Acids on Lipoproteins, Apo A-I, Apo B, and Malondialdehyde in Hyperlipidemic Patients

BACKGROUND Control of hyperlipidemia is vital in patients with cardiovascular disease (CVD). Omega-3 fatty acids (n-3FAs) have desirable effects on serum triglyceride (TG) levels, thrombosis, and arrhythmia, but lead to increases in serum low-density lipoprotein (LDL) and apo-B as well. OBJECTIVE To determine and compare the effects of administration of n-3FAs, vitamin C (VitC) and n-3FAs + VitC on the serum levels of LDL, apoB, other serum lipids, and malondialdehyde (MDA). The present study was performed in Tehran University of Medical Sciences from 2000 to 2001. DESIGN In a double-blind, placebo trial of parallel design, 68 hyperlipidemic patients [total cholesterol (TC) and TG greater than 200 mg/dL] were randomly assigned to receive daily 500 mg VitC, 1 g n-3FAs, 500 mg VitC + 1 g n-3FAs, or placebo (control) for 10 weeks. Fasting blood samples were collected at the beginning and at the end of the period. TG, TC, LDL-cholesterol-C (LDL-C), and high-density lipoprotein-cholesterol (HDL-C) were measured enzymatically, VitC and MDA colorimetrically, and apo-B and apo-A-I immunoturbidometrically. The pattern of food consumption, socio-economic, and anthropometric indices were determined; there was no significant change in these indices during the study. RESULTS There was a significant difference in the blood VitC level at the end of the study in comparison to the initial value in the VitC (p = 0.001) and VitC + n-3FAs (p = 0.027) groups. Similarly, the serum TG level at the end of study was significantly different from the initial value in the n-3FAs group (p = 0.002) and also from the final value in the control group (p = 0.013). In the VitC group, there was a significant decrease in TC (p = 0.004), apo-B (p = 0.005), and MDA (p = 0.015) at the end of study as compared to the respective initial values. There was also a significant increase in blood VitC compared to the control value (p = 0.018) and a significant decrease in MDA compared to the n-3FAs group (p = 0.034). At the end of study, in the n-3FAs group, there was a significant (p = 0.04) and a marginally significant decrease (p = 0.05), respectively, in TG/HDL and apo-B levels as compared to the initial values, and the TG/HDL ratio showed a significant decrease as compared to the control group (p = 0.047). CONCLUSION Simultaneous administration of n-3FAs and VitC had no beneficial effects on the lipid profile of hyperlipidemic patients, but 1 g purified n-3FAs daily for 10 weeks is a beneficial supplement for decreasing TG without any increase in LDL-C, apo-B or MDA. Administration of 500 mg VitC for more than 10 weeks might decrease significantly TC and apo-B in hyperlipidemic patients.

Association between vitamin A and E and apolipoprotein A and B levels in type 2 diabetes

Abstract Objective. To determine the relationship between serum vitamin A and E and apolipoprotein levels in type 2 diabetic patients. Setting. Shariati Hospital, Tehran, Iran. Subjects and methods. One hundred and seventeen eligible type 2 diabetic patients who attended the Endocrine Research and Metabolism Center between 2002 and 2004 were enrolled in the study. Blood samples were collected after a 12 - 14-hour overnight fast for the measurement of serum levels of total cholesterol, triglyceride, high-density lipoprotein (HDL), low-density lipoprotein (LDL), apolipoprotein (apo) A1 and apoB, and vitamins A and E. Anthropometric indices were determined by physical examination. Data were analysed statistically using Pearsons coefficient, multiple regression, and partial and bivariate correlations. Results. The mean body mass index (BMI) of the subjects was 27.4 ± 3.7 kg/m2. The mean (± standard deviation (SD)) serum levels of vitamins A and E were 0.5 ± 0.1 µg/ml and 9.5 ± 2.6 µg/ml, respectively. There were no significant differences in the plasma levels of vitamins A and E in males and females. Mean serum levels of vitamins A and E were within the normal range for both sexes. Serum lipid levels (total cholesterol, triglyceride and apoB) correlated with serum levels of vitamin E (p < 0.05). Serum levels of vitamins A and E were also correlated (p < 0.05). Standardised vitamin E levels showed significant negative correlation with most studied lipid profiles (p < 0.05). Conclusion. This study found that mean serum levels of the natural antioxidants vitamin E, and especially vitamin A, were close to the lower end of the normal range of these antioxidants in type 2 diabetics. Also, serum vitamin E and standardised vitamin E levels were important predictors of serum apoA1 levels in these patients.

Serum IgG levels to bovine insulin in type I diabetes mellitus

Objectives: This study was undertaken to determine humoral immune response to bovine insulin in Iranian children with type 1 diabetes mellitus.Methods: Serum samples were taken from 93 children aged 4–17 years with type I diabetes mellitus from two centers in Iran (the Iranian Association of Diabetes in Tehran and Center for Diabetes Research in Hamedan), 17 apparently healthy siblings of the diabetic patients (related controls), 28 apparently healthy age- and sex-matched controls (unrelated controls), 14 patients aged 11–15 years with auto-immune thyroiditis, and 45 patients with type II diabetes (aged 44–68 years). Samples were then examined for specific IgG to bovine insulin by enzyme-linked immunosorbent assay (ELISA). A questionnaire on medical history, duration of exclusive and non-exclusive breast feeding and daily intake of dairy products was completed before bleeding.Results: Duration of exclusive and non-exclusive breast-feeding showed no significant difference between patients with type I diabetes, related and unrelated controls and thyroid patients. Diabetic children, however, had significantly higher serum levels of anti-bovine insulin IgG than did unrelated and related healthy controls and patients with type II diabetes (P < 0.01). There was no significant difference between healthy siblings of diabetic children and unrelated controls. In type I diabetic patients and their healthy siblings, serum levels of IgG to bovine insulin were inversely correlated with the duration of non-exclusive breast feeding (rs= -0.37, P= 0.016 and rs -0.53, P= 0.049, respectively). There was no con-elation between serum levels of IgG to bovine insulin with daily intake of dairy products. Bovine insulin cross-reacted with human insulin as judged by ELISA inhibition assay.Conclusion: The emergence of anti-insulin antibodies in Iranian patients with type I DM, which is associated with the duration of breast-feeding is less likely to be due to early exposure of infants with the proteins found in cow’s milk. One speculation could be that the production of antibodies to insulin in type I diabetes may just be a physiologic response (probably to increase the half-life of the circulating insulin). The importance of anti-insulin antibodies in type I diabetes mellitus needs further studies.