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Vitamin E Unlikely to
Reduce Microvascular Complications in Diabetics
posted 12/06/02
Vitamin E supplementation has no
demonstrable effect on major cardiovascular outcomes, microvascular
complications or glycemic control in diabetics at high risk for cardiac events.
That's according to
results of the Heart Outcomes Prevention Evaluation (HOPE) trial and the
Microalbuminuria Cardiovascular Renal Outcomes (MICRO-HOPE) substudy.
Results of the
original HOPE study, published in 2000 in The New England Journal of Medicine,
showed no cardiovascular benefit to vitamin E in individuals at high risk for
MI, stroke or other CV-related death.
In the MICRO-HOPE
substudy researchers looked at the effects of vitamin E therapy on CV events and
microvascular outcomes in 3654 middle-aged and elderly diabetics in the HOPE
trial. The results of MICRO-HOPE are published in the November issue of Diabetes
Care.
Dr. Eva Lonn of
McMaster University in Hamilton, Ontario, Canada said that, MICRO-HOPE is "the
largest study of vitamin E on microvascular complications of diabetes ever
published."
Briefly, Dr. Lonn and
colleagues randomized diabetics to daily administration of 400 IU vitamin E and
10 mg ramipril, or their respective placebos, and followed them for an average
of 4.5 years.
In addition to the
neutral effect of vitamin E on macrovascular outcomes, the current study found
"no effect on diabetic nephropathy and other microvascular complications, [such
as] the need for laser therapy for diabetic retinopathy," she said. Vitamin E
also had no marked effect on glycemic control.
"The use of
antioxidant vitamins was advocated as potentially particularly beneficial in
people with diabetes, as these people have higher oxidative stress related to
hyperglycemia," Dr. Lonn said.
"Unfortunately, based on the results of our study, vitamin E cannot be recommended in the prevention of vascular disease or microvascular complication...in people with diabetes," she added. "The use of proven effective preventive therapies such as lipid lowering, blood pressure control and glycemic control needs to be pursued."
Source: Diabetes In Control Dot Com:
Diabetes Care 2002;25:1919-1927.
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