Ожирение и метаболизм (Jun 2020)
Antioxidant vitamin status of obese patients in terms of the risk of comorbidities
Abstract
BACKGROUND: Synchronously optimized concentrations of vitamins C, E, A, carotenoids and their ratios in blood plasma help to prevent or slow down the development of many alimentary-dependent diseases and their complications. AIMS: to characterize the vitamin status of obese patients from the standpoint of the risk of progression of existing and development of associated diseases. MATERIALS AND METHODS: An observational single-site cross-sectional study of the sufficiency with antioxidant vitamins in 81 patients (21 men, 60 women) aged 20–75 years with body mass index 40,7±1,2 kg/m2, enrolled for treatment from April to June in Federal Research Centre of Nutrition, Biotechnology had been conducted. The concentration of α- and γ-tocopherols, retinol, ascorbic acid, β-carotene was determined in blood serum and their ratios with lipid profile were calculated. RESULTS: Indicators of vitamin status were determined in 35 patients with obesity, 27 patients with obesity and cardiovascular diseases (CVD), 19 patients with obesity and type 2 diabetes mellitus (T2DM). The concentration of ascorbic acid in more than 50% of patients did not reach the optimal level (50 µmol/l). Compared to patients of other groups, patients with T2DM were better supplied with vitamin E, but worse with other vitamins. They have a non-optimal ratio of concentrations of vitamin C and E more often compared with patients of other groups (p≤0.050). Among them, the combined suboptimal level of vitamin C and β-carotene (<0.4 µmol/l) was detected 1.6–1.8 fold more often. The lack of antioxidants in patients with T2DM according to simultaneously reduced vitamin C/vitamin E ratio (<1.5) and β-carotene level was detected 3.3-fold more often, synchronously lowered vitamin C/vitamin E ratio and vitamin C level – 2.4-fold. γ-tocopherol level in serum of patients with T2DM tended to increase compared with that in patients with obesity (p=0.063) and CVD (p=0.081), γ-tocopherol/triacylglycerides ratio was 1.5-fold higher (respectively р=0.009 и р=0.076). Only in 2 patients with obesity and 2 patients with CVD all serum indicators corresponded to the optimal level of all vitamins. In terms of α-tocopherol/cholesterol (<5 µmol/mol), an increased risk of myocardial infarction was detected in 10.5–42.9% of the examined patients. Glucose level was positively associated with serum levels of α- and γ-tocopherols, as well as cholesterol-adjusted individual tocopherols; while glycemia was inversely associated with triacylglycerides-standardized individual tocopherols, as well as β-carotene and vitamin C/vitamin E ratio. CONCLUSIONS: In most patients, a non-optimal serum vitamin content was found according to one or several parameters. In order to vitamin C/vitamin E ratio, patients with T2DM need to increase vitamin C intake. Increasing serum β-carotene and achieving an optimal C/E ratio will help to prevent an increase in glycemia.
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