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Vitamin E supplementation increases circulating vitamin E metabolites tenfold in end-stage renal disease patients

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Lipids

Abstract

Vitamin E supplementation could elevate circulating vitamin E metabolites while modulating oxidative and inflammatory status in end-stage renal failure patients undergoing hemodialysis. Plasma concentrations of carboxyethyl-hydroxychromanols (α-and γ-CEHC), ascorbic acid, α-and γ-tocopherols, E2-isoprostanes, and inflammatory biomarkers [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), ferritin, and C-reactive protein (CRP)] were measured in blood samples obtained from patients (n=11) before and after dialysis on two occasions prior to, and at 1 and 2 mon of daily vitamin E supplementation (400 IU RRR-α-tocopherol). Supplementation nearly doubled plasma α-tocopherol concentrations (from 18±0.5 to 31±1.7 μM, P<0.0001), whereas γ-tocopherol concentrations decreased (from 2.8±0.3 to 1.7±0.2 μM, P=0.001). Serum α-CEHC increased 10-fold from 68±3 to 771±175 nM (P<0.0001), and γ-CEHC increased from 837±164 to 1136±230 nM (P=0.008). Vitamin E supplementation also increased postdialysis hematocrits from 38±1% to 41±1% (P<0.001). Dietary antioxidant intakes (vitamins E and C) were low in most subjects; plasma ascorbic acid levels (88±27 μM) decreased significantly with dialysis (33±11 μM, P=0.01). Plasma Il-6, CRP, TNF-α, and free F2-isoprostane concentrations were elevated throughout the study. There is a complex relationship between chronic inflammation and oxidative stress that is not mitigated by short-term vitamin E supplementation. Importantly, serum vitamin E metabolite concentrations that increased 10-fold within 30 d of supplementation did not increase further, suggesting routes other than urine for removal of metabolites.

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Abbreviations

α-and γ-CEHC:

α-and γ-carboxyethyl-hydroxychromanols

CRP:

C-reactive protein

CYP:

cytochrome

DTPA:

diethylene triamine pentaacetic acid

EPO:

erythropoietin

HD:

hemodialysis

hsCRP:

high-sensitivity CRP

IL-6:

interleukin-6

rHuEPO:

recombinant human erythropoietin

TIBC:

total iron-binding capacity

TNF-α:

tumor necrosis factor-α

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Authors and Affiliations

  1. Department of Nutrition and Food Management, Oregon State University, 571 Weniger Hall, 97331-6512, Corvallis, OR

    Kylie Sherée Smith, Chia-Lin Lee, James W. Ridlington & Maret G. Traber

  2. Laboratory for Atherosclerosis and Metabolic Research, University of California-Davis Medical Center, 95817, Sacramento, California

    Scott W. Leonard & Maret G. Traber

  3. Department of Pathology, University of California-Davis Medical Center, 95871, Sacramento, California

    Sridevi Devaraj

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  1. Kylie Sherée Smith
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  2. Chia-Lin Lee
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  3. James W. Ridlington
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  4. Scott W. Leonard
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  5. Sridevi Devaraj
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  6. Maret G. Traber
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Correspondence to Maret G. Traber.

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Smith, K.S., Lee, CL., Ridlington, J.W. et al. Vitamin E supplementation increases circulating vitamin E metabolites tenfold in end-stage renal disease patients. Lipids 38, 813–819 (2003). https://doi.org/10.1007/s11745-003-1130-9

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  • DOI: https://doi.org/10.1007/s11745-003-1130-9

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