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Vitamins B-12 and C Supplementation Improves Arterial Reactivity and Structure in Passive Smokers: Implication in Prevention of Smoking-Related Atherosclerosis

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The journal of nutrition, health & aging

Abstract

Background

Atherosclerosis is an important medical problem of modern society. High environmental tobacco smoke in casino is associated with an accelerated atherogenic process. We have previously shown vitamin B12 and C supplementation improves vascular reactivity and may be beneficial in vascular protection.

Objective

To evaluate the impact of vitamin supplementation on atherosclerosis (brachial artery reactivity FMD and carotid intima-media thickness IMT) in subjects exposed to high environmental tobacco smoke.

Design

Double-blind 2×2 factorial design fashion.

Setting

Computer randomization in 4 treatment groups: placebo (n=24), vitamin B12 (n=21), vitamin C (n=23) and vitamin B12+C (n=23) groups.

Participants

91 passive-smoking casino employees (19.2% male, mean age 45.0±8.2 years).

Intervention

Subjects were randomized to receive vitamin B12 (500µg daily), vitamin C (200mg daily), vitamin B12+C or image-matched placebo capsules for 1 year. Measurement: Brachial FMD and carotid IMT (surrogate atherosclerotic markers) were measured by ultrasound at baseline and on completion at 12 months.

Methods

91 passive smoking casino employees (19.2% male, mean age 45.0±8.2 years) were randomized to receive vitamin B12 (500µg daily), vitamin C (200mg daily), vitamin B12+C or image-matched placebo capsules in double-blind 2 × 2 factorial design fashion for 1 year. Brachial FMD and carotid IMT (surrogate atherosclerotic markers) were measured by ultrasound at baseline and 12 months.

Results

Of the 78 (85.7%) passive-smoking employees completed the study, 11.5% had hypertension, 5.1% diabetes mellitus and 15.4% hypercholesterolemia. There were no significant changes in their blood pressures, lipid profiles, glucose and body mass index after supplementation for 1 year, but mild decrease in DBP (p<0.001) and blood creatinine (p<0.01) after combined vitamin B12 and C, and significant increase in blood B12 after vitamin B12 (p<0.01) and vitamin B12+C supplementations (p<0.001). Brachial FMD and cartotid IMT improved after the 3 vitamin supplementations (p<0.001), but not after placebo, being more significant after combined vitamin supplementations (p<0.0001). No adverse effects were reported.

Conclusion

Vitamin B12 or C supplementation in passive smokers improved vascular reactivity and structures at 1 year, with implication in long term atherosclerosis prevention.

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Acknowledgement

We wish to acknowledge the support of Dr Stanley Ho Medical Development Foundation in funding this project, Mr Jimmy CL Chu of Macau Heart Foundation in helping recruitment of casino employees, and the chemical pathology laboratory of Hospital Central Corde de. Januario, Macau, in performing the blood assay.

Author information

Authors and Affiliations

  1. Department of Medicines and Therapeutics, United College, The Chinese University of Hong Kong, 4th Floor, Tsang Shiu Tim Building, Hong Kong, China

    K. S. Woo, T. W. C. Yip, P. Chook, A. P. W. Lee & T. C. Y. Kwok

  2. Institute of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong, China

    P. Chook

  3. Hospital Central Corde de S. Januario, Macau, China

    K. V. Koon

  4. Macau Heart Foundation, Macau, China

    H. C. Leong

  5. Kiang Wu Hospital, Macau, China

    X. H. Feng

Authors
  1. K. S. Woo
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  2. T. W. C. Yip
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  8. T. C. Y. Kwok
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Corresponding author

Correspondence to K. S. Woo.

Ethics declarations

Conflict of Interest: All authors declare no conflict of interest.

Ethical standards All participants provided their written informed consents. The written informed consent was kept by the chief coordinator for 5 years on completion of the project. The ethics committee of The Chinese University of Hong Kong approved the informed written consent.

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Woo, K.S., Yip, T.W.C., Chook, P. et al. Vitamins B-12 and C Supplementation Improves Arterial Reactivity and Structure in Passive Smokers: Implication in Prevention of Smoking-Related Atherosclerosis. J Nutr Health Aging 25, 248–254 (2021). https://doi.org/10.1007/s12603-020-1529-7

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  • DOI: https://doi.org/10.1007/s12603-020-1529-7

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