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Diabetes 54:204-211, 2005
© 2005 by the American Diabetes Association, Inc.

The Effect of Vitamin E on Endothelial Function of Micro- and Macrocirculation and Left Ventricular Function in Type 1 and Type 2 Diabetic Patients

Panayiotis A. Economides1, Lalita Khaodhiar2, Antonella Caselli2, A. Enrique Caballero1, Hillary Keenan1, Sven-Erik Bursell1, George L. King1, Michael T. Johnstone3, Edward S. Horton1, and Aristidis Veves2

1 Joslin Diabetes Center, Boston, Massachusetts
2 Microcirculation Laboratory, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
3 Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts

We examined the effects of high-dosage vitamin E treatment over a 12-month period on the vascular reactivity of micro- and macrocirculation and left ventricular function in diabetic patients. Subjects (n = 89) were randomized to vitamin E (1,800 IU daily) or placebo and were followed for 12 months. High-resolution ultrasound images were used to measure the flow-mediated dilation (FMD; endothelium dependent) and nitroglycerin-induced dilation (NID; endothelium independent) of the brachial artery. Laser Doppler perfusion imaging was used to measure vascular reactivity in the forearm skin. Left ventricular function was evaluated using transthoracic echocardiogram. At the end of the 6-month period, a worsening in endothelium-dependent skin vasodilation (P = 0.02) and rise in endothelin levels (P = 0.01) were found in the vitamin E compared with the placebo group. At the end of the 12-month period, a worsening was observed in NID (P = 0.02) and a marginal worsening was seen in systolic blood pressure (P = 0.04) and FMD (P = 0.04) in the vitamin E compared with the placebo group. In addition C-reactive protein levels decreased marginally in the vitamin E compared with the placebo group (P = 0.05). No changes were observed in left ventricular function. We concluded that long-term treatment with 1,800 IU of vitamin E has no beneficial effects on endothelial or left ventricular function in diabetic patients. Because vitamin E–treated patients had a worsening in some vascular reactivity measurements when compared with control subjects, the use of high dosages of vitamin E cannot be recommended.

Address correspondence and reprint requests to Aristidis Veves, MD, Microcirculation Laboratory, Palmer 317, BIDMC/West, 1 Deaconess Rd., Boston, MA, 02215. E-mail: aveves{at}bidmc.harvard.edu


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Copyright © 2005 by the American Diabetes Association.