Introduction
About 50% of patients presenting acute coronary syndrome not displayed classical risk factors, remaining inaccessible for prevention. Plasma hsCRP [1] and cobalt–albumin binding (ABSU) test [2] were recently introduced as more informative cardiovascular risk markers. Ischemia modified albumin (IMA) assessed with ABSU test, appears to be an indicator of oxidative stress, may not be specific for cardiac ischemia. Data about IMA concentrations in noncardiac ischemia are limited. Vitamin E and C, potent antioxidants have several anti-atherogenic effects [3].
The aim of the study
The aim of study was to assess the effects of short-term dietary supplementation with vitamin E and C on the relation between plasma hsCRP, IMA level and oxidative stress/antioxidant capacity parameters.
Patients and methods
Forty-four cardiovascular event-free obese men without others CHD risk factors, without symptoms of inflammatory disease and the control group of normoweight healthy subjects (n = 18) were included in the study. Combined supplementary vitamin E and C (2 × 100 mg and 2 × 200 mg daily, respectively) was administered to obese subjects and the control group during dinner, for 14 days, after 14 days of washing period. All subjects were evaluated using lipoprotein profile, plasma hsCRP and cobaltalbumin binding assay (ABSU expressed as IMA/alb ratio) as ischemia marker [3], anthropometric parameters, body composition (BMI, WHR, % of adipose tissue) and insulin resistance (HOMA-IR). Parameters of oxidative stress: TBARS, total plasma lipid hydroperoxides (LOOH), LDL oxidative susceptibility (AUC LDL), and antioxidant potency parameters: ferric reducing/antioxidant power test (FRAP), thiol/albumin ratio (SH, SH/alb), LDL oxidative resistance (LDL lag phase), vitamin E and C plasma levels were measured. Redox compensation index (RCI) was calculated from formula:
Results
hsCRP, IMA/alb ratio, and biomarkers of oxidative damage were higher, biomarkers of antioxidant defense were lower in obese subjects compared to control group (Figs. 1, 2). Plasma hsCRP and IMA/alb high-risk tertile revealed oxidative alteration of LDL, higher plasma content of hydroperoxides and TBARS, RCI was significantly reduced. HsCRP and IMA directly correlated with BMI, WHR and the percent of body fat (Tables 1, 2). The short supplementary therapy with vitamins augmented plasma antioxidant potency (Fig. 3). The magnitude of oxidative stress reduction in response to vitamin supplementation was related to hsCRP and ischemia modified albumin plasma levels (Tables 3, 4).
Fig. 1.
Plasma hsCRP and IMA/alb level in obese subjects compared to control group (white bar control group, grey bar obese group). *P < 0.05
Fig. 2.
Biomarkers of oxidative damage and antioxidant defence in obese subjects compared to control group (white bar control group, grey bar obese group). *P < 0.05
Table 1.
Relation of hsCRP with plasma markers of oxidative stress/antioxidant defense and anthropometric parameters
| SBP (mmHg) | DPB (mmHg) | BMI (kg/m2) | Waist (cm) | WHR (cm/cm) | Adipose tissue (%) | |
|---|---|---|---|---|---|---|
| Baseline hsCRP (mg/l) | r = 0.33* | r = 0.38* | r = 0.54* | r = 0.57* | r = 0.55* | r = 0.54* |
| Tg (mmol/L) | Log (Tg/HDL) | HDL-chol (mmol/L) | Vit E (μM) | Vit C (μM) | FRAP (mM) | |
|---|---|---|---|---|---|---|
| Baseline hsCRP (mg/l) | r = 0.31* | r = 0.34* | r = −0.20* | r = −0.35* | r = −0.26* | r = −0.27* |
| SH (μM) | LDL lag phase (min.) | IMA/alb (kU/g) | ||||
|---|---|---|---|---|---|---|
| Baseline hsCRP (mg/l) | r = −0.38* | r = −0.23* | r = 0.36* |
* P < 0.05
Table 2.
Relation of IMA/alb with plasma markers of oxidative stress/antioxidant defense and anthropometric parameters
| SBP (mmHg) | DBP (mmHg) | WHR (cm/cm) | Adipose Tissue (%) | Vit E (μM) | SH (μM) | |
|---|---|---|---|---|---|---|
| Baseline IMA/alb (kU/g) | r = 0.43* | r = 0.36* | r = 0.21* | r = 0.28* | r = −0.51* | r = −0.41* |
| FRAP (mM) | RCI | LDL lag phase (min) | AUC LDL | hsCRP (mg/l) | ||
|---|---|---|---|---|---|---|
| Baseline IMA/alb (kU/g) | r = −0.50* | r = −0.22* | r = −0.40* | r = 0.47* | r = 0.36* |
* P < 0.05
Fig. 3.
The effect of antioxidant therapy on plasma markers of antioxidant defence/oxidative stress in obese subjects compared to control group(white bar control group, grey bar obese group). *P < 0.05
Table 3.
Effectiveness of the antioxidant therapy in relation to hsCRP
| vit. E/lip. (% of change) | FRAP (% of change) | ||
|---|---|---|---|
| hsCRP before supplementation | r = 0.42* | r = 0.38* |
| IMA/alb after supplementation | WitE/lip after supplementation | SH/alb after supplementation | |
|---|---|---|---|
| hsCRP aftersupplementation | r = 0.30* | r = −0.32* | r = −0.39* |
* P < 0.05
Table 4.
Effectiveness of the antioxidant therapy in relation to IMA/alb
| vitE (% of change) | vit. E/lip. (% of change) | vitC (% of chang)e | LDLlag phase (% of change) | AUC LDL (% of change) | |
|---|---|---|---|---|---|
| IMA/alb before supplementation | r = 0.28* | r = 0.35* | r = 0.26* | r = 0.39* | r = − 0.30* |
| hsCRP after supplementation | |||||
|---|---|---|---|---|---|
| IMA/alb after supplementation | r = 0.30* |
* P < 0.05
Conclusion
Plasma hsCRP and cobalt–albumin binding score may serve as potential marker of oxidative stress in obesity and may be useful for selecting patients who are candidates for supplementation with antioxidant vitamins.
References
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