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 2075 years with body mass index 40,71,2 kg/m2, enrolled for treatment from April to June in Federal Research Centre of Nutrition, Biotechnology had been conducted. The concentration of - and -tocopherols, retinol, ascorbic acid, -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 mol/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 (p0.050). Among them, the combined suboptimal level of vitamin C and -carotene (0.4 mol/l) was detected 1.61.8 fold more often. The lack of antioxidants in patients with T2DM according to simultaneously reduced vitamin C/vitamin E ratio (1.5) and -carotene level was detected 3.3-fold more often, synchronously lowered vitamin C/vitamin E ratio and vitamin C level 2.4-fold. -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), -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 -tocopherol/cholesterol (5 mol/mol), an increased risk of myocardial infarction was detected in 10.542.9% of the examined patients. Glucose level was positively associated with serum levels of - and -tocopherols, as well as cholesterol-adjusted individual tocopherols; while glycemia was inversely associated with triacylglycerides-standardized individual tocopherols, as well as -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 -carotene and achieving an optimal C/E ratio will help to prevent an increase in glycemia.
Background. Inadequate supply with vitamins is a risk factor for the development of many nutritionally-related diseases and their progression. Data on the actual vitamin status of patients are necessary to develop measures for its improvement. Aim. To characterize the supply of persons with non-communicable diseases with vitamins A, E, C, B2 and -carotene by determining their level in the blood of patients. Material and methods. The blood serum level of vitamins C, A, E, B2 and -carotene in 138 patients (41 men and 97 women) 2280 years old with cardiovascular diseases, obesity, gastrointestinal diseases, type 2 diabetes mellitus (T2DM), osteoarthrosis has been determined. Results. Vitamin C concentration corresponded to adequate status in approximately 2/3 of the examined patients; among patients with T2DM, such sufficiency occurred 1.61.9 fold less often than in other groups. The frequency of reduced levels of vitamins C, A and E was statistically significantly more frequent in patients with gastrointestinal diseases. The -/-tocopherol ratio in the serum of patients in all groups was close to 1:50, while in patients with gastrointestinal diseases reached 1:60.7. The proportion of patients sufficiently supplied with all studied vitamins ranged from 15.8 to 70.0%. Patients with osteoarthrosis were best of all provided with all vitamins: multiple (3 or more vitamins) vitamin deficiency was not found. In other groups of patients, multiple vitamin deficiency occurred in 5.327.6% of the examined (an average of 16.4%). Among patients with gastrointestinal diseases there was not a single person sufficiently provided with all the studied vitamins. Multiple vitamin deficiency in patients with gastrointestinal diseases was detected more often (p 0.01) compared with patients with T2DM and osteoarthrosis. Given the high prevalence of vitamin D deficiency, it is possible to extrapolate that a significant proportion of patients with a combined deficiency of 2 vitamins (6.931.6% in the samples examined) will move into the category of persons with a simultaneous deficiency of 3 vitamins. Conclusion. The purposeful development of supplements containing effective doses of vitamins for various nosologies is necessary.
The article discusses topical issues reflecting the high prevalence of diabetes mellitus (DM), the continuing trend towards an increase in the number of patients, the high incidence of vascular complications that lead to early disability and high mortality. The review presents current data on the role of oxidative stress in the development and progression of vascular complications in patients with type 2 diabetes, as well as the mechanisms underlying the imbalance between prooxidants and the antioxidant defense system in this disease. The article presents the role of a balanced diet in achieving metabolic goals and increasing antioxidant protection in type 2 diabetes. The review provides data on the role of vitamins in the correction of metabolic disorders in type 2 diabetes. The increased need for antioxidant vitamins in diabetes is due to impaired glucose metabolism in this category of patients. Food products, which contain polyphenolic compounds, have a pronounced antioxidant and antithrombotic activity, which favorably affect metabolic parameters that contribute to weight loss. Thus, one of the ways to optimize the therapeutic nutrition of patients with type 2 diabetes is the inclusion in the standard hypocaloric diet of specialized food products containing antioxidant vitamins and minor biologically active substances with pronounced antioxidant properties.
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