Antioxidant state and mortality from coronary heart disease in lithuanian and swedish men: concomitant cross sectional study of men aged 50

Kristenson, Margareta; Ziedén, Bo; Kučinskienė, Zita Aušrelė; Elinder, Liselotte Schäfer; Bergdahl, Björn; Elwing, B; Abaravicius, Algis; Razinkovienė, L.; Čalkauskas, Henrikas; Olsson, Anders

doi:10.1136/bmj.314.7081.629

Cited by 165 publications

(83 citation statements)

References 31 publications

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“…The alcohol intake was similar in the 2 study populations. 4 The finding that the Lithuanian population with a high risk for cardiovascular disease has a lower plasma ␥-tocopherol level is also interesting in relation to a recent report that CHD patients have reduced serum levels of ␥-but not ␣-tocopherol. 24 Although ␥-tocopherol is less efficient as an antioxidant compared with ␣-tocopherol, it has been shown to be superior in detoxifying nitrogen dioxide.…”

Section: Discussionmentioning

confidence: 55%

Increased Plasma 7β-Hydroxycholesterol Concentrations in a Population With a High Risk for Cardiovascular Disease

Ziedén¹,

Kaminskas²,

Kristenson³

et al. 1999

ATVB

118

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Abstract-The mortality in coronary heart disease among 50-to 54-year-old men is 4 times higher in Lithuania than in Sweden. It was recently suggested that traditional risk factors could not explain this mortality difference. LDL of Lithuanian men showed, however, a lower resistance to oxidation than that of Swedish men. In addition, the plasma concentration of ␥-tocopherol, lycopene, and ␤-carotene were lower in Lithuanian men. In the present investigation, we determined plasma oxysterols in men from Lithuania and Sweden and found that the plasma concentration of 7␤-hydroxycholesterol was higher in Lithuanian men, 12Ϯ5 versus 9Ϯ8 (SD) ng/mL (Pϭ0.0011). This oxysterol is a cholesterol autoxidation product and there is no indication that it should have an enzymatic origin. Mean LDL oxidation lag time was shorter in Lithuanian men (75Ϯ14 versus 90Ϯ13 minutes, PϽ0.0001) and the concentration of LDL linoleic acid was lower (249Ϯ56 versus 292Ϯ54 g/mg of LDL protein, PϽ0.0001). Lipid corrected ␥-tocopherol was 0.07Ϯ0.02 mg/mL in Vilnius men and 0.12Ϯ0.04 mg/mL (PϽ0.0001) in Linköping men. There was a negative correlation between the concentration of 7␤-hydroxycholesterol and lag time (RϭϪ0.31, Pϭ0.0023). It is suggested that the higher 7␤-hydroxycholesterol concentration in Lithuanian men is an indication of an increased in vivo lipid peroxidation. (Arterioscler Thromb Vasc Biol. 1999;19:967-971.)Key Words: oxysterols Ⅲ LDL oxidation Ⅲ vitamins Ⅲ fatty acids Ⅲ cross-sectional study C oronary heart disease (CHD) incidence and mortality is rising in the East European countries, in contrast to the decreasing trend in Western Europe and in the United States. [1][2][3] For example, the mortality in CHD among 50-to 54-year-old men was 4 times higher in Lithuania than in Sweden in 1994. In LiVicordia I, a cross-sectional population study, we investigated the prevalence of ultrasound-detected subclinical atherosclerosis and possible causes for these diverging coronary mortality trends in the 2 countries. 4 Lithuanian men had more carotid atherosclerosis. Although traditional risk factors could not explain the difference in CHD mortality, we found that Lithuanian men had a higher LDL susceptibility to oxidation and lower concentrations of the plasma antioxidant vitamins ␥-tocopherol, ␤-carotene, and lycopene than Swedish men. There is a high correlation between the plasma concentrations of these vitamins and the corresponding vitamin content in LDL. 5 The increased susceptibility to oxidation and lower concentrations of LDLassociated vitamins in the Lithuanian population may be caused by dietary factors or an increased in vivo oxidation of LDL. We have recently shown that cholesterol oxidation products (oxysterols) are good markers of LDL oxidation in vitro. 6 In addition, the oxysterol 7␤-hydroxycholesterol, together with an increased oxidation susceptibility of VLDLϩLDL, were the strongest predictors of progression of carotid atherosclerosis in Finnish men. 7 We therefore decided to determine oxysterols in plasma from the 2 p...

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Section: Discussionmentioning

confidence: 55%

Increased Plasma 7β-Hydroxycholesterol Concentrations in a Population With a High Risk for Cardiovascular Disease

Ziedén¹,

Kaminskas²,

Kristenson³

et al. 1999

ATVB

118

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“…This leads to a lower ratio of a-to g-tocopherol after the RO diet compared to the SAT diet. A low g-tocopherol concentration and a high a-to g-tocopherol ratio has been reported in patients with CHD compared to controls Kontush et al, 1999) and in a population with a high incidence of CHD (Kristenson et al, 1997). These results suggest that a serum tocopherol profile with low g-tocopherol levels and a high a-to g-tocopherol ratio may be an indicator of an increased risk for CHD and that rapeseed oil-rich diets may help to increase the levels of g-tocopherol in the body.…”

Section: Discussionmentioning

confidence: 98%

A diet containing rapeseed oil-based fats does not increase lipid peroxidation in humans when compared to a diet rich in saturated fatty acids

et al. 2001

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Objective: To compare the effects of a rapeseed oil-based diet containing an increased proportion of easily oxidised polyunsaturated fatty acids such as a-linolenic acid with a diet rich in saturated fatty acids on the degree of lipid peroxidation in the human body. Design: A randomised cross-over study. Subjects and interventions: Nineteen healthy moderately hyperlipidemic subjects (six women and 13 men, age 50 AE 8 y and body mass index (BMI) 24.5 AE 2.6 kg=m 2 ) were given a rapeseed oil-based diet (RO) and a control diet (SAT) rich in saturated fatty acids during two consecutive 4 week periods separated by a 4 week wash-out period. Biomarkers of lipid peroxidation and antioxidants were analysed in plasma and urine. Results: No significant differences in plasma or urinary levels of free 8-iso-prostaglandin F 2a , plasma total 8-isoprostaglandin F 2a plasma hydroperoxides or plasma malondialdehyde were observed between the RO and SAT diets (P ¼ 0.14 -0.95). A higher concentration of serum g-tocopherol was detected after the RO diet compared to the SAT diet (P < 0.001), whereas the serum a-tocopherol concentration and plasma antioxidative capacity did not differ between the two test diets. The total cholesterol, LDL cholesterol and LDL=HDL ratio were lower after the RO diet compared to the SAT diet (P < 0.001), while HDL cholesterol and total triglyceride levels were similar after the two diets. Conclusion: These results suggest that a rapeseed oil-based diet rich in a-linolenic acid does not seem to increase the degree of lipid peroxidation in plasma and urine compared to a diet rich in saturated fats. This is possibly due to a sufficient content of antioxidants in the rapeseed oil diet to increase circulating concentrations of antioxidants that may protect unsaturated fatty acids from oxidation.

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“…In another study, we found that plasma levels of carotenoids in Czech middle aged men were about half of those in Bavaria and Israel (Bobak et al, submitted for publication). A recent study comparing Swedish and Lithuanian men reported that Lithuanians had signi®cantly lower levels of several carotenoids, as well as lower resistance of low density lipoprotein to oxidation (Kristenson et al, 1997).…”

Section: Discussionmentioning

confidence: 99%

Could antioxidants play a role in high rates of coronary heart disease in the Czech Republic?

Bobák

Brunner

et al. 1998

Eur J Clin Nutr

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Objectives: To compare plasma levels of antioxidant vitamins in the Czech population with those in a western European population, and to investigate whether plasma levels of antioxidant vitamins in Czech population are related to risk of MI. Design: The study has two parts: a cross-sectional survey and a population based case-control study. Setting: Adult population in two districts of the Czech Republic, and London based civil servants group as the comparison. Subjects: A random sample of men and women aged 25±64 y resident in two districts were selected for the cross-sectional survey. Subjects in the age group 40±49 y were compared to a sample of British civil servants of the same age enrolled in the Whitehall II Study. Men in the Czech sample served as controls to 52 male cases of ®rst non-fatal myocardial infarction (MI) which occurred in the same population. Plasma samples were obtained from venepuncture during an interview in hospital in the population sample and immediately after hospitalization in the MI cases. Main outcome measures: Plasma levels of b-carotene and a-tocopherol, and the event of MI. Identical protocol and one laboratory was used for all analyses. Results: The mean plasma levels of b-carotene and a-tocopherol in healthy Czech men and women were substantially lower than in a subsample of British civil servants examined in the same laboratory. Smoking was strongly related to b-carotene in both populations but differences between Czechs and Brits were present in both smokers and non-smokers. In the case-control study among Czech men, low levels of the vitamins were strongly related to an increases risk of MI. Age-adjusted odds ratios for concentrations below the median were 3.33 (95% con®dence interval 1.43±8.33) for b-carotene and 1.89 (0.94±3.45) for a-tocopherol; further adjustment for a range of variables reduced these estimates only slightly. Conclusions: Plasma concentrations of antioxidants in the Czech population appeared to be very low, and men with low levels of these substances are at increased risk of MI. This indicates that sub-optimal intake of antioxidants or related dietary factors may have played a role in the high rates of coronary heart disease in this population. Sponsorship: This study was supported by grants from the Wellcome Trust, Czech Ministry of Health and the British Heart Foundation. MB was a Wellcome Trust fellow in clinical epidemiology.

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Antioxidant state and mortality from coronary heart disease in lithuanian and swedish men: concomitant cross sectional study of men aged 50

Abstract: Objective: To investigate possible risk factors and mechanisms behind the four times higher and diverging mortality from coronary heart disease in Lithuanian compared with Swedish middle aged men.

Cited by 165 publications

References 31 publications

Increased Plasma 7β-Hydroxycholesterol Concentrations in a Population With a High Risk for Cardiovascular Disease

Increased Plasma 7β-Hydroxycholesterol Concentrations in a Population With a High Risk for Cardiovascular Disease

A diet containing rapeseed oil-based fats does not increase lipid peroxidation in humans when compared to a diet rich in saturated fatty acids

Could antioxidants play a role in high rates of coronary heart disease in the Czech Republic?

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