Tocotrienol-Rich Vitamin E from Palm Oil (Tocovid) and Its Effects in Diabetes and Diabetic Nephropathy: A Pilot Phase II Clinical Trial

Tan, Suzanne May Quinn; Yilynn, Chiew; Ahmad, Badariah; Kadir, Khalid Abdul

doi:10.3390/nu10091315

Cited by 44 publications

(44 citation statements)

References 36 publications

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“…Interestingly, a recent clinical trial reported the beneficial effects of supplementation with the poorly-studied tocotrienol-rich vitamin E from palm oil (Tocovid) in DKD patients. Tocotrienols have been shown to have significantly more potent antioxidant properties compared to tocopherol with superior antiglycaemic, anticholesterolaemic, anti-inflammatory, neuroprotective, and cardioprotective properties 53 .…”

Section: Discussionmentioning

confidence: 99%

Serum xanthophyll carotenoids are associated with estimated glomerular filtration rate in an aged cohort

Browne

Williams

Maxwell

et al. 2019

Sci Rep

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Progressive renal decline is associated with increasing oxidative stress. However, the majority of studies have investigated endogenous antioxidants in predominantly advanced stages of kidney disease. Many traditional risk factors associated with renal dysfunction have been linked with cognitive decline as the kidneys and brain share comparable anatomic and haemodynamic characteristics that leave them susceptible to common pathogenic mechanisms. The objective of this study was to examine serum dietary antioxidants and their association with renal function characterised by estimated glomerular filtration rate (eGFR) in a cross-sectional analysis of 570 participants. High performance liquid chromatography quantified serum levels of retinol, α-tocopherol, γ-tocopherol and six carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lutein, lycopene and zeaxanthin) in participants. Multiple regression analyses were used to evaluate associations while adjusting for potential confounders. A sensitivity analysis was performed in cognitively-intact participants only. Serum levels of the xanthophyll carotenoid lutein were positively associated with eGFR in analyses adjusted for age (years), gender, smoking, APOE4 status and Alzheimer’s disease. Retinol was inversely associated with eGFR, although was no longer significant in the smaller sensitivity analysis. Our findings identify significant associations between the xanthophyll carotenoids and eGFR. Further investigations are required to confirm these findings.

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Section: Discussionmentioning

confidence: 99%

Serum xanthophyll carotenoids are associated with estimated glomerular filtration rate in an aged cohort

Browne

Williams

Maxwell

et al. 2019

Sci Rep

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“…Our team previously reported in our interim analysis, that 2 months of high-dose supplementation resulted in a reduction in serum creatinine compared with placebo. 16…”

Section: Methodsmentioning

confidence: 99%

“…15 Tan et al . found that 2 months of supplementation of tocotrienol-rich vitamin E as Tocovid significantly reduced serum creatinine in patients with DN, but not HbA1c, urine albumin:creatinine ratio (UACR), AGE, RAGE, Nε-CML, or Cystatin C. 16…”

Section: Introductionmentioning

confidence: 97%

Tocotrienol-rich vitamin E improves diabetic nephropathy and persists 6–9 months after washout: a phase IIa randomized controlled trial

Tan

Phang

et al. 2019

Therapeutic Advances in Endocrinology

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Chronic hyperglycemia in type 2 diabetes mellitus increases oxidative stress and inflammation which contributes to long-term diabetic kidney disease. Tocotrienol-rich vitamin E, as Tocovid, has been shown to reduce oxidative stress and inflammation to ameliorate diabetes in rat models and human subjects. In this prospective, multicenter, double-blinded, placebo-controlled clinical trial, 54 patients (duration = 18.4 years, HbA1c = 8.8%) with diabetic nephropathy were randomized to receive Tocovid 200 mg or placebo for 12 weeks. Fasting blood samples were taken to measure HbA1c, serum creatinine, estimate glomerular filtration rate (eGFR), urine albumin:creatinine ratio, malondialdehyde, tumor necrosis factor receptor-1, vascular cell adhesion molecule-1 (VCAM-1), and thromboxane-B2. Patients were reassessed 6-9 months post-washout. After 12 weeks of supplementation, Tocovid significantly decreased serum creatinine levels (mean difference: -3.3 ± 12.6 versus 5.4 ± 14.2, p = 0.027) and significantly increase eGFR (mean difference: 1.5 ± 7.6 versus -2.9 ± 8.0, p = 0.045) compared with placebo. There were no significant changes in HbA1c, blood pressure, and other parameters. Subgroup analysis revealed that in patients with low serum vitamin E concentrations at baseline, Tocovid reduced serum creatinine, eGFR, and VCAM-1 significantly. After 6-9 months of washout, persistent difference in serum creatinine remained between groups (mean difference: 0.82 ± 8.33 versus 11.26 ± 15.47, p = 0.031), but not eGFR. Tocovid at 400 mg/day significantly improved renal function in 12 weeks of supplementation, as assessed by serum creatinine and eGFR, which remained significant 6-9 months postwashout.

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“…The beneficial effects of antioxidant supplementation on diabetic nephropathy with micro or macroalbuminuria were demonstrated in the past [25], and recent studies confirmed the potential application of tocotrienols and tocopherols in patients with diabetic nephropathy [26]. In addition, vitamin E supplementation in patients with ESRD and pre-existent cardiovascular disease seems to reduce even the risk of fatal and non-fatal myocardial infarction [27], confirming the concomitant renal and systemic beneficial effects of vitamin E supplementation acting on multiple pathways, such as inflammation, vascular health, and oxidative stress.…”

Section: Diabetic Nephropathy and Vitamin Ementioning

confidence: 99%

Antioxidant, Anti-Inflammatory, and Metabolic Properties of Tocopherols and Tocotrienols: Clinical Implications for Vitamin E Supplementation in Diabetic Kidney Disease

Vincenzo

Tana

et al. 2019

IJMS

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Diabetes mellitus is a metabolic disorder characterized by the development of vascular complications associated with high morbidity and mortality and the consequent relevant costs for the public health systems. Diabetic kidney disease is one of these complications that represent the main cause of end-stage renal disease in Western countries. Hyperglycemia, inflammation, and oxidative stress contribute to its physiopathology, and several investigations have been performed to evaluate the role of antioxidant supplementation as a complementary approach for the prevention and control of diabetes and associated disturbances. Vitamin E compounds, including different types of tocopherols and tocotrienols, have been considered as a treatment to tackle major cardiovascular outcomes in diabetic subjects, but often with conflicting or even negative results. However, their effects on diabetic nephropathy are even less clear, despite several intervention studies that showed the improvement of renal parameters after supplementation in patients with diabetic kidney disease. Then we performed a review of the literature about the role of vitamin E supplementation on diabetic nephropathy, also describing the underlying antioxidant, anti-inflammatory, and metabolic mechanisms to evaluate the possible use of tocopherols and tocotrienols in clinical practice.

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Tocotrienol-Rich Vitamin E from Palm Oil (Tocovid) and Its Effects in Diabetes and Diabetic Nephropathy: A Pilot Phase II Clinical Trial

Cited by 44 publications

References 36 publications

Serum xanthophyll carotenoids are associated with estimated glomerular filtration rate in an aged cohort

Serum xanthophyll carotenoids are associated with estimated glomerular filtration rate in an aged cohort

Tocotrienol-rich vitamin E improves diabetic nephropathy and persists 6–9 months after washout: a phase IIa randomized controlled trial

Antioxidant, Anti-Inflammatory, and Metabolic Properties of Tocopherols and Tocotrienols: Clinical Implications for Vitamin E Supplementation in Diabetic Kidney Disease

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