Improved glucose metabolism in mice lacking α-tocopherol transfer protein

Background Conflicting evidence suggests a possible role for vitamin E in mammalian glucose metabolism and the protection from type 2 diabetes. The alpha-tocopherol transfer protein (α-TTP) mediates the transfer of α-tocopherol (α-TOH) from hepatocytes to very-low-density lipoproteins, thereby controlling plasma levels of α-TOH. Aim of the study The aim of this study was to investigate the putative impact of α-TTP knock-out on glucose metabolism in mice. Methods Mice deficient for α-TTP and wild-type control littermates were fed a diet containing 200 mg α-tocopheryl acetate per kg to ameliorate α-TOH deficiency in knock-out mice. We investigated fasting and postprandial plasma glucose, insulin and triglyceride levels of both groups of mice at different ages. All genotypes and age groups were further subjected to glucose and insulin tolerance tests, and number of insulin-producing islets of Langerhans were determined. Results Plasma α-TOH levels of knock-out mice were 34% the levels of wild-type controls: Any signs of α-TOH deficiency were absent at any age. Unexpectedly, serum glucose levels both in the fasted and in the fed state were lower in α-TTP-deficient mice at any age. Removal rates for intraperitoneally injected glucose were found to be significantly increased in young α-TTP-deficient mice. This improved glucose tolerance was caused by increased insulin secretion in response to an intraperitoneal glucose challenge due to an increased number of pancreatic islets, as well as by increased sensitivity to intraperitoneally injected insulin, both significantly promoting glucose metabolism in α-TTP-deficient mice. Conclusions Our findings suggest that α-TTP-deficiency in states of α-TOH supplementation unexpectedly promotes glucose tolerance in mice due to both increased insulin secretion and insulin action, suggesting differential roles of α-TTP and α-TOH in the pathogenesis of type 2 diabetes mellitus. Marc Birringer and Doreen Kuhlow have contributed equally to this publication.     

Establishment of a Risk Prediction Model for Mild Cognitive Impairment Among Elderly Chinese

Mild cognitive impairment (MCI) is a transitional stage of cognitive function between normal aging and dementia. Substantial variations in the prevalence of MCI in different countries have been studied including China. In this study, we established a prediction system to assess the risk of MCI among the elderly in China. The Rothman-Keller model was conducted on the basis of the risk factors of MCI obtained by the combined results of a meta-analysis. The accuracy of the model was verified using actual population data. A total of 1826 subjects as a verification set were enrolled in this study in February 2019. There were statistically significant differences in the combined results of 10 risk factors including hypertension, diabetes, educational level, hyperlipidemia, smoking, physical exercise, living alone, stroke, drinking and heart disease (P<0.05). The area under the curve (AUC) of the actual data and the predictive results of this model was 0.859 (95%CI: 0.812–0.906, P<0.05), the sensitivity was 86.6% and the specificity was 76.5%. This model performs an effective prediction that may be applied to the primary prevention for patients with MCI, helping to reduce the risk of MCI.     

2型糖尿病患者自我管理行为与认知功能各维度的关系研究

目的 探讨2型糖尿病(type 2 diabetic mellitus,T2DM)患者认知功能现状及其与自我管理行为之间的相关性。 方法 选取2016年1-10月合肥市某三甲医院内分泌科住院的149例T2DM患者为研究对象,采用一般资料调查表、长沙版蒙特利尔认知评估量表和糖尿病自我管理活动问卷进行调查,应用t检验、 χ²检验及多因素logistic回归分析T2DM患者轻度认知损害(mild cognitive impairment,MCI)患病现状、影响因素及自我管理行为与认知功能各维度的关系。 结果 T2DM患者MCI的患病率为40.94%,年龄、合并脑梗塞是MCI的危险因素(OR=4.38、5.25),受教育程度、喝茶和自我管理行为是MCI的保护因素(OR=0.52、0.29、0.03)。自我管理行为中饮食正向预测视空间/执行、命名、注意功能和认知功能总分(β=0.16、0.20、0.29、0.12),运动正向预测定向功能(β=0.25),遵医嘱服药正向预测视空间/执行、延迟记忆和定向功能(β=0.13、0.16、0.15)。 结论 T2DM患者自我管理行为与认知功能之间存在相关性,临床医护工作者可通过对T2DM患者自我管理行为进行针对性地预防、干预,延缓T2DM患者MCI的发生、进展。     

Association between vitamin A,vitamin E and apolipoprotein E status with mild cognitive impairment among elderly people in low-cost residential areas

Abstract

Rationale

The influence of nutritional parameters and genetic susceptibility on poor cognitive impairment has been documented; however, the association between lipid-soluble vitamins with genetic susceptibility on mild cognitive impairment (MCI) has not yet been studied extensively.

Objectives

The aim of the present study was (i) to determine the prevalence of MCI and its associated risk factors and (2) to investigate the influence of the apolipoprotein E (APOE) ?4 allele on peripheral vitamin A and E concentration in MCI and non-MCI groups.

Methods

A total of 333 subjects aged 60 years and above, residing in public housing areas in Kuala Lumpur, Malaysia were interviewed to obtain information on their neuropsychological status. Fasting venous blood was taken for determination of vitamin A and vitamin E concentration using high-performance liquid chromatography. Restriction fragment length polymorphism analysis was performed to determine the APOE genotypes.

Results

The prevalence of MCI was 21.1%. Binary logistic regression indicated that the predictors of MCI were being married, overweight or obesity, and had vitamin A deficiency. In non-MCI subjects, vitamin E levels were lower among APOE?4 allele carriers as compared to the non-carriers (P < 0.05).

Conclusion

The study highlighted the importance of maintaining good nutritional status and vitamin A status for optimal cognitive function. The presence of APOE?4 allele has a prominent role in affecting vitamin E levels, particularly among cognitively healthy elderly in our unique population.     

2型糖尿病中老年住院患者轻度认知障碍与载脂蛋白E基因多态性的关系

目的探讨2型糖尿病（T2DM）中老年住院患者轻度认知功能障碍（MCI）与载脂蛋白E（ApoE）基因多态性的关系。方法采用蒙特利尔认知评估（MoCA）量表和日常生活能力评定（ADL）量表对研究对象的认知功能进行评定,共纳入T2DM患者218例,其中合并MCI患者114例（T2DM合并MCI组）,认知功能正常患者104例,以糖耐量正常、认知功能正常的119例健康者为正常对照组。采用等位基因特异性多重（multi—ARMS）聚合酶链反应（PCR）技术检测研究对象的ApoE基因型。分析各组等位基因及基因型频率分布特点并比较MoCA评分结果。结果T2DM合并MCI患者的E4／X基因型（包括基因型e3／4和e4／4）频率（37．0％）、￡4等位基因频率（24．6％）均高于患T2DM且认知功能正常患者（分别为19．8％、12．0％）及正常对照组（分别为16．4％、10．1％）,差异均有统计学意义（P〈0．05）。携带84等位基因的T2DM患者MoCA测试中视空间与执行能力、注意力与计算力、抽象和定向评分均低于未携带￡4等位基因的T2DM患者,差异均有统计学意义（P〈0.05）。结论ApoE基因多态性与T2DM合并MCI有关,S4等位基因可能是T2DM合并MCI的危险因素。     

载脂蛋白E基因多态性与2型糖尿病患者轻度认知功能障碍的相关性研究

目的探讨载脂蛋白E（ApoE）基因多态性与2型糖尿病（T2DM）患者轻度认知功能障碍（MCI）的相关性及T2DM合并MCI的相关危险因素。方法选择T2DM合并MCI患者40例,T2DM非MCI患者80例,应用聚合酶链式反应-限制性片段长度多态性（PCR—RFLP）方法检测ApoE的基因多态性,依据病程、血糖、血脂、体重指数等临床资料,进行非条件logistie回归分析T2DM合并MCI的独立危险因素。结果ApoE￡。等位基因的频率在T2DMMCI组高于非MCI组（25．0％vs10．0％）,差异有统计学意义（P〈0．01）。T2DM合并MCI组与非MCI组差异有统计学意义的指标：年龄、病程、餐后2h血糖、糖化血红蛋白、体重指数、糖尿病家族史、高血压、糖尿病视网膜病变、糖尿病周围神经病变、ApoE基因,其中独立危险因素有糖尿病视网膜病变（OR=3．452,P〈0．05）、周围神经病变（OR=3．252,P〈0．05）、ApoE基因（OR=2．441,P〈0．01）、糖化血红蛋白（OR=1．372,P〈0．05）、餐后2h血糖（OR=1．194,P〈0．05）、年龄（OR=1．194,P〈0．01）、病程（OR=1．142,P〈0．05）。结论ApoE8。等位基因与T2DM合并MCI明显相关,糖尿病患者的年龄、病程、血糖控制和微血管并发症均与认知功能明显相关。     

Vitamin A and β-carotene supply of women with gemini or short birth intervals

Background An adequate supply of vitamin A during pregnancy and breastfeeding plays an important role for development of foetus and neonate, especially in lung development and function. Aim of the study Aim of this pilot study was to analyze vitamin A and β-carotene status and to investigate the contribution of nutrition to the vitamin A and β-carotene supply in mother–infant pairs of gemini or births within short birth intervals. Methods Twenty-nine volunteers aged between 21 and 36 years were evaluated for 48 h after delivery. During this time frame a food frequency protocol considering 3 months retrospective was obtained from all participants. In order to establish overall supply retinol and β-carotene levels were determined in maternal plasma, cord blood and colostrum via HPLC analysis. Results Regardless of the high to moderate socio-economic background, 27.6% of participants showed plasma retinol levels below 1.4 μmol/l which can be taken as borderline deficiency. In addition, 46.4% showed retinol intake <66% of RDA and 50.0% did not consume liver at all although liver contributes as a main source for preformed retinol. Despite high total carotenoid intake of 6.9 ± 3.6 mg/d, 20.7% of mothers showed plasma levels <0.5 μmol/l β-carotene. Retinol and β-carotene levels were highly significantly correlated between maternal plasma versus cord blood and colostrum. In addition, significantly lower levels were found in cord blood (31.2 ± 13.0% (retinol), 4.1 ± 1.4% (β-carotene) compared with maternal plasma. Conclusions Despite the fact that vitamin A and β-carotene rich food is generally available, risk groups for low vitamin A supply exist in the western world.     

Bioavailability of vitamins A and E from whole and vitamin-fortified milks in control subjects

Background Dairy products fortified with vitamins and minerals represent a growing market that is of interest to those sectors of the population with unbalanced diets and increased needs. However, there is little information on the bioavailability of micronutrients in milk products at dietary intake levels. Aim of the study To evaluate the bioavailability of vitamins A and E in whole milk and fortified whole and skimmed milk in control subjects. Methods A single-dose bioavailability study was performed using three commercially available milks (unfortified whole milk and whole and skimmed milk fortified with vitamins A and E). Nineteen volunteers (10 women and 9 men) ingested 430 ml of each milk on different days. The contents of retinol and α-tocopherol provided in the milks and the retinyl esters and α-tocopherol in triglyceride-rich lipoprotein fractions (TRL) from plasma collected for 6.5 h postprandially were assayed using a quality-controlled HPLC method. The relative absorption of vitamins A and E from milks was calculated on the basis of area under the curve (AUC) versus time curve estimations, adjusted for plasma volume and expressed as percentage of the amount of nutrient provided. Results The total amounts of retinol and α-tocopherol provided ranged between 0.48 and 4.15 μmol and 0.41 and 32.49 μmol, respectively. The AUC value of retinyl palmitate in TRL was higher for fortified whole milk than for the other two milks (unfortified whole and fortified skimmed milk). The percent relative absorption of vitamin A did not differ among the three types of milk. The AUC for α-tocopherol was no different after the ingestion of any of these milks. Conclusion The mean percentage of retinol absorption was apparently similar for the three types of milk, regardless of the amount of fat ingested with each type of milk and the vitamin A provided.     

Relationship between dietary intake, antioxidant status and smoking habits in female Austrian smokers

Summary Background Previous studies have shown that cigarette smoke contains many oxidants and free radicals, which can increase lipid peroxidation. Aim of the study The association between smoking, food pattern, especially vitamin intake and plasma concentrations of important antioxidants, as well as lipid peroxidation products was assessed in this cross-sectional study. Subjects and methods Sixty Austrian women aged 18–40 y were enrolled in the study. Twenty-nine women were allocated to the smoking group; thirty-one women served as nonsmoking controls. Plasma concentrations of α- and γ-tocopherol, α- and β-carotene, lycopene, cryptoxanthin, retinol, ascorbate and malondialdehyde were determined by HPLC; dietary intake and food pattern had been assessed by four 24-h dietary intake recalls and one food frequency questionnaire. Results Generally, food intake patterns were not different between smoking and nonsmoking women. But, a significantly higher intake of alcohol was observed in the smoking group (P < 0.05). Plasma ascorbic acid concentration of the smoking group did not differ from the nonsmoking women. Despite the increased utilization because of the oxidative stress in smokers, this result might be explained by the high dietary intake of vitamin C in our smoking group. Significantly lower plasma concentrations of α-, β-carotene and lycopene have been partly ascribed to the enhanced metabolic turnover resulting from smoking-induced oxidative stress. Our results confirm that smoking had no effects on plasma tocopherol and plasma retinol concentrations. Conclusions The poor supply with the carotenoids α-, β-carotene and lycopene may result from the increased metabolism of antioxidants caused by oxidative stress and may be responsible for significantly higher levels of lipid peroxidation products in smokers compared to nonsmokers (P < 0.05). Received: 17 August 2000 / Accepted: 2 May 2001     

Association between diabetes mellitus and hypertension with anthropometric indicators in older adults: Results of the Mexican Health Survey, 2000

Objective: To determine the association between anthropometric indicators of adiposity with type 2 diabetes mellitus (T2DM) and hypertension (HTN) in older adults.Design: Cross-sectional study of participants of the Mexican Health Survey 2000 (MHS).Setting: Mexico, subjects recruited from the general community.Participants: The analytic sample included 7,322 adults who were ≥60 years of age at the time of the survey. T2DM data were available on 6,994 individuals, who represent 95.5% of the original sample; data on HTN was available on 6,268 subjects, which accounted for 86.5% of the original sample.Measurements: Type 2 diabetes mellitus and hypertension, as well as anthropometric indicators including body mass index (BMI), waist circumference (WC), and conicity index (CI).Results: The prevalence of T2DM and HTN in this age group was 34.3% and 73.9%, respectively. After adjusting for other variables, the association between high WC and T2DM (OR=1.59 95%CI=1.26-2.01, P < 0.001) was stronger than the association with overweight (OR=1.26, 95%CI= 1.01–1.58, P=0.04) and obesity (OR=1.38, 95%CI= 1.08–1.79, P< 0.01) using BMI, and slightly higher than tertile 2 of the CI (OR=1.49, 95%CI=1.20–1.88, P< 0.01), while tertile 3 showed a stronger association with T2DM (OR=1.60, 95%CI=1.22–2.08, P< 0.001). However, the association between obesity and HTN measured by BMI (OR=1.98, 95%CI=1.48–2.65, P< 0.001) was stronger than what was observed with overweight (OR=1.42, 95%CI 1.13–1.77, P< 0.01), with high WC (OR=1.62, 95%CI=1.25–2.10, P< 0.001) and tertiles 2 and 3 of the CI (OR=1.23, 95%CI=0.99–1.55, P= 0.09); (OR=1.53, 95%CI= 1.16–2.03, P< 0.01) respectively.Conclusions: BMI and abdominal obesity are significantly and independently associated with an increase in the prevalence of T2DM and HTN among older Mexican adults.     

Visceral Fat Accumulation is Associated with Mild Cognitive Impairment in Community-Dwelling Older Japanese Women

Visceral fat accumulation is detrimental for brain health and is associated with cognitive impairment in older adults. The objectives of the present study were to examine the association between visceral fat accumulation and prevalence of mild cognitive impairment and its subtypes. Design: a cross-sectional study. This study enrolled 6,109 community-dwelling older adults, including 3,434 women (mean age: 74.4 years) and 2,675 men (mean age: 74.3 years). Individuals with dementia, Parkinson’s disease, stroke, Mini-Mental State Examination scores ≤23, and who could not perform basic activities of daily living independently were excluded. Participants underwent neurocognitive assessments to assess mild cognitive impairment (MCI) and its subtypes. Visceral fat area (VFA) was measured using abdominal bioelectrical impedance analysis. Participants were divided into quartile groups by VFA. There were 731 (21.3%) women and 562 (21.0%) men with MCI, and the median VFA values were 63.3 cm2 and 96.3 cm2, respectively. Women participants in the second (adjusted odds ratios [aOR], 0.71; 95% confidence interval [95% CI], 0.54–0.94), third (aOR, 0.66; 95% CI, 0.47–0.92), and fourth quartiles of VFA (aOR, 0.62; 95% CI, 0.41–0.93) had a significantly lower risk of MCI than those in the first quartile. Higher VFA quartiles in women were associated with lower risk of non-amnestic MCI. There were no significant differences in men between quartiles. Visceral fat accumulation was associated with MCI, especially non-amnestic MCI, in community-dwelling older Japanese women. These results suggest that visceral fat accumulation is partially protective against cognitive impairment.     

Role of MAPK in apolipoprotein CIII-induced apoptosis in INS-1E cells

Background  

Individuals with type 2 diabetes mellitus (T2DM) have elevated levels of circulating apolipoprotein CIII (apoCIII). ApoCIII plays an important role for plasma triglyceride levels and elevated levels of the apolipoprotein have been connected with dyslipidemia in T2DM subjects. In addition, apoCIII has been linked to enhanced β-cell apoptosis. The present study was undertaken to investigate apoptotic mechanisms induced by the apolipoprotein.     

Red palm oil in the maternal diet increases provitamin A carotenoids in breastmilk and serum of the mother-infant dyad

Background Despite vitamin A supplementation programs, vitamin A deficiency in children remains a public health concern in Honduras. Aim of the study We investigated the effectiveness of short-term dietary supplementation of mothers with red palm oil as a strategy for improving the vitamin A status of the mother-infant dyad. Methods Lactating mothers in Colonia Los Pinos, a barrio of Tegucigalpa, Honduras, consumed a total of 90-mg β-carotene as red palm oil (n = 32) supplements (n = 36) or placebo (n = 18) in six equal doses over 10 days. Carotenoids and retinol in maternal and infant serum, and breastmilk carotenoids and retinol were measured before and after supplementation. Maternal diet was evaluated by 24-hour recall. Results Maternal serum α-carotene and β-carotene concentrations were increased 2 fold by palm oil compared with 1.2 fold by β-carotene supplements. Changes were significantly different in infant serum α-carotene but not β-carotene among the three experimental groups. Increases in breastmilk β-carotene were greater for the palm oil group (2.5 fold) than for the β-carotene supplement group (1.6 fold) and increases in milk α-carotene concentrations (3.2 fold) were slightly greater than those of β-carotene. There were also small but significant changes among groups in breastmilk lutein and lycopene. Breastmilk retinol was not significantly different among the groups over the treatment period. Conclusions Red palm oil in the maternal diet increases provitamin A carotenoids in breastmilk and serum of the mother-infant dyad. The use of dietary red palm oil to improve the vitamin A status of this population should be further investigated. Received: 24 August 2000, Accepted: 12 January 2001     

Association of passive and active smoking with incident type 2 diabetes mellitus in the elderly population: the KORA S4/F4 cohort study

Active smoking is a risk factor for type 2 diabetes (T2DM), but it is unclear whether exposure to environmental tobacco smoke (ETS) is also associated with T2DM. The effect of passive and active smoking on the 7-year T2DM incidence was investigated in a population-based cohort in Southern Germany (KORA S4/F4; 1,223 subjects aged 55–74 years at baseline in 1999–2001, 887 subjects at follow-up). Incident diabetes was identified by oral glucose tolerance tests or by validated physician diagnoses. Among never smokers, subjects exposed to ETS had an increased diabetes risk in the total sample (odds ratio (OR) = 2.5; 95% confidence interval (CI): 1.1, 5.6) and in a subgroup of subjects having prediabetes at baseline (OR = 4.4; 95% CI: 1.5, 13.4) after adjusting for age, sex, parental diabetes, socioeconomic status, and lifestyle factors. Active smoking also had a statistically significant effect on diabetes incidence in the total sample (OR = 2.8; 95% CI: 1.3, 6.1) and in prediabetic subjects (OR = 7.8; 95% CI: 2.4, 25.7). Additional adjustment for components of the metabolic syndrome including waist circumference did not attenuate any of these associations. This study provides evidence that both passive and active smoking is associated with T2DM.     

Different components of nutritional status in older inpatients with cognitive impairment

Objectives

To evaluate different components of nutritional status in older patients with cognitive deficit, particularly in those with mild cognitive impairment (MCI).

Design

Cross-sectional study.

Setting and participants

560 elderly subjects aged ?? 65 years consecutively admitted to an acute Geriatric Unit of Apulia region of southern Italy.

Measurements

A standardized comprehensive geriatric assessment was used to evaluate medical, cognitive, affective and social aspects. Nutritional status was assessed using the mini nutritional assessment (MNA). The cognitive function was categorized into three levels ?? MCI, dementia or normal cognition (NoCI) ?? according to the neuropsychological test score.

Results

Subjects with cognitive decline had significantly lower frequency of well-nourished (MCI=10%, dementia=8%, NoCI=22%, p<0.05) and higher frequency of malnourished (MCI=47%, dementia=62%, NoCI=19%, p<0.001) than patients with normal cognition. Similarly, MNA total score, MNA-3 and MNA-4 subscores were significantly lower in patients with MCI and dementia than patients with normal cognition (p<0.001).

Conclusions

These results suggest that cognitive decline may be associated with malnutrition in this sample of hospitalized older patients. Dietary habits (MNA-3) and subjective assessment of self-perceived quality of health and nutrition (MNA-4) are particularly poor also in patients with MCI and could be. very important variables to be considered in the multidimensional evaluation of subjects with cognitive impairment.     

Sperm DNA damage correlates with polycyclic aromatic hydrocarbons biomarker in coke-oven workers

Objectives: The aim was to determine whether occupational exposure to polycyclic aromatic hydrocarbons (PAHs) in men has adverse effect on semen quality. Methods: Forty-eight coke-oven workers, including 16 topside-oven (TO) workers and 32 sideoven (SO) workers, were studied. Ambient PAHs exposure, urinary 1-hydroxypyrene (1-OHP) levels, and parameters of semen quality were determined. Results: TO workers had significantly higher ambient PAHs exposure (3,436.1±3,411.0 vs. 1,123.1±1,829.3 ng/m³, P<0.01), urinary 1-OHP levels (207.8±176.4 vs. 54.0±44.8 μg/g, P<0.001), frequency of oligospermia (18.8 vs. 0%, P<0.05), and morphological abnormality in sperm (32.3 vs. 14.6%, P<0.01) than SO workers. Among cigarette smokers, TO workers had significantly higher rates of DNA denaturation in spermatozoa (αT) and percentage of sperm with increased DNA denaturation (COMP αT) levels than SO workers (246.2±49.5 vs. 198.1±30.3 for αT; 34.8±14.4 vs. 19.3±13.9% for COMP αT, P<0.05). There was a positive correlation between urinary 1-OHP and αT, COMP αT, and abnormal sperm morphology and a tenfold increase in urinary 1-OHP associated with a 2.35-fold increase in αT, as well as a 1.07-fold increase in percentage of sperm with abnormal morphology. Conclusions: A potential risk of sperm dysfunction should be considered for workers occupationally exposed to high levels of PAHs. Cigarette smoking may aggravate this risk. Urinary 1-OHP can be used as a biomarker predicting sperm dysfunction.     

The relationship between reduced vitamin antioxidant concentrations and the systemic inflammatory response in patients with common solid tumours

BACKGROUND AND AIMS: The majority of patients with advanced cancer have reduced circulating concentrations of the vitamin antioxidants including retinol, alpha-tocopherol and carotenoids. However, the basis of this reduction is not known. Vitamin antioxidant concentrations have been reported to be correlated with a systemic inflammatory response (as evidenced by C-reactive protein) in normal subjects and in patients with lung cancer. In order to determine whether this relationship was independent of tumour type patients other common solid tumours were studied. METHODS: Fasting circulating concentrations of vitamin antioxidants and C-reactive protein were measured in normal subjects (n=30) and patients with breast (n=15), prostate (n=15) and colorectal cancer (n=11). RESULTS: Concentrations of C-reactive protein were higher (P<0.0001) and vitamin antioxidants lower (P<0.0001) in the cancer patients. In normal subjects and cancer patients, C-reactive protein concentrations were inversely correlated with circulating concentrations of retinol (r(2)=0.162), alpha-tocopherol (r(2)=0.297), lutein (r(2)=0.256), lycopene (r(2)=-0.171), alpha-(r(2)=0.140) and beta-carotene (r(2)=0.254): (all P<0.001). CONCLUSIONS: Concentrations of retinol, alpha -tocopherol and carotenoids are inversely associated with the magnitude of the systemic inflammatory response. These relationships appear to be independent of the presence and type of cancer.     

Plasma tocopherols and risk of cognitive impairment in an elderly Italian cohort

BACKGROUND: Evidence that vitamin E may preserve cognitive function in elderly subjects is conflicting. The most abundant and most investigated form of vitamin E in humans is alpha-tocopherol, but other antioxidant tocopherols (beta, gamma, and delta) exist in nature. OBJECTIVE: We aimed to investigate plasma concentrations of the natural tocopherols and the tocopherol oxidation markers alpha-tocopherylquinone (alphaTQ) and 5-nitro-gamma-tocopherol (5NGT) in relation to cognitive function in the elderly. DESIGN: Baseline plasma tocopherols and their oxidation markers were measured in 761 elderly Italian subjects from a population-based cohort assessed in 1999-2000 for mild cognitive impairment (MCI) and dementia. In 2003-2004, information about cognitive status was collected for 615 of the 666 subjects without baseline cognitive impairment. Tocopherols and oxidation markers were analyzed as plasma absolute values divided by serum total cholesterol because lipids affect their blood availability. Analyses were adjusted for sociodemographic, genetic, lifestyle, and medical confounders. RESULTS: Compared with the corresponding lowest tertile, the risk of prevalent dementia was higher for the highest tertile of delta-tocopherol/cholesterol [odds ratio (OR): 3.87; 95% CI: 1.46, 10.27] and alphaTQ/cholesterol (4.02; 1.45, 11.14), but the risk of incident dementia was not directly associated with plasma vitamin E metabolites. A U-shaped association, with lower risk for intermediate tertiles, was found for prevalent MCI with 5NGT/cholesterol (0.39; 0.17, 0.91) and for incident dementia with gamma-tocopherol/cholesterol (hazard ratio: 0.42; 95% CI: 0.22, 0.84). CONCLUSIONS: Plasma concentrations of some non-alpha-tocopherol forms of vitamin E are associated with cognitive impairment in elderly people. However, the associations depend on concurrent cholesterol concentration and need further investigation.     

Associations Between the Dietary Inflammatory Index,Brain Volume,Small Vessel Disease,and Global Cognitive Function

BackgroundAn inflammatory diet is related to poorer cognition, but the underlying brain pathways are unknown.ObjectiveThe aim of this study was to examine associations between the Energy-Adjusted Dietary Inflammatory Index (E-DII) and brain volume, small vessel disease, and cognition in people with and without type 2 diabetes mellitus (T2DM).DesignThis is a secondary cross-sectional analysis of data from the Cognition and Diabetes in Older Tasmanians study.Participants/settingsThis study included 641 participants (n = 326 with T2DM) enrolled between 2005 and 2011 from Tasmania, Australia.Main outcome measuresThe E-DII was computed from the 80-item Dietary Questionnaire for Epidemiological Studies, version 2. Brain volumes (gray matter, white matter, and white matter hyperintensities), infarcts, and microbleeds were obtained from magnetic resonance imaging. Global cognition was derived from a comprehensive battery of neuropsychological tests.Statistical analysisLogistic and linear regressions were performed to examine associations between E-DII and brain measures and a global cognitive score, adjusting for demographics, energy, T2DM, mood, ambulatory activity, and cardiovascular risk factors. An E-DII × T2DM interaction term was tested in each model.ResultsThe mean (standard deviation) age of participants was 69.8 (7.4) years. There were no associations between the E-DII and any of the brain structural measures or global cognitive function in fully adjusted models. There was a modification effect for T2DM on the association between E-DII and gray matter volume (T2DM: β = 1.38, 95% CI –3.03 to 5.79; without T2DM: β = –4.34, 95% CI, –8.52 to –0.16), but not with any of the other outcome measures.ConclusionsIn this cross-sectional study, E-DII was not associated with brain structure or global cognition. In 1 of the 7 outcomes, a significant modification effect for T2DM was found for the associations between E-DII and gray matter. Future prospective studies are needed to clarify the associations between diet-related inflammation and brain health.     

Elevated vitamin A intake and serum retinol in preadolescent children with cystic fibrosis

BACKGROUND: Persons with cystic fibrosis (CF) and pancreatic insufficiency (PI) are at risk of vitamin A deficiency because of steatorrhea, despite pancreatic enzyme replacement. Long-standing vitamin A supplementation may increase the risk of vitamin A toxicity. OBJECTIVE: The aim was to describe the vitamin A intake and serum retinol concentrations of preadolescent children with CF, PI, and mild-to-moderate pulmonary disease, who were cared for under current practice recommendations. DESIGN: This cross-sectional study evaluated children aged 8.0-11.9 y with CF and PI from 13 US CF centers. Dietary and supplemental vitamin A intakes were compared with the Dietary Reference Intakes (DRIs) for healthy children, CF recommendations, and data from the National Health and Nutrition Examination Survey (NHANES), 1999-2000. Serum retinol concentrations were compared with NHANES data. RESULTS: The 73 subjects with CF had a dietary vitamin A intake of 816 +/- 336 microg retinol activity equivalents (165 +/- 69% of the recommended dietary allowance), which was similar to the NHANES value. The supplement intake provided 2234 +/- 1574 microg retinol activity equivalents/d and exceeded recommendations in 21% of the subjects with CF. Total preformed retinol intake exceeded the DRI tolerable upper intake level in 78% of the subjects with CF. The serum retinol concentration was 52 +/- 13 microg/dL (range: 26-98 microg/dL), which was significantly higher than the NHANES value (37 +/- 10 microg/dL; range: 17-63 microg/dL; P < 0.001). CONCLUSION: Although supplementation helps to prevent vitamin A deficiency in children with CF and PI, their high vitamin A intakes and serum retinol concentrations suggest that usual care may result in excessive vitamin A intake and possible toxicity that would increase the risk of CF-associated liver and bone complications.