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Ann Epidemiol. 1993 May. 3(3). P 225-34 This intervention trial carried out in
Uzbekistan (former USSR) in an area with a high
incidence of oral and esophageal cancer involved
random allocation of 532 men, 50 to 69 years old,
with oral leukoplakia and/or chronic esophagitis to
one of four arms in a double-blind, two-by-two
factorial design, with active arms defined by the
administration of (a) riboflavin; (b) a combination
of retinol, beta-carotene, and vitamin E; or (c)
both. Weekly doses were 100,000 IU of retinol, 80
mg of vitamin E, and 80 mg of riboflavin. The dose
of beta-carotene was 40 mg/d. Men in the trial were
followed for 20 months after randomization. The aim
of the trial was to determine whether treatment
with these vitamins or their combination could
affect the prevalence of oral leukoplakia and/or
protect against progression of oral leukoplakia and
esophagitis, conditions considered to be precursors
of cancer of the mouth and esophagus. A significant
decrease in the prevalence odds ratio (OR) of oral
leukoplakia was observed after 6 months of
treatment in men receiving retinol, beta-carotene,
and vitamin E (OR = 0.62; 95% confidence interval
(CI): 0.39 to 0.98). After 20 months of treatment,
no effect of vitamin supplementation was seen when
the changes in chronic esophagitis were compared in
the four different treatment groups, although the
risk of progression of chronic esophagitis was
lower in the subjects allocated to receive retinol,
beta-carotene and vitamin E (OR = 0.65; 95% CI:
0.29 to 1.48) A secondary analysis not based on the
randomized design revealed a decrease in the
prevalence of oral leukoplakia in men with medium
(OR = 0.45; 95% CI: 0.21 to 0.96) and high (OR =
0.59; 95% CI: 0.29 to 1.20) blood concentrations of
beta-carotene after 20 months of treatment. Risk of
progression of chronic esophagitis was also lower
in men with a high blood concentration of
beta-carotene, odds ratios being 0.30 (95% CI: 0.10
to 0.89) and 0.49 (95% CI: 0.15 to 1.58) for medium
and high levels, respectively. A decrease in risk,
also statistically not significant, was observed
for high vitamin E levels (OR = 0.39; 95% CI: 0.14
to 1.10). These results were based on levels of
vitamins in blood drawn after 20 months of
treatment.
Vopr Med Khim (RUSSIA) Sep-Oct 1993, 39 (5)
p33-6 In 35 children of 9-13 years old with
insulin-dependent diabetes mellitus distinct
alterations in metabolism of vitamin B2 were
detected, which were manifested as elevated rate of
riboflavin excretion with urine and a decrease in
the vitamin content in erythrocytes, as 1.5-fold
increase in activity of erythrocyte glutathione
reductase and augmented affinity of erythrocyte
glutathione reductase to exogenous FAD. Alterations
in metabolism of riboflavin did not involve the
vitamin deficiency as shown by analysis of vitamins
B6 and PP (4-pyridoxic acid and I-methyl
nicotinamide, respectively) excretion with urine as
well as by study of the coenzymes content in blood
of healthy and sick children with various rates of
riboflavin consumption. Rates of 4-pyridoxic acid
and I-methyl nicotinamide excretion with urine were
similar both in healthy children of 9-13 years and
in children of this age with diabetes mellitus. The
data obtained suggest that rates of riboflavin
consumption in patients with diabetes mellitus
differed from those of healthy persons; these
reasons should be taken into consideration in
evaluation of vitamins B2 consumption in patients
with diabetes mellitus.
Int J Vitam Nutr Res (SWITZERLAND) 1993, 63 (2)
p140-4 Changes in circulating and tissue concentrations
of several vitamins have been reported in diabetic
animals and human subjects. In this study, the
effect of short-term (2 weeks) streptozotocin
diabetes on folate, B6, B12, thiamin, nicotinate,
pantothenate, riboflavin and biotin in liver,
kidney, pancreas, heart, brain and skeletal muscle
of rats was investigated. The tissue distribution
of vitamins varied widely in normal rats. Diabetes
significantly lowered folate in kidney, heart,
brain, and muscle; B6 in brain; B12 in heart;
thiamin in liver and heart; nicotinate in liver,
kidney, heart and brain; pantothenate in all
tissues; riboflavin in liver, kidney, heart, and
muscle. These results indicate that experimental
diabetes causes a depression of several
water-soluble vitamins in various tissues of rats.
Z Ernahrungswiss (GERMANY, WEST) Mar 1980, 19
(1) p1-13 Investigations on the vitamin pattern of
diabetic neuropathy: thiamine, riboflavin,
pyridoxine, cobalamin and tocopherol. The contents
of the vitamins mentioned above have been measured
in the blood of 119 patients (53 diabetic
neuropathies, 66 diabetics without neuropathy). The
incidence of neuropathy shows a strong correlation
with the duration of the diabetic state, but not
with sex, nor with concomitant diseases such as
adipositas, hypertension, heart and circulatory
diseases, except retinopathia diabetica. Most of
the diabetics in our study are well supplied with
vitamins B1, B2, and E; B6 and B12 are occasionally
low, but there is no statistically relevant
difference between diabetic controls and
neuropathies. Adipose patients have neither a
markedly different vitamin content nor a different
calory uptake from non-adipose patients. A general
trend towards reduced total calory uptake is seen
in old age, men (lower protein intake) and women
(lower carbohydrate intake) obviously differing
somewhat in their habits. The influence of therapy
on the vitamin pattern is not clear cut, except for
patients under diet and biguanide-therapy showing a
higher proportion of low or subnormal B12 values.
The increased frequency of neuropathies in patients
treated with sulfonyl-urea approaches only the
limits of significance and needs further
investigations.
Nutrition Research (USA), 1996, 16/7 (1251-1266) Dietary factors can play a crucial role in the
development of atherosclerosis. High fat, high
calorie diets are well known risk factors for this
disease. In addition, there is strong evidence that
dietary animal proteins also can contribute to the
development of atherosclerosis. Atherogenic effects
of animal proteins are related, at least in part,
to high levels of methionine in these proteins. An
excess of dietary methionine may induce
atherosclerosis by increasing plasma lipid levels
and/or by contributing to endothelial cell injury
or dysfunction. In addition, methionine imbalance
elevates plasma/tissue homocysteine which may
induce oxidative stress and injury to endothelial
cells. Methionine and homocysteine metabolism is
regulated by the cellular content of vitamins B6,
B12, riboflavin and folic acid. Therefore,
deficiencies of these vitamins may significantly
influence methionine and homocysteine levels and
their effects on the development of
atherosclerosis.
INT. J. EPIDEMIOL. (United Kingdom), 1988,
17/2 (414-418) The relationship between liver cirrhosis
death rates and certain nutritional factors was
studied in 38 countries where mortality statistics
were considered to be reliable. A partial
correlation analysis showed that several food
commodity consumption factors were independently
and negatively (p < 0.01) associated with liver
cirrhosis death rates after adjustment for alcohol
consumption. These factors were total calories,
protein, fat, calcium, vitamin A and vitamin B2.
The significant association of protein, vitamin A,
vitamin B2 and calcium with the cirrhosis death
rates is of importance since they were not
intercorrelated with alcohol consumption. Further
results showed that animal protein was more
significantly related to cirrhosis death rates than
vegetable protein. However, in view of certain
limitations of this study, the findings do not
necessarily reflect causal relationships but rather
support the consideration by scientists that
protein and vitamin deficiency may have certain
effects on liver cirrhosis.
Vopr Med Khim (RUSSIA) Apr-Jun 1996, 42 (2)
p153-8 Metabolism of vitamins C, B2, B6 and niacin in
children with insulin-dependent diabetes mellitus
was distinctly different from that of healthy
persons of the same age as shown by studies of the
correlation between content of vitamins or their
coenzyme forms in blood, excretion of the vitamins
with urine and content of the vitamins in a diet.
These data corroborated once again that in
estimation of the vitamins consumption suitable for
ill children, the criteria of healthy children
requirements for vitamins should not be taken into
consideration. Dissimilar metabolism in healthy and
impaired persons may also demonstrate some
differences in consumption of these vitamins.
Preliminary data showed that requirements of the
impaired children for vitamin C were slightly
increased, for vitamin B2--similar or slightly
decreased as compared with healthy children. These
results suggest that additional investigations are
required for evaluation of vitamins consumption in
children with diabetes mellitus of the I type.
Vopr Med Khim (RUSSIA) Nov-Dec 1995, 41 (6)
p58-62 By mathematically analysing the curves of
urinary excretion of vitamins, their plasma and
erythrocytic concentrations or of TDP-effect, by
constructing and mathematically interpreting the
variation curves of distribution of a given plasma
concentration of riboflavin and pyridoxal phosphate
for 10-14-old-year children suffering from
insulin-dependent diabetes mellitus after
supplementation of vitamin, as a criterion of
normal requirement for vitamin B2, the authors are
prone to recommend the concentration of riboflavin
over 10 micrograms/ml in plasma and over 96
micrograms/ml in erythrocytes, the hourly excretion
of more than 27 micrograms. It has been ascertained
that the criteria for the optimal body's
requirements for vitamins in diabetes mellitus
children do not differ from those in healthy
age-matched children. Thus, the value of TDP-effect
is less than 1.25, the concentration of pyridoxal
phosphate is over 8.4 micrograms/ml plasma, the
excretion values of thiamine and 4-pyridoxic acid
are 13.5 and 64.0 micrograms/h, respectively.
Vopr Med Khim (RUSSIA) Sep-Oct 1993, 39 (5)
p26-9 Metabolism of vitamins B, involving evaluation
of these vitamins content in blood and excretion of
their metabolites with urine, was studied in adult
healthy persons as well as in patients with
insulin-dependent and -independent forms of
diabetes mellitus. Distinct alterations in
metabolism of vitamin B2 were detected in the
insulin-dependent diabetes: its content in
erythrocytes and the rate of excretion with urine
were increased. This phenomenon made some problems
in evaluation of riboflavin consumption in patients
with diabetes mellitus of the I type, while
parameters of vitamin consumption in
insulin-independent diabetes were similar to those
of healthy persons. Parameters of metabolism of
vitamins B1, B6 and PP were not different in
patients with insulin-dependent and -independent
forms of diabetes mellitus. Rates of excretion of
4-pyridoxic acid, 1-methyl nicotinamide, thiamine
with urine as well as concentration of the
corresponding vitamins in blood were similar to
those parameters of healthy persons.
Med Klin (GERMANY) Aug 15 1993, 88 (8) p453-7 The present study was aimed to determine the
vitamin status of vitamins A, E, beta-carotene, B1,
B2, B6, B12 and folate in plasma using HPLC and
vitamins B1, B2 and B6 in erythrocytes using the
apoenzyme stimulation test with the Cobas-Bio
analyzer in 29 elderly type II diabetic women with
(G1: n = 17, age: 68.6 +/- 3.2 years) and without
(G2: n = 12, age: 71.8 +/- 2.7 years) diabetic
polyneuropathy. The basic parameters as age,
hemoglobin A1c, fructosamine and duration of the
disease did not differ in both groups. Furthermore,
retinopathy was assessed with fundoscopy and
nephropathy with creatinine clearance. The
creatinine clearance (G1: 50.6 +/- 3.4 vs. G2: 63.6
+/- 3.7 ml/min, 2p < 0.025) and the percentage of
retinopathy (G1: 76.5% vs. G2: 16.7%, 2p = 0.002)
were different indicating that G1 had significantly
more severe late complications than G2. Current
plasma levels of all measured vitamins (A, E,
beta-carotene, B1, B2, B6, B12 and folate) and the
status of B1, B2 and B6 in erythrocytes did not
vary between the two groups (2p > 0.1). In summary,
we found a lack of association between the actual
vitamin condition in plasma and erythrocytes and
diabetic neuropathy.
Am Fam Physician (UNITED STATES) Jan 1979, 19
(1) p119-23 Major effects of oral contraceptives on
nutritional status are elevation of triglycerides,
decline in glucose tolerance, an apparent increase
in the need for folate and vitamins C, B2 and B6,
and a decrease in iron loss. Women at greater risk
of nutritional deficits due to oral contraceptives
include those who have just had a baby, are
planning to have a baby later, already show
nutritional deficiencies, have had recent illness
or surgery, have poor dietary habits, are still
growing or have a family history of diabetes or
heart disease.
Fernandez-Banares F.; Abad-Lacruz A.; Xiol X.; Gine J.J.; Dolz C.; Cabre E.; Esteve M.; Gonzalez-Huix F.; Gassull M.A. Department of Gastroenterology, Hospital de Bellvitge 'Princeps d'Espanya', Barcelona Spain AM. J. GASTROENTEROL. (USA), 1989, 84/7
(744-748) The status of water- and fat-soluble vitamins
was prospectively evaluated in 23 patients (13 men,
10 women, mean age 33 plus or minus 3 yr) admitted
to the hospital with acute or subacute attacks of
inflammatory bowel disease. Protein-energy status
was also assessed by means of simultaneous
measurement of triceps skin-fold thickness, mid-arm
muscle circumference, and serum albumin. Fifteen
patients (group A) had extensive acute colitis
(ulcerative or Crohn's colitis), and eight cases
(group B) had small bowel or ileocecal Crohn's
disease. Eighty-nine healthy subjects (36 men, 53
women, mean age 34 plus or minus 2 yr) acted as
controls. In both groups of patients, the levels of
biotin, folate, beta-carotene, and vitamins A, C,
and B1 were significantly lower than in controls (p
< 0.05). Plasma levels of vitamin B12 were
decreased only in group B (p < 0.01), whereas
riboflavin was lower in group A (p < 0.01). The
percentage of patients at risk of developing
hypovitaminosis was 40% or higher for vitamin A,
beta-carotene, folate, biotin, vitamin C, and
thiamin in both groups of patients. Although some
subjects had extremely low vitamin values, in no
case were clinical symptoms of vitamin deficiency
observed. Only a weak correlation was found between
protein-energy nutritional parameters and vitamin
values, probably due to the small size of the
sample studied. The pathophysiological and clinical
implications of the suboptimal vitamin status
observed in acute inflammatory bowel disease are
unknown. Further studies on long-term vitamin
status and clinical outcome in these patients are
necessary.
COMPR. THER. (USA), 1990, 16/4 (62) It has long been known that an inadequate diet
lacking in certain essential vitamins can cause
ocular disorders. On an Egyptian papyrus dated
about 1500 BC, it is recorded that liver was used
as a food to cure night blindness. Healthy eyes
depend on a well-balanced diet. Vitamin A maintains
the normal function of the epithelial cells of the
eye and is essential for the synthesis of visual
photosensitive pigments. Deficiencies of vitamin A
lead to clinical manifestations including night
blindness, conjunctival pigmentation, and dry eyes.
The B vitamins are important for maintaining good
vision. Vitamin B1 (thiamine) deficiency produces
optic nerve dysfunction. Vitamin B12 deficiency can
produce vascular changes in the retina. Deficiency
of riboflavin (part of the B complex) has been
implicated in the formation of cataracts and may
also be a factor in producting xerophthalmia (dry
eyes). Vitamin C is necessary to prevent scurvy.
The scorbutic manifestations in the eyes are
bleeding from the lids, conjunctiva, anterior
chamber, and retina. Vitamin C deficiency may also
be a factor in cataract formation. Finally, vitamin
K deficiency causes retinal hemorrhages in
neonates. Deficiencies of vitamin D and E have not
been shown to have a negative effect on the visual
process, but vitamin E therapy improves retrolental
fibroplasia (retinopathy of prematurity).
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