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1 Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA
2 Division of Cellular and Molecular Physiology, Joslin Diabetes Center, Boston, MA, USA
3 Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, USA
* To whom correspondence should be addressed. E-mail: jbeckman{at}partners.org.
Oxidative stress decreases the bioavailability of endothelium-derived nitric oxide in diabetic patients. We investigated whether impaired endothelium-dependent vasodilation (EDV) in diabetes can be improved by long-term administration of oral antioxidants. Methods and Results: 49 diabetic subjects (26 type 1 (T1) and 23 type 2 (T2)) and 45 matched healthy control subjects were randomized to oral vitamin C 1000 mg and vitamin E 800 IU daily or matching placebo for six months. Vascular ultrasonography was used to determine brachial artery EDV and endothelium-independent vasodilation (EIV). EDV was decreased in both T1(4.9 ± 0.9%, p = .015) and T2(4.1± 1.0%, p < .01) subjects compared to control subjects, (7.7 ± 0.7%). EIV was decreased in T2(15.0 ± 1.2%, p < .01) but not T1 subjects (18.5 ± 2.3%, p = 0.3) compared to controls (21.8 ± 1.8%). Administration of antioxidant vitamins increased EDV in T1(by 3.4 ± 1.4%, p = 0.023), but not T2 subjects(by 0.5. ± 0.4%, p = 0.3). Antioxidant therapy had no signigicant affect on EIV. Conclusion: Oral antioxidant therapy improves EDV in T1 but not T2 diabetes. These results are consistent with the lack of clinical benefit in studies that have included primarily type 2 diabetic patients.
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