| Vitamin E reduces cardiovascular disease in individuals with diabetes mellitus and the haptoglobin 2-2 genotype. | |
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MedLine Citation:
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PMID: 20415560 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: Individuals with both diabetes mellitus (DM) and the Haptoglobin (Hp) 2-2 genotype are at increased risk of cardiovascular disease. As the antioxidant function of the Hp 2-2 protein is impaired, we sought to test the pharmacogenomic hypothesis that antioxidant vitamin E supplementation would provide cardiovascular protection to Hp 2-2 DM individuals. MATERIALS & METHODS: We determined the Hp genotype on DM participants from two trials (HOPE and ICARE) and assessed the effect of vitamin E by Hp genotype on their common prespecified outcome, the composite of stroke, myocardial infarction and cardiovascular death. Data was analyzed with a fixed-effect model. These results were input into a simulation model, the Evidence Based Medicine Integrator, in order to estimate their long-term implications in a real-world population from Kaiser Permanente (CA, USA). RESULTS: Meta-analysis of the two trials demonstrated a significant overall reduction in the composite end point in Hp 2-2 DM individuals with vitamin E (odds ratio: 0.58; 95% CI: 0.40-0.86; p = 0.006). There was a statistically significant interaction between the Hp genotype and vitamin E on the composite end point. In these trials, Hp typing of 69 DM individuals and treating those with the Hp 2-2 with vitamin E prevented one myocardial infarct, stroke or cardiovascular death. Lifelong administration of vitamin E to Hp 2-2 DM individuals in the Kaiser population would increase their life expectancy by 3 years. CONCLUSION: A pharmacogenomic strategy of screening DM individuals for the Hp genotype and treating those with Hp 2-2 with vitamin E appears to be highly clinically effective. |
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Authors:
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Shany Blum; Moshe Vardi; Jonathan B Brown; Allen Russell; Uzi Milman; Chen Shapira; Nina S Levy; Rachel Miller-Lotan; Rabea Asleh; Andrew P Levy |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Pharmacogenomics Volume: 11 ISSN: 1744-8042 ISO Abbreviation: Pharmacogenomics Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-04-26 Completed Date: 2010-07-21 Revised Date: 2011-07-25 |
Medline Journal Info:
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Nlm Unique ID: 100897350 Medline TA: Pharmacogenomics Country: England |
Other Details:
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Languages: eng Pagination: 675-84 Citation Subset: IM |
Affiliation:
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Technion Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Antioxidants
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metabolism,
pharmacology* Cardiovascular Diseases / genetics, metabolism Diabetes Mellitus / genetics, metabolism* Genotype Haptoglobins / genetics*, metabolism, pharmacology Humans Myocardial Infarction / genetics, metabolism* Stroke / genetics, metabolism Tocopherols / metabolism, pharmacology Vitamin E / genetics, metabolism, pharmacology* |
| Grant Support | |
ID/Acronym/Agency:
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R01 DK085226-01A1/DK/NIDDK NIH HHS; R01KD085226//PHS HHS; R21HS017643-01/HS/AHRQ HHS |
| Chemical | |
Reg. No./Substance:
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0/Antioxidants; 0/Haptoglobins; 1406-18-4/Vitamin E; 1406-66-2/Tocopherols |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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