Korean J Nutr KJN Korean Journal of Nutrition 0367-6463 2005-7121 The Korean Nutrition Society 10.4163/kjn.2009.42.4.318 Original Article Vitamin A and Vitamin E Status of Diabetic Patients and Normal Adults in Korea Oh Hyun-Mee 1 Yoon Ji-Young 2 Cho Sung-Hee 3 Yoon Jin-Sook 1 Department of Food and Nutrition, Keimyung University, Daegu 704-701, Korea. The Korean Nutrition Society, Seoul 135-703, Korea. Department of Food and Nutrition, Daegu Catholic University, Daegu 712-702, Korea. To whom correspondence should be addressed. (jsook@kmu.ac.kr) 06 2009 30 06 2009 42 4 318 326 01 05 2009 28 05 2009 01 06 2009 © 2009 The Korean Nutrition Society 2009

We evaluated the vitamin A and E status of type 2 diabetic patients and normal adults living in Daegu area. Dietary intakes for two non-consecutive days were measured by 24-hour recall method for 76 diabetic patients and 72 normal adults. Plasma levels of retinol and α-tocopherol were measured using HPLC method. Dietary intakes of vitamin A were not significantly different between the diabetic and the normal adults. However, the diabetic patients had significantly lower vitamin E intakes than the normal adults. Major food sources for vitamin A intake were red pepper powder and carrot. Half of the subjects from diabetic as well as normal adults consumed less than estimated average requirement of vitamin A. Plasma levels of retinol and tocopherol were maintained within normal ranges for most of the subjects regardless of diabetic status. Dietary intake of vitamin A was associated with vitamin E intake, however, there was no significant correlations between vitamin E intake and plasma α-tocopherol levels. It seems that diabetic patients should try to increase dietary intake of vitamin E, as prolonged lower-level intake of vitamin E could eventually lead to vitamin E depletion. Further studies are needed to identify the magnitude of dietary variance at individual and seasonal levels, and to understand the discrepancies in dietary intake and plasma levels before establishing the dietary reference intake based on Korean dietary pattern.

 diabetes vitamin A intake vitamin E intake plasma α-tocopherol plasma retinol

This research was supported by a 2003 research grant of Ministry of Health and Welfare (03-PJ1-PG3-22000-0024).

 Strain JJ Disturbances of micronutrient and antioxidant status in diabetes Proc Nutr Soc 1991 50 3 591 601 Baynes JW Thorpe SR Role of oxidative stress in diabetic complications in diabetes: A new perspective on an old paradigm Diabetes 1999 48 1 1 9 Faure P Protective effects of antioxidant micronutrients (vitamin E, Zinc and selenium) in Type 2 diabetes mellitus Clin Chem Lab Med 2003 41 8 995 998 Thompson KH Godin DV Micronutrients and antioxidants in the progression of diabetes Nutr Res 1995 15 9 1377 1410 Baynes JW Role of oxidative stress in development of complications in diabetes Diabetes 1991 40 4 405 412 Moustafa SA Zinc might protect oxidative changes in the retina and pancreas at the early stage of diabetes rats Toxicol Appl Pharmacol 2004 201 2 149 155 Aydin A Orhan H Sayal A Ozata M Sahin G Isimer A Oxidative stress and nitric oxide related parameters in Type II diabetes mellitus: effects of glycemic control Clin Biochem 2001 34 1 65 70 Maxwell SR Thompson H Sandler D Leguen C Baxter MA Thorpe GHG Jones AF Barnett AH Antioxidant status in patients with uncomplicated insulin-dependent and non-insulin-dependent diabetes mellitus Eur J Clin Invest 1997 27 6 484 490 Montonen J Knekt P Järvinen R Reunanen A Dietary antioxidant intake and risk of type 2 diabetes Diabetes Care 2004 27 2 362 366 Ylönen K Alfthan G Groop L Saloranta C Aro A Virtanen SM Dietary intakes and plasma concentrations of carotenoids and tocopherols in relation to glucose metabolism in subjects at high risk of type 2 diabetes: the Botnia Dietary Study Am J Clin Nutr 2003 77 6 1434 1441 Salonen JT Nyyssönen K Tuomainen TP Máenpáá PH Korpela H Kaplan GA Lynch J Helmrich SP Salonen R Increased risk of non-insulin dependent diabetes mellitus at low plasma vitamin E concentrations: a four year follow up study in men BMJ 1995 311 7013 1124 1127 Kim NE Kim WK Effect of antioxidant vitamins supplementation on antioxidant status and plasma lipid profiles in Korean NIDDM patients Korean J Nutr 1999 32 7 775 780 Mayer-Davis EJ Costacou T King I Zaccaro DJ Bell RA The Insulin Resistance and Atherosclerosis Study (IRAS). Plasma and dietary vitamin E in relation to incidence of type 2 diabetes Diabetes Care 2002 25 12 2172 2177 Czernichow S Couthouis A Bertrais S Vergnaud AC Dauchet L Galan P Hercberg S Antioxidant supplementation does not affect fasting plasma glucose in the Supplementation with Anti-oxidant Vitamins and Minerals (SU.VI.MAX) study in France: association with dietary intake and plasma concentrations Am J Clin Nutr 2006 84 2 395 399 Liu S Lee IM Song Y Van Denburgh M Cook NR Manson JE Buring JE Vitamin E and risk of type 2 diabetes in the women's health study randomized controlled trial Diabetes 2006 55 10 2856 2862 Havivi E Bar OH Reshef A Stein P Raz I Vitamins and trace metals status in non insulin dependent diabetes mellitus Inter J Vit Nutr Res 1991 61 4 328 333 Straub RH Rokitzki L Schumacher T Hillmann C Palitzsch KD Scholmerich J No evidence of deficiency of vitamin A, E, β-carotene, B1, B2, B6, B12, and folate in neuropathic type II diabetic women Inter J Vit Nutr Res 1993 63 3 239 240 Basualdo CG Wein EE Basu TK Vitamin A (retinol) status of first nation adults with non-insulin-dependent diabetes mellitus J Am Coll Nutr 1997 16 1 39 45 The Korean Nutrition Society Dietary Reference intakes for Koreans 2005 Seoul Ministry of Health & Welfare Report on 2005 National health and nutritional survey 2006 Seoul: Republic of Korea Korean Food Research Institute Handbook of Portion Size for Food Intake Research 1998 Seoul Bieri JG Tolliver TJ Catignani GL Simultaneous determination of alpha-tocopherol and retinol in plasma or red cells by high pressure liquid chromatography Am J Clin Nutr 1979 32 10 2143 2149 Lee RD Nieman DC Nutritional assessment 2007 4th ed McGraw-Hill Machlin LJ Handbook of Vtamins 1984 New York Marcel Dekker Inc. Ministry of Health & Welfare Report on 2001 National health and nutritional survey 2002 Seoul: Republic of Korea Stephensen CB Gildengorin G Serum retinol, the acute phase response, and the apparent misclassification of vitamin A status in the third National Health and Nutrition Examination Survey Am J Clin Nutr 2000 72 5 1170 1178 Ha AW Kim HM The study of lipid-peroxidation, antioxidant enzymes, and the antioxidant vitamins in NIDDM patients with microvascular-diabetic complications Korean J Nutr 1999 32 1 17 23 Kim Y Mok JH Na HJ Han KH Kim KN Hyun TS Nutritional status and dietary intake of vitamin A in primary school children Korean J Nutr 2001 34 6 671 677 Kim YN Giraud DW Cho YO Driskell JA Vitamin A inadequacy observed in a group of 2- to 6-year-old children living in Kwangju, Republic of Korea Int J Vit Nutr Res 2007 77 5 311 319 Cho SH Lee OJ In JG Choi Y Ryu R Park WH A study on the status of antioxidant nutrients and lipid in the middle-ages Korean men living in Taegu Korean J Nutr 1995 28 1 33 45 Shim JE Paik HY Lee SY Moon HK Kim YO Kwon HH Kim JH Assessment of vitamin A and E status in Korean rural adult population by dietary intake and serum levels Korean J Nutr 2001 34 2 213 221

General characteristics of subjects

Anthropometric characteristics of the study subjects

Values are means ± SD

1) BMI: Body Mass Index

Dietary Intakes of Vitamin A, E and C by the study subjects

Values are means ± SD

*: p < 0.05, **: p < 0.01, ***: p < 0.001 by t-test

Proportion of the study subjects with insufficient dietary intake

1) Proportion of subjects with dietary intake less than EAR of vitamin A

2) Proportion of subjects with dietary intake less than 75% AI of vitamin E

3) Proportion of subjects with dietary intake less than EAR of vitamin C

Major food items of vitamin A intake

Major food items for vitamin E intake

Plasma levels of retinol and α-tocopherol in diabetic patients and normal adults

Values are means ± SD

Plasma retinol level by Vitamin A intake status

Values are means ± SD

Low Vit A: subjects with vitamin A intake < EAR of vitamin A

High Vit A: subjects with vitamin A intake > EAR of vitamin A

Plasma tocopherol level by Vitamin E intake status

Values are means ± SD

Low Vit E: subjects with vitamin E intake < 75% AI of vitamin E

High Vit E: subjects with vitamin E intake > 75% AI of vitamin E

Relationships among dietary intakes and plasma levels of retinol and tocopherol

*: p < 0.05, **: p < 0.001 by Pearson's corelation