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(Hypertension. 1999;34:1002-1006.)
© 1999 American Heart Association, Inc.
Scientific Contributions |
From the Institute of Internal Medicine and GeriatricsUniversity of Palermo, Palermo, Italy (M.B., L.J.D.); Division of Endocrinology, Metabolism and Hypertension, Wayne State University, Detroit, Mich (L.J.D., L.M.R.); and Department of Geriatric Medicine and Metabolic DiseasesII University of Naples, Naples, Italy (R.T., G.P.).
Correspondence to Mario Barbagallo, MD, PhD, Viale F. Scaduto 6/c, 90144 Palermo, Italy. E-mail mabar{at}unipa.it
AbstractVitamin E is an antioxidant that has been demonstrated to improve insulin action. Glutathione, another natural antioxidant, may also be important in blood pressure and glucose homeostasis, consistent with the involvement of free radicals in both essential hypertension and diabetes mellitus. Our group has recently suggested that the effects of reduced glutathione on glucose metabolism may be mediated, at least in part, by intracellular magnesium levels (Mg[i]). Recent evidence suggests that vitamin E enhances glutathione levels and may play a protective role in magnesium deficiencyinduced cardiac lesions. To directly investigate the effects of vitamin E supplementation on insulin sensitivity in hypertension, in relation to the effects on circulating levels of reduced (GSH) and oxidized (GSSG) glutathione and on Mg[i], we performed a 4-week, double-blind, randomized study of vitamin E administration (600 mg/d) versus placebo in 24 hypertensive patients and measured whole-body glucose disposal (WBGD) by euglycemic glucose clamp, GSH/GSSG ratios, and Mg[i] before and after intervention. The relationships among WBGD, GSH/GSSG, and Mg[i] in both groups were evaluated. In hypertensive subjects, vitamin E administration significantly increased WBGD (25.56±0.61 to 31.75±0.53 µmol/kg of fat-free mass per minute; P<0.01), GSH/GSSG ratio (1.10±0.07 to 1.65±0.11; P<0.01), and Mg[i] (1.71±0.042 to 1.99±0.049 mmol/L; P<0.01). In basal conditions, WBGD was significantly related to both GSH/GSSG ratios (r=0.58, P=0.047) and Mg[i] (r=0.78, P=0.003). These data show a clinical link between vitamin E administration, cellular magnesium, GSH/GSSG ratio, and tissue glucose metabolism. Further studies are needed to explore the cellular mechanism(s) of this association.
Key Words: glutathione magnesium hypertension glucose insulin resistance antioxidants
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