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- All Subjects: Vitamin C
- Creators: Johnston, Carol S
Description
Background Hemodialysis (HD) patients elicit an oxidant-antioxidant imbalance in addition to a selenium deficiency, possibly contributing to cardiovascular disease (CVD) mortality. Objective To evaluate the effect of selenium supplementation on CVD outcomes and antioxidant status in HD patients. Design A randomized controlled intervention trial conducted from October 2012 to January 2013. Participants/setting The study included 27 maintenance HD patients (61.1+17.5y, 14M, 13F) receiving HD in the greater Phoenix, AZ area. Intervention Patients received one of three treatments daily: 2 Brazil nuts, (5g, 181µg/day of selenium as selenomethionine [predicted]), 1 tablet of selenium (200µg/day of selenium as selenomethionine), or control (3 gummy bears). Main outcome measures Antioxidant status outcome measures included total antioxidant capacity, vitamin C, and RBC and plasma glutathione peroxidase (GSH-Px). CVD outcomes measures included brain natriuretic peptide; plasma cholesterol, high density lipoprotein, low density lipoprotein, triglycerides; blood pressure, and thoracic cavity fluid accumulation. Statistical analyses performed Repeated measures ANOVA analyzed changes over time and between groups at months 0 and 2 and months 0 and 3. Results Independent analysis showed the Brazil nuts provided 11µg of selenium/day and the pill provided 266µg of selenium/day. Consequently, the Brazil nut group was combined with the placebo group. 21 patients completed 2 months of the study and 17 patients completed the study in its entirety. Data was analyzed for months 0, 1 and 2. No significant differences were noted for antioxidant status outcome measures with the exception of plasma GSH-Px. Patients receiving the selenium pill had a significant increase in plasma GSH-Px compared to the placebo group (6.0+11 and -4.0+7.6, respectively, p=0.023 for change between month 0 and month 2). No significant differences were seen in total antioxidant capacity or for CVD outcome measures over time or between groups. Conclusions These data indicate that selenium supplementation increased plasma GSH-Px concentration in HD patients; however, oxidative stress was not altered by selenium supplementation. The low vitamin C status of HD patients warrants further research, specifically in conjunction with selenium supplementation.
ContributorsSussman, Elizabeth Jessica (Author) / Johnston, Carol S (Thesis advisor) / Boren, Kenneth (Committee member) / Mayol-Kreiser, Sandra (Committee member) / Sweazea, Karen (Committee member) / Vaughan, Linda (Committee member) / Arizona State University (Publisher)
Created2013
Description
Among its many roles in the body, ascorbic acid functions as a cofactor in carnitine and catecholamine synthesis, metabolites involved in fat oxidation and mood regulation, respectively. Given that fat oxidation and mood affect one's feelings of vigor, I hypothesized that those with lower levels of plasma ascorbic acid would be less likely to exercise at high levels than individuals with adequate or high levels of vitamin C. To test this, I conducted a double-blind, placebo-controlled intervention. A group of healthy, non-smoking males between the ages of 18 and 40 were put on a vitamin C-restricted diet for two weeks and then randomized to a control group that received placebo capsules for six weeks or an intervention group that received 500 mg of vitamin C daily for six weeks. The men were restricted from eating foods high in vitamin C, instructed to wear a pedometer daily and to record their step counts, and to take a pill daily (either the placebo or vitamin C supplement). Unexpectedly, the subjects receiving the intervention had lower step counts than the control group; the control group, rather than the vitamin C group, significantly (p=0.017) increased their steps at week 8 compared to week 2. However, I also estimated daily Metabolic Equivalent Tasks (METs), and subjects receiving the placebo had lower MET outputs than subjects receiving vitamin C at the end of the trial, in spite of having higher step counts. This means the intensity of their activity was higher, based on METs expenditure. Additionally, depression scores (POMS-D) as measured by the Profile of Mood States (POMS) questionnaire were significantly higher (p=0.041) among subjects receiving the placebo at the end of the study. These latter results are consistent with my expectations that subjects with higher levels of plasma vitamin C would have improved mood and higher energy output than subjects with low levels of vitamin C.
ContributorsNetland, Heidi (Author) / Johnston, Carol S (Thesis advisor) / Swan, Pamela D (Committee member) / Hampl, Jeffery S (Committee member) / Arizona State University (Publisher)
Created2011