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Relationships Between Erythrocyte Osmotic Fragility and Vitamin C Nutriture in Adults with or without Type 2 Diabetes

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Diabetes is the 7th leading cause of death globally. In 2018, 34.2 million Americans had type 2 diabetes. Many symptoms of diabetes are similar to those of scurvy or vitamin C deficiency. Vitamin C marginality and inadequacy are more prevalent in Type 2 Diabetes/prediabetes than with normal glucose tolerance. Intracellular…

Diabetes is the 7th leading cause of death globally. In 2018, 34.2 million Americans had type 2 diabetes. Many symptoms of diabetes are similar to those of scurvy or vitamin C deficiency. Vitamin C marginality and inadequacy are more prevalent in Type 2 Diabetes/prediabetes than with normal glucose tolerance. Intracellular vitamin C inadequacy is suspected due to competition between dehydroascorbic acid and glucose at GLUT 1 and 3 cellular receptors. Erythrocyte osmotic fragility is noted in Gulo -/- knockout mice unable to synthesize endogenous vitamin C. The ascorbate deficient red blood cells presented with low cytoskeletal B-spectrin, spherocyte appearance, and impaired deformability. This cross-sectional study investigated the relationships between diabetes status, erythrocyte osmotic fragility, and serum vitamin C status. Participants were aged 18-65, non-smoking, reported no unresolved health complications, and denied prior vitamin C supplementation. Those with T2D indicated diagnosis of >1 year. All participants provided written informed consent and the study was approved by the local Institutional Review Board in January 2021. Participants provided one fasted blood sample. Erythrocyte osmotic fragility was measured via UV/Vis spectrophotometry with various concentrations of sodium chloride (0.85% - 0.10%) to induce osmotic stress. In addition, plasma was extracted and mixed 1:1 with 10% (w/v) metaphosphoric acid in 2 mmol/L disodium EDTA and centrifuged. The supernatant was stored at -80°C until analysis with isocratic reverse-phase UV-HPLC separation. Participant characteristics did not differ significantly between groups apart from age (p< 0.01) and HbA1c (p=0.002). Data are presented for adults with T2D (n=14; 36% female; 55.5±8.2 y; 31.5±9.0 kg/m2; HbA1c: 7.4±1.9%; plasma vitamin C: 36.0±12.2 uM) and without T2D (n=16; 69% female; 38.7±13.5 y; 26.8±6.6 kg/m2; A1c: 5.4±0.3%; plasma vitamin C: 34.8±10.9uM). Erythrocyte osmotic fragility was significantly elevated (+4.4% hemolysis) in adults without T2D at 0.35% saline (p=0.039). Greater VC status (>30 uM) was associated with lower hemolysis at 0.35% NaCl (p=0.031). Erythrocyte osmotic stability was linked to greater vitamin C intake at 0.20% saline in those without T2D (p =0.019). In this pilot study, vitamin C status did not differ significantly by diabetes status. Vitamin C status was directly linked to erythrocyte osmotic stability in adults without T2D.
ContributorsLundy, Ciara Cheyanne (Author) / Johnston, Carol (Thesis advisor) / Sweazea, Karen (Committee member) / Alexon, Christy (Committee member) / Arizona State University (Publisher)
Created2022
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Vinegar Intake on Metabolic Syndrome Risk in a Randomized Control Trial

Description
The medicinal use of vinegar dates to ancient times, and empirical evidence has mounted over the past several decades supporting health benefits from vinegar ingestion, including reductions in blood glucose, blood pressure, and blood cholesterol. Additionally, although clinical trial data are mixed, there are several reports demonstrating reductions in body…

The medicinal use of vinegar dates to ancient times, and empirical evidence has mounted over the past several decades supporting health benefits from vinegar ingestion, including reductions in blood glucose, blood pressure, and blood cholesterol. Additionally, although clinical trial data are mixed, there are several reports demonstrating reductions in body mass and fat mass with daily vinegar ingestion. This blinded, randomized placebo-controlled trial examined the impact of daily vinegar ingestion on anthropometric measures in healthy young adults recruited from a campus population. Participants (n=28; aged 25.8±7.0 y; body mass index [BMI] > 23 kg/m2) were stratified by age, sex, and BMI and randomly assigned to the liquid [VIN] or pill [CON] groups. VIN participants diluted 2 tablespoons of red wine vinegar (750 mg acetic acid; Pompeian Inc.) in 8-12 ounces of water to drink with food at mealtime twice daily. CON participants consumed 1 vinegar pill daily (22.5 mg acetic acid; Spring Valley). All participants provided written consent for this IRB approved trial. The study lasted four weeks, and anthropometric measurements were conducted in a fasted state at weeks 0 and 4. Study adherence varied slightly (90±17% and 100±14% for VIN and CON respectively, p=0.029); hence, adherence was controlled for in all analyses. Changes in BMI (-0.1±0.5 and +0.1±0.3 kg/m2, p=0.127) and body weight (-0.3±1.4 and +0.1±1.1 kg, p=0.158) did not differ significantly between VIN and CON groups, respectively. However, both waist circumference and percent body fat were reduced significantly for VIN participants in comparison to CON participants (-0.5±1.3 vs. +0.6±2.4 cm [p=0.026]and -0.4±0.7 vs. +0.3±1.0% [p=0.045]. Although the observed differences between groups are modest, the study was short in duration and this protocol did not apply energy restriction or exercise interventions, suggesting a possible benefit of vinegar ingestion on adiposity.
ContributorsMeyer, Lexie Rae (Author) / Johnston, Carol (Thesis advisor) / Alexon, Christy (Committee member) / Grant, Shauna (Committee member) / Arizona State University (Publisher)
Created2024