Effects of metabolic control on vitamin E nutritional status in children with type 1 diabetes mellitus

Objective: To evaluate the effects of the metabolic control of the insulin-dependent diabetes mellitus (IDDM) on the nutritional status of vitamin E. Methods: A total of 47 children with IDDM and a mean age of 11.91±1.60 (mean±SD) years were studied, matched for age and sex with 16 healthy children (11.75±1.83 years). Following the American and British Associations for IDDM, we used a classification of ‘good’, ‘moderate’ or ‘poor’ control of the illness: (a) good control [glycosilated haemoglobin (HbAlc) ≤7%]; (b) moderate control (7%< HbAlc ≤8%); and (c) poor control (HbAlc>8%). Serum concentrations of total cholesterol (CHOL), triglycerides (TG), high-density lipoproteins-cholesterol (HDLc), very low- and low-density lipoproteins cholesterol (VLDLc and LDLc), plasma and erythrocyte vitamin E (Vit Ep and Vit Ee) and plasma vitamin A (Vit Ap) were measured in all children. Results: The children with ‘poor’ metabolic control of the illness presented significantly higher plasma concentrations of CHOL, LDLc, VLDLc, LDLc/HDLc, (VLDL+LDL)c/HDLc, TG and Vit Ep; higher indices Vit Ep/Vit Ee and Vit Ep/Vit Ap relative to those with a ‘good’ control of the illness. Direct-linear correlations were found between Vit Ep and the percentage of HbAlc and with the markers of atherogenic risk in the IDDM children. Conclusion: There is a significant rise in Vit Ep concentrations as metabolic control of the illness worsens, whereas Vit Ee remained unchanged. These results suggest that vitamin E maintains its nutritional status despite a poor control of the IDDM during childhood.