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Curr Diab Rep. 2017 Jun;17(6):42. doi: 10.1007/s11892-017-0868-1.

Interaction Between the Haptoglobin Genotype and Vitamin E on Cardiovascular Disease in Diabetes.

Author information

1
Institute of Endocrinology, Diabetes and Metabolism, Rambam HealthCare Campus, Haifa, Israel. i_hochberg@rambam.health.gov.il.
2
Technion Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel.
3
Clalit Health Services, Haifa and western Galilee District, Haifa, Israel.

Abstract

PURPOSE OF REVIEW:

Despite compelling evidence regarding the importance of oxidant stress in the development of vascular complications and observational studies suggesting that vitamin E may be protective from these complications, multiple clinical trials have failed to show benefit from vitamin E supplementation in the prevention of vascular complications in diabetes. One possible explanation for this failure of vitamin E may have been inappropriate patient selection. This review seeks to provide the clinical evidence and mechanistic basis for why a subset of individuals defined by their haptoglobin (Hp) genotype may derive cardiovascular protection by vitamin E supplementation.

RECENT FINDINGS:

Clinical trial data from the HOPE, ICARE, and WHS studies is presented showing a pharmacogenomic interaction between the Hp genotype and vitamin E on the development of CVD. Specifically, in individuals with diabetes and the Hp2-2 genotype, vitamin E has been shown to be associated with an approximately 35% reduction in CVD. Cardioprotection by vitamin E in individuals with the Hp2-2 genotype appears to be mediated in part by an improvement in HDL functionality as demonstrated in three independent trials in both type 1 diabetes and type 2 diabetes. Vitamin E may provide benefit in reducing CVD in Hp2-2 individuals with diabetes. However, in order for this pharmacogenomic algorithm to be accepted as a standard of care and used clinically, an additional large prospective study will need to be performed.

KEYWORDS:

Cardiovascular disease; Haptoglobin; High-density lipoproteins; Oxidative stress; Vitamin E

PMID:
28451949
DOI:
10.1007/s11892-017-0868-1
[Indexed for MEDLINE]

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