Vitamin E and coronary heart disease in Tunisians

Background: Vitamin E (VE) is thought to be effective in preventing atheros clerosis. However, to date no consistent relationship has been identified b etween VE and coronary heart disease (CHD). This study was designed to asse ss the degree of association between VE and CHD in a sample of the Tunisian population. Methods: Sixty-two angiographically confirmed coronary atherosclerotic pati ents and 65 age- and sex-matched controls were included. VE was measured in plasma and in the LDL fraction by HPLC. Cholesterol, triglycerides, and ph ospholipids were measured by enzymatic methods. Results: A trend toward a meaningful decrease of plasma VE was observed in affected patients compared with controls (P = 0.06). VE concentrations stan dardized for cholesterol and lipid concentrations were significantly lower (P <0.02) in coronary patients than in controls (4.35 +/- 1.03 vs 4.82 +/- 1.23 mmol/mol for cholesterol-adjusted VE and 2.35 +/- 0.56 vs 2.66 +/- 0.6 5 mmol/mol for lipid-adjusted VE, respectively). In the LDL fraction, only cholesterol-standardized VE was significantly lower in cases than controls (3.84 +/- 1.13 vs 4.41 +/- 1.16 mmol/mol). This association between VE and CHD remained unchanged independent of age, sex, smoking habit, hypertension , and diabetes. In CHD patients, lower lipid-adjusted VE was associated wit h enhanced LDL susceptibility to oxidation but without alteration of the se rum fatty acid profile. Conclusions: These results support the hypothesis that VE plays a role in p reventing atherosclerosis. (C) 2000 American Association for Clinical Chemi stry.