Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Vitamin A, retinol binding protein and lipids in type 1 diabetes mellitus

Abstract

Objective: A case–control study was conducted to evaluate the effects of type 1 diabetes mellitus (IDDM) on plasma levels of vitamin A (retinol) and serum levels of retinol-binding protein (RBP) and their relationship with the atherogenic indicators.

Subjects: A total of 47 randomised IDDM children were recruited from those treated at the Endocrinology Unit of the University Hospital of Granada (Spain). They were matched for age and sex with 16 healthy children.

Methods: The following parameters were measured in all patients: serum concentrations of total cholesterol, triglycerides, high (HDL, spectrophotometry), very low (VLDL) and low (LDL) density lipoprotein cholesterol (Friedewald's formula); serum levels of RBP (kinetic nephelometry); plasma vitamin A and glycosilated haemoglobin (HbA1c; high performance chromatography).

Results: Higher RBP concentrations in IDDM children (P=0.05), lower retinol levels (P=0.05) and lower vitamin A/cholesterol ratio (P=0.02) than in the control group were found; no differences in the atherogenic indicators were observed. There was a correlation between RBP and vitamin A (P=0.0001). Relationships between retinol, RBP and atherogenic indicators were demonstrated in the IDDM group (A-LDLc/HDLc (P=0.01); A-(VLDL+LDL)c/HDLc (P=0.007); RBP-LDLc/HDLc (P=0.05); RBP-(VLDL+LDL)c/HDLc (P=0.02)), and an inverse relationship was found between the vitamin A/TG ratio and HbA1c (P=0.004). The children with HbA1c>8% showed increased atherogenic indicators and lower vitamin A/CHOL and vitamin A/TG ratios than those with good control of the illness.

Conclusions: The IDDM children with poor metabolic control face a higher atherogenic risk and vitamin A ‘relative deficiency’ risk than those with good metabolic control of their illness. Relationships between retinol and RBP with atherogenic indicators were found. The results suggest that vitamin A therapeutic supplements in IDDM children may reduce or prevent atherogenic risk.

Your institute does not have access to this article

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

References

  • Abahusain MA, Wright J, Dickerson JW, De-Vol EB . 1999 Retinol, alpha-tocopherol and carotenoids in diabetes Eur. J. Clin. Nutr. 53: 630–635

    CAS  Article  Google Scholar 

  • Atabani GS, Saeed BO, el Mahdi EM, Adam ME, Hassan DA . 1989 Glycated haemoglobin and other biochemical parameters in Sudanese diabetics Ann. Clin. Biochem. 26: 332–334

    Article  Google Scholar 

  • Baena RMa, Campoy C, Blanca E, Fernández JM, Bayés R . 1999 Proteína transportadora de retinol y riesgo aterogénico en la diabetes mellitus tipo 1 Quím. Clín. 18: 76 (abstract).

    Google Scholar 

  • Bagdade JD, Buchanan WE, Kuusi T, Taskinen MR . 1990 Persistent abnormalities in lipoprotein composition in noninsulin-dependent diabetes after intensive insulin therapy Arteriosclerosis 10: 232–239

    CAS  Article  Google Scholar 

  • Basu TK, Basualdo C . 1997 Vitamin A homeostasis and diabetes mellitus Nutrition 13 Suppl 9: 804–806

    CAS  Article  Google Scholar 

  • Basu TK, Tze WJ, Leichter J . 1989 Serum vitamin A and retinol-binding protein in patients with insulin-dependent diabetes mellitus Am. J. Clin. Nutr. 50: 329–331

    CAS  Article  Google Scholar 

  • Basualdo CG, Wein EE, Basu TK . 1997 Vitamin A (retinol) status of first nation adults with non-insulin-dependent diabetes mellitus J. Am. Coll. Nutr. 16: 39–45

    CAS  Article  Google Scholar 

  • Bayés R, Campoy C, Pérez-Bonilla E, Molina JA . 1991 Optimización del autocontrol domiciliario en niños diabéticos: Disminución del riesgo aterogénico An. Esp. Pediatr. 34: 194–202

    Google Scholar 

  • Bayés R, Campoy C, Fernández JM, Molina-Font JA . 1998 Relationship between alfa-tocopherol and glucosilated haemoglobin in normal and in type 1 diabetes affected children Pediatr. Res. 44: 423 (abstract).

    Article  Google Scholar 

  • Biesalski HK, Frank J, Beck SC, Heinrich F, Illek B, Reifen R, Gollnick H, Seeliger MW, Wissinger B, Zrenner E . 1999 Biochemical but not clinical vitamin A deficiency results from mutations in the gene for retinol binding protein Am. J. Clin. Nutr. 69 Suppl 5: S931–S936

    Article  Google Scholar 

  • Butler C, Peters J, Stott N . 1995 Glycated haemoglobin and metabolic control of diabetes mellitus: external versus locally established clinical targets for primary care Br. Med. J. 310: 784–788

    CAS  Article  Google Scholar 

  • Campoy C, Cano MD, Bayés R . 1996 Glucosilación Proteica y vitamina E en la diabetes insulino-dependiente An. Esp. Pediatr. 87 Suppl 87: S44–S45 (abstract).

    Google Scholar 

  • Friedewald WT, Levy RI, Frederickson DS . 1972 Estimation of plasma low-density lipoprotein cholesterol concentration without use of preparative ultracentrifugation Clin. Chem. 18: 499–509

    CAS  PubMed  Google Scholar 

  • Gey KF . 1995 Cardiovascular disease and vitamins. Concurrent correction of ‘suboptimal’ plasma antioxidant levels may, as important part of ‘optimal’ nutrition, help to prevent early stages of cardiovascular disease and cancer, respectively Bibl. Nutr. Dieta 52: 75–91

    Google Scholar 

  • Gonzalez-Corbellá MJ, Lloberas N, Castellote MaI, López-Sabater MC, Rivero M . 1994 Determination of α-tocopherol in plasma and erythrocytes by high-performance liquid chromatography J. Chromatogr. B 600: 395–400

    Article  Google Scholar 

  • Herbeth B, Spyckerelle Y, Deschamps JP . 1991 Determinants of plasma retinol, beta-carotene, and alpha-tocopherol during adolescence Am. J. Clin. Nutr. 54 Suppl 5: S884–S889

    Article  Google Scholar 

  • Hozumi M, Murata T, Morinobu T, Manago M, Kuno T, Tokuda M, Konishi K, Mingci Z, Tamai H . 1998 Plasma β-carotene, retinol, and α-tocopherol levels in relation to glycemic control of children with insulin-dependent diabetes-mellitus J. Nutr. Sci. Vitaminol. 44: 1–9

    CAS  Article  Google Scholar 

  • Jain SK, Mcvie R, Duett J, Herbst JJ . 1989 Erythrocyte membrane lipid peroxidation and glycosylated hemoglobin in diabetes Diabetes 38: 1539–1543

    CAS  Article  Google Scholar 

  • Kerscher L, Town MH et al. 1985 The combined determination of two parameters on the same sample and in the same cuvette using the Hitachi 705 Clin. Chem. 21: 94–98

    Google Scholar 

  • Kobbah AM, Vessby B, Tuvemo T . 1988 Serum lipids and apolipoproteins in children with type 1 (insulin-dependent) diabetes during the first two years of the disease Diabetologia 31: 195–200

    CAS  Article  Google Scholar 

  • Krill D, O'leary L, Koehler AN, Kramer MK, Warfy V, Wagner MA, Dorman JS . 1997 Association of retinol binding protein in multiple-case families with insulin-dependent diabetes Hum. Biol. 69 Suppl 1: S89–S96

    Google Scholar 

  • Laakso M . 1995 Epidemiology of diabetic dyslipemia Diabetes Rev. 3: 408–422

    Google Scholar 

  • Lindblad BS, Patel M, Hamadeh M, Helmy N, Ahmad I, Dawodu A, Zaman S . 1998 Age and sex are important factors in determining normal retinol levels J. Trop. Pediatr. 44: 96–99

    CAS  Article  Google Scholar 

  • Martín-Andrés A, Luna JA . 1998 Bioestadística para Ciencias de la Salud, 4th edn. Madrid: Norma

    Google Scholar 

  • Martinoli L, Di Felice M, Seghieri G, Ciuti M, De Giorgio LA, Fazzini A . 1993 Plasma retinol and α-tocopherol concentrations in insulin-dependent diabetes mellitus: their relationship to microvascular complications. Internat J. Vitamin Nutr. Res. 63: 87–93

    CAS  Google Scholar 

  • NCEP . 1992 Report of the expert panel on blood cholesterol levels in children and adolescents Pediatrics 89: 525–583

    Google Scholar 

  • Olmedilla B, Granado F, Gil-Martinez E, Blanco I, Rojas-Hidalgo E . 1997 Reference values for retinol, tocopherol, and main carotenoids in serum of control and insulin-dependent diabetic Spanish subjects Clin. Chem. 43: 1066–1071

    CAS  PubMed  Google Scholar 

  • Ostlund RE Jr., Semenkovich CF, Schechtam KB . 1989 Quantitative relationship between plasma lipids and glycohemoglobin in type I patients. Longitudinal study of 212 patients Diabetes Care 12: 332–336

    Article  Google Scholar 

  • Peña M, Bayés R, Cano MD . 1994 Marcadores de riesgo aterogénico en la diabetes tipo I Rev. Diagn. Biol. 43: 193–197

    Google Scholar 

  • Romero D, Villaba MP, Camacho C, Gonzalez F . 1992 Estrés oxidativo y su relación con la patología pediátrica An. Esp. Pediatr. 36: 85–97

    Google Scholar 

  • Sale AK, Moussa MAA . 1985 An automated liquid chromatographic system for convenient determination of glycated hemoglobin Alc Clin. Chem. 31: 1872–1876

    Google Scholar 

  • Sato Y, Hotta N, Sakamoto N, Matsuoka S, Ohishi N, Yagi K . 1979 Lipid peroxide level in plasma of diabetic patients Biochem. Med. 21: 104–107

    CAS  Article  Google Scholar 

  • Smith DK, Greene JM, Leonard SB, Kuske TT, Feldman DS, Feldman EB . 1992 Vitamin A in hypercholesterolemia Am. J. Med. Sci. 304: 20–24

    CAS  Article  Google Scholar 

  • Sochett E, Daneman D . 1999 Early diabetes-related complications in children and adolescents with type 1 diabetes. Implications for screening and intervention Endocrinol. Metab. Clin. N. Am. 28: 865–882

    CAS  Article  Google Scholar 

  • Sugiuchi H, Uji Y, Okabe H, Irie T, Uekama K, Kayahara N, Miyauchi K . 1995 Direct measurement of high density lipoprotein cholesterol in serum with polyethylene glycol-modified enzymes and sulfated α-cyclo-dextrin Clin. Chem. 41: 717–723

    CAS  PubMed  Google Scholar 

  • The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus . 1997 Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus Diabetes Care 20: 1183–1197

    Article  Google Scholar 

  • Thurnham DI, Northrop-Clewes CA . 1999 Optimal nutrition: vitamin A and carotenoids Proc. Nutr. Soc. 58: 449–457

    CAS  Article  Google Scholar 

  • Tomlinson PA, Dalton RN, Turner C, Chantler C . 1990 Measurement of β-2-microglobulin, retino-binding protein, α-1-microglobulin and urine protein 1 in healthy children using enzyme-linked immunosorbent assay Clin. Chim. Acta 192: 99–106

    CAS  Article  Google Scholar 

  • Tsai EC, Hirsch IB, Brunzell JD, Chait A . 1994 Reduced plasma peroxy radical trapping capacity and increased susceptibility of LDL to oxidation in poorly controlled IDDM Diabetes 43: 1010–1014

    CAS  Article  Google Scholar 

  • Winocour PH, Durrington PN, Ishola M, Gordon C, Jeacock J, Anderson DC . 1989 Does residual insulin secretion (assessed by C-peptide concentration) affect lipid and lipoprotein levels in insulin-dependent diabetes mellitus? Clin. Sci. 77: 369–374

    CAS  Article  Google Scholar 

  • Wolffenbuttel BH, Weber RF, Weeks L, Van Koetsveld PM, Verschoor L . 1990 Twice daily insulin therapy in patients with type 2 diabetes and secondary failure to sulphonylureas Diabetes Res. 13: 79–84

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank Glenn Harding for checking and revising the English and style of the article.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C Campoy.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Baena, R., Campoy, C., Bayés, R. et al. Vitamin A, retinol binding protein and lipids in type 1 diabetes mellitus. Eur J Clin Nutr 56, 44–50 (2002). https://doi.org/10.1038/sj.ejcn.1601279

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ejcn.1601279

Keywords

  • diabetes mellitus type 1
  • vitamin A
  • retinol binding protein
  • atherogenic risk

Further reading

Search

Quick links