Vitamin C affects thrombosis/ fibrinolysis system and reactive hyperemia in patients with type 2 diabetes and coronary artery disease

Diabetes Care. 2003 Oct;26(10):2749-53. doi: 10.2337/diacare.26.10.2749.

Abstract

Objective: To examine the effect of vitamin C on forearm vasodilatory response to reactive hyperemia and on plasma level of plasminogen activator inhibitor 1 (PAI-1), von Willebrand factor (vWF), tissue plasminogen activator (tPA), antithrombin III (ATIII), proteins C and S, and factors V (fV) and VII (fVII) in patients with both type 2 diabetes and CAD.

Research design and methods: A total of 39 patients with type 2 diabetes and CAD were divided into two groups and received vitamin C (2 g/day) or no antioxidant for 4 weeks. Forearm blood flow was determined using venous occlusion gauge-strain plethysmography at baseline and after treatment. Forearm vasodilatory response to reactive hyperemia (RH%) or nitrate (NTG%) was defined as the percent change of flow from baseline to the maximum flow during reactive hyperemia or after administration of nitrate, respectively. Biochemical markers were determined by enzyme-linked immunosorbent assay (ELISA) or other standard methods.

Results: RH% was significantly increased after treatment with vitamin C (from 62.4 +/- 7.2 to 83.1 +/- 9.3%, P = 0.024) but remained unaffected in the control group. Vitamin C decreased plasma levels of fV (from 143 +/- 5.4 to 123 +/- 6.03%, P = 0.038), vWF (from 133.5 +/- 14.5 to 109.5 +/- 11.4%, P = 0.016), and tPA (from 12.3 +/- 0.99 to 8.40 +/- 0.60 ng/ml, P = 0.001), whereas these levels remained unaffected in the control group. The changes in RH%, vWF, and tPA were significantly greater (P = 0.028, 0.036, and 0.007, respectively) in the vitamin C-treated group than in the control group. Levels of ATIII, proteins S and C, fVII, and PAI-1 remained unchanged in all groups.

Conclusions: Short-term treatment with high doses of vitamin C improved RH% and decreased plasma levels of tPA and vWF in patients with type 2 diabetes and CAD.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Aged
  • Antioxidants / administration & dosage*
  • Antithrombin III / metabolism
  • Ascorbic Acid / administration & dosage*
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / complications*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Factor V / metabolism
  • Factor VII / metabolism
  • Female
  • Fibrinolysis / drug effects
  • Forearm / blood supply
  • Humans
  • Hyperemia / blood
  • Hyperemia / drug therapy*
  • Male
  • Middle Aged
  • Plasminogen Activator Inhibitor 1 / blood
  • Protein C / metabolism
  • Protein S / metabolism
  • Regional Blood Flow / drug effects
  • Thrombosis / blood
  • Thrombosis / complications
  • Thrombosis / drug therapy*
  • Tissue Plasminogen Activator / blood
  • Vasodilation / drug effects
  • von Willebrand Factor / metabolism

Substances

  • Antioxidants
  • Plasminogen Activator Inhibitor 1
  • Protein C
  • Protein S
  • von Willebrand Factor
  • Antithrombin III
  • Factor V
  • Factor VII
  • Tissue Plasminogen Activator
  • Ascorbic Acid