Access Type

Open Access Thesis

Date of Award

January 2013

Degree Type

Thesis

Degree Name

M.S.

Department

Nutrition and Food Science

First Advisor

Pramod Khosla

Abstract

Chronic hemodialysis (HD) patients have an increased risk of cardio vascular diseases (CVD) driven by dyslipidemia, oxidative stress and inflammation. Vitamin E isomers (tochopherols and tocotrienols) are fat-soluble anti oxidants. Tocotrienol isomers (T3) are fewer studies than tochopherol isomers, but they have multifaceted effects on oxidative stress, inflammation and lipid metabolism. We investigated the lipid modifying effects of tocotrienol rich fractions (TRF) on CKD patients receiving HD in a randomized, placebo-controlled, double-blind parallel trial on 81 patients (43M, 38F). Subjects (n=41) were given 220 mg/day of either TRF (180mg TRF, comprising of 34% áT3, 3%âT3, 50% ãT3, 13%äT3 and 40 mg á- tocopherol), or placebo (n=40) which provided 0.24 mg T3 and 0.44 mg á-tocopherol. We used standard kids to measure lipid profile=[plasma triglycerides (TG), plasma total cholesterol (TC), HDL-cholesterol (HDL-C), LDL- cholesterol (LDL-C) using Friedwald equation, and the corresponding TC/HDL-C ratios] during stating point, week 8, week 12 and week 16. Statistical analysis used double t-test and for mean differences between TRF and placebo groups with p<0.05 as significant. We found that TG was progressively declined in the TRF group while HDL-C improved at week 12 and 16(p<0.05). We evaluated CETP activity and apo A1 using a fluoremetric essay and Elisa, respectively to further evaluate HDL and apo B lipoprotein metabolism. We found an increase in plasma apo A1 among TRF group at week 12 as compared with placebo, while week 16 changes were attributed to depressed CETP activity. We concluded that TRF supplements improved lipids in this HD group. A multi-center trial is needed to further study the mechanism which TRF work, and with higher doses of TRF.

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