13 Aug Type 1 Diabetes: Coronary Artery Disease and Oxidative Stress Response

MedicalResearch.com Interview with: Tina Costacou, Ph.D. Assistant Professor of Epidemiology University of Pittsburgh MedicalResearch.com: What are the main findings of the study? Answer: The generation of reactive oxygen species is a natural and essential feature of human physiology, although excess production of free radicals has been related to the development and progression of diabetes complications. Simply put, a “balance” is required between the pro- and the anti-oxidant forces to maintain good health. Our aim in this study of people with type 1 diabetes was to evaluate whether an individual’s antioxidant vitamin levels in blood can modify the heart disease risk conferred by increased oxidative stress. Indeed, we observed that higher concentrations of α-tocopherol (a form of vitamin E) in blood overtime were related to lower risk of developing coronary heart disease, whereas greater oxidative stress (as measured by urinary 15-isoprostane F2t) was related to greater risk of disease. Interestingly, the ratio of α-tocopherol to urinary 15-isoprostane F2t, which we used as a measure of an individual’s ability to respond to / counteract oxidative stress, also was a strong predictor of subsequent coronary heart disease development. Our findings thus point to a different way of assessing a person’s risk for developing disease. Currently in clinical practice, physicians assess an individual’s risk factors (e.g. oxidative stress) for a pathologic condition (e.g. heart disease) to make inferences about the person’s risk to develop this condition and take preventive measures if needed (e.g. assign a treatment regimen). Our findings, however, suggest that an individual’s risk for disease may be better evaluated by simultaneously assessing factors representing the risk and those representing protection from or resistance to the risk. Thus, though two individuals may have similarly high levels of oxidative stress, there may be differences in the concentration of antioxidant vitamins between the two (and vice versa), which may put them at different risk categories, with one person potentially requiring vitamin supplementation while the second not needing to use supplements.