Tocotrienol-Rich Vitamin E for Diabetic Nephropathy.

Fifty-four Malaysian patients (mean age, 61 years) with type 2 diabetes and diabetic nephropathy were randomly assigned to receive, in double-blind fashion, tocotrienol-rich vitamin E (Tocovid SupraBio; 1 capsule twice a day) or placebo for 12 weeks. Each capsule contained 200 mg of tocotrienols (62 mg of d-alpha tocotrienol, 112 mg of d-gamma-tocotrienol, and 26 mg of d-delta-tocotrienol) and 92 IU of d-alpha-tocopherol. The mean serum creatinine concentration decreased in the active-treatment group from 1.36 mg/dl at baseline to 1.32 mg/dl at 12 weeks, and increased in the placebo group from 1.39 mg/dl at baseline to 1.45 mg/dl at 12 weeks (p < 0.03 for the difference in the change between groups). The mean estimated glomerular filtration rate (ml/minute/1.73m2) increased in the active-treatment group from 61.0 at baseline to 62.7 at 12 weeks, and decreased in the placebo group from 59.5 at baseline to 56.7 at 12 weeks (p < 0.05 for the difference in the change between groups). Compared with placebo, active treatment had no significant effect on hemoglobin Ale levels.

Comment: Hyperglycemia increases oxidative stress and inflammation, which may contribute to the pathogenesis of diabetic nephropathy. Tocotrienols are considered part of the vitamin E complex (which includes tocopherols and tocotrienols). Tocotrienol-rich vitamin E has been shown to reduce oxidative stress and inflammation and to decrease the severity of diabetic nephropathy in rats. In the present study, supplementation with tocotrienol-rich vitamin E improved renal function in patients with type 2 diabetes and diabetic nephropathy. In previous studies, supplementing with alpha-tocopherol resulted in little or no improvement in diabetic nephropathy, so the positive results seen in the present study may have been due mostly to the tocotrienols.

Tan GC, et al. Tocotrienol-rich vitamin E improves diabetic nephropathy and persists 6-9 months after washout: a phase IIa randomized controlled trial. Ther Adv Endocrinol Metab. 2019;10:2042018819895462.

by Alan R. Gaby, MD

drgaby@earthlink.net