Evidence for anti-inflammatory effects of combined administration of vitamin E and C in older persons with impaired fasting glucose: impact on insulin action.

Objective: Vitamin E and C given separately improve insulin sensitivity due to an inhibitory effect on oxidative stress and inflammation, however their combined effect on glucose control and inflammation is unknown. To investigate combined effect of Vitamin E and C in elderly with Impaired Fasting Glucose (IFG) on insulin action and substrate oxidation. Design: Controlled-trial administration of Vitamin E (1000 mg/day)and Vitamin C (1000 UI/day) for four weeks. Hyperinsulinemic euglycemic glucose clamp was performed before and following supplementation. Setting: Out-patient clinic. Participants: Thirteen older men with IFG. Main Outcome Parameters: Variations in whole body glucose disposal WBGD), anti-oxidant, and inflammatory cytokines plasma levels. Results: An increase in plasma Vitamin E (8.3 + 0.8 vs. 64.9 + 2.1 micromol/l; p < 0.001] and C (35.9 + 5.4 vs. 79.4 + 7.4 micromol/l; p < 0.001) was found. Vitamin administration reduced insulin, glucose, lipid, TNF-alpha and [8-]isoprostane levels. Increase in plasma vitamin E levels correlated with decline in both plasma [8-]isoprostane levels (r= -0.58; p = 0.048) and TNF-alpha levels (r=-0.62; p = 0.025), while no correlations were found for Vitamin C. Whole body glucose disposal (WBGD) (22.7 + 0.6 vs. 30.4 + 0.8 mmol x kg-1 x min-1; p = 0.001) and non-oxidative glucose metabolism rose after supplementation. Rise in plasma levels of Vitamin C and E correlated with WBGD. Multivariate linear regression models showed independent associations among the change in Vitamin E and the decline in TNF-alpha and [8-]isoprostane levels. Conclusions: Combined administration of Vitamin E and C lowered inflammation and improved insulin action through a rise in non-oxidative glucose metabolism.