Acute Ischemic Heart Disease
Inverse association between carotid intima-media thickness and the antioxidant lycopene in atherosclerosis*

https://doi.org/10.1067/mhj.2002.120776Get rights and content

Abstract

Background Antioxidants may prevent atherosclerosis by interfering with endothelial activation, which involves the expression of endothelial adhesion molecules. The aim of this study was to explore the relationship between plasma levels of some lipid-soluble antioxidants (γ-tocopherol, α-tocopherol, lycopene, β-carotene, and ubiquinone), carotid maximum intima-media thickness (IMTmax), an index of atherosclerotic extension/severity, and soluble adhesion molecules (vascular cell adhesion molecule-1 [VCAM-1], intercellular adhesion molecule-1 [ICAM-1], and E-selectin), which are taken as a reflection of vascular cell expression of adhesion molecules. Methods We studied 11 healthy control subjects, 11 patients with uncomplicated hypertension (UH), and 11 patients with essential hypertension plus peripheral vascular disease (PVD) who were matched for age, sex, smoking habit, and body mass index. Results Patients with PVD had elevated IMTmax (2.7 [1.1-3.1] mm, median [range]) compared with both patients with UH(1.2 [0.8-2.4] mm) and control subjects (1.0 [0.6-2] mm). In patients with PVD, soluble (s)VCAM-1 and sICAM-1 were also significantly higher than in the 2 other categories. Plasma levels of lycopene had a trend toward lower values in patients with PVD compared with other groups (P =.13). A statistically significant correlation was found between lycopene and IMTmax (r = 0.42, P =.014) at univariate analysis, which persisted at multivariate analysis (P <.05) and was independent of low-density lipoprotein cholesterol, creatinine clearance, and plasma insulin. Plasma lycopene did not significantly correlate with any of the soluble adhesion molecules tested. Conclusions We conclude that the inverse relationship of plasma lycopene with IMTmax is compatible with a protective role of this natural dietary antioxidant in atherosclerosis, although the mechanism of protection does not apparently involve a decrease in endothelial activation measured through soluble adhesion molecules. (Am Heart J 2002;143:467-74.)

Section snippets

Patients

Subjects enrolled in this study were previously analyzed in a reported study of the relationship of soluble adhesion molecules with atherosclerosis13 and comprised the following 3 groups.

(1) There were 11 healthy, sedentary, normotensive, nonobese control subjects. They were taking no drugs, and physical examination, routine blood and urine tests, blood pressure, electrocardiogram, abdominal ultrasonography, and ankle/arm pressure index all had normal findings. Age was 57 ± 9 years. Two of the

Results

The 3 patient categories were comparable for age, sex, prevalence of smoking, and body mass index as the result of the selection. Habitual physical exercise was less frequent in patients with PVD (Table I). Ankle/arm pressure was normal (>0.96) in control subjects and patients with UH but reduced in patients with PVD (Table I). Systolic, diastolic, and mean arterial pressures were higher in patients with UH and PVD compared with control subjects, with higher (P <.01) values for systolic blood

Discussion

This study shows that plasma concentrations of one lipid-soluble dietary antioxidant, lycopene, negatively correlates with IMTmax, an independently assessed index of atherosclerosis extension or severity, across a small population ranging from healthy persons to hypertensive patients to patients with severe atherosclerosis over a wide range of IMTmax values. A significant negative correlation of lycopene with IMTmax persisted at multiple regression analysis after taking into account a

Acknowledgements

We thank Giulia Dell'Omo, MD, for help in patient recruitment and Ms Caterina Baldocchi and Dr Valentina Berti for assistance in the preparation of the manuscript.

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    *

    Reprint requests: Raffaele De Caterina, MD, PhD, Laboratory for Thrombosis and Vascular Research, C. N. R. Institute of Clinical Physiology, via Moruzzi, 1-56100 Pisa, Italy.[email protected]

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