The effect of antioxidant supplementation on a serum marker of free radical activity and abnormal serum biochemistry in alcoholic patients admitted for detoxification

• Published in: Journal of hepatology Vol. 19; no. 1; pp. 105 - 109
• Main Authors: Butcher, Graham P., Rhodes, Johnathan M., Walker, Robin, Krasner, Neville, Jackson, Malcolm J.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier B.V 01.08.1993; Elsevier
• Subjects: Adult; Aged; Alcohol; Alcoholism and acute alcohol poisoning; Alpha tocopherol; Antioxidant; Antioxidants - administration & dosage; Antioxidants - metabolism; Ascorbic acid; Ascorbic Acid - administration & dosage; Beta carotene; Biological and medical sciences; Biomarkers - blood; Carotenoids - administration & dosage; Diene conjugate; Double-Blind Method; Drug Therapy, Combination; Ethanol - adverse effects; Female; Free radical; Free Radicals; Hematologic Tests; Humans; Liver Diseases, Alcoholic - blood; Liver Diseases, Alcoholic - enzymology; Liver Diseases, Alcoholic - etiology; Male; Medical sciences; Middle Aged; Selenium - administration & dosage; Substance Withdrawal Syndrome - blood; Substance Withdrawal Syndrome - complications; Toxicology; Vitamin E - administration & dosage; Ascorbic acid; Diene conjugate; Alcohol; Antioxidant; Alpha tocopherol; Free radical; Beta carotene; Human; Ethanol; Enzyme; Transaminases; Transferases; Aspartate transaminase; Serum; α-Tocopherol; Deintoxication; Comparative study; Linoleic acid
• ISSN: 0168-8278; 1600-0641
• DOI: 10.1016/S0168-8278(05)80183-7

Alcoholics admitted for detoxification were entered into a double blind placebo controlled trial of oral supplementation with an antioxidant cocktail (vitamin E, beta carotene, vitamin C and selenium) in order to determine the effect of this supplementation on the rate of resolution of a serum marker of free radical activity and abnormal serum biochemistry. The molar proportion of linoleic acid that was diene conjugated (a marker of free radical activity), was increased in the alcoholics 2.9% ± 1.2 (mean ± S.D.) compared to normal controls 1.3% ± 0.6 (P < 0.0001) but fell at a similar rate during the first week of hospitalisation in supplemented and placebo-treated patients with a mean fall of 53.7% (± 16.4 S.D.) in the placebo group and 56.0% (± 23.7) (P = 0.32, NS) in the antioxidant supplemented group. Similarly, there was no difference in the rate of fall between serum aspartate transaminase (AST) concentration in the two groups: the placebo group falling by a mean of 68.9% (± 35.2) and the antioxidant supplemented group falling by 70.1% (± 10.0) (P = 0.41, NS) over the first 7 days of hospitalization. Alcoholics had low serum concentrations of vitamin E compared with controls (15.6 mg/l ± 6.2 S.D.) which rose more in the supplemented group over the period of a week (7.7 mg/l ± 4.4 to 21.6 mg/l ± 5.1) (a mean rise of 180.5%) compared with the placebo group (8.6 mg/l ± 6.8 to 9.6 mg/l ± 5.7) — a mean rise of 11.6% (P = 0.006). Serum beta carotene concentrations were also very low in alcoholics compared with controls (24.9 mg/l ± 19.1 S.D.) and rose more in the supplemented group (6.6 mg/l ± 6.8 to 57.8 mg/l ± 24.2) compared with the placebo group (4.3 mg/l ± 4.9 to 15.7 mg/l ± 8.4) a mean rise of 775.8% in the treated group compared with 265.1% in the unsupplemented group (P = 0.034). This study confirms the elevated serum concentration of diene conjugated linoleic acid in alcoholics, but shows that oral supplementation with antioxidants, although correcting the severely subnormal concentration of the antioxidants β-carotene and vitamin E had no effect on the rate of normalisation of either the serum diene conjugated linoleic acid or the serum AST concentration.