Serum vitamin C concentration is low in peripheral arterial disease and is associated with inflammation and severity of atherosclerosis.
BACKGROUND
Peripheral arterial disease (PAD) is a severe atherosclerotic condition frequently accompanied by inflammation and oxidative stress. We hypothesized that vitamin C antioxidant levels might be low in PAD and are related to inflammation and disease severity.


RESULTS
We investigated vitamin C (L-ascorbic acid) levels in 85 PAD patients, 106 hypertensives without PAD, and 113 healthy subjects. Serum L-ascorbic acid concentrations were low among PAD patients (median, 27.8 micromol/L) despite comparable smoking status and dietary intake with the other groups (P<0.0001). Subclinical vitamin C deficiency (<11.4 micromol/L), confirmed by low serum alkaline phosphatase activity, was found in 14% of the PAD patients but not in the other groups. Serum C-reactive protein (CRP) concentrations were significantly higher in PAD patients (P<0.0001) and negatively correlated with L-ascorbic acid levels (r=-0.742, P<0.0001). In stepwise multivariate analysis, low L-ascorbic acid concentration in PAD patients was associated with high CRP level (P=0.0001), smoking (P=0.0009), and shorter absolute claudication distance on a standardized graded treadmill test (P=0.029).


CONCLUSIONS
Vitamin C concentrations are lower in intermittent claudicant patients in association with higher CRP levels and severity of PAD. Future studies attempting to relate vitamin C levels to disease occurrence should include in their analysis an inflammatory marker such as CRP.
Langlois
M
M
Departments of Clinical Chemistry, Ghent University Hospital, Ghent, Belgium. michel.langlois@rug.ac.be
Duprez
D
D
Delanghe
J
J
De Buyzere
M
M
Clement
D L
DL
D000368:Aged; D001161:Arteriosclerosis / Q000097:blood* / Q000473:pathology; D001205:Ascorbic Acid / Q000097:blood*; D001241:Aspirin / Q000494:pharmacology; D002097:C-Reactive Protein / Q000187:drug effects / Q000378:metabolism; D005260:Female; D005340:Fibrinogen / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000097:blood; D007249:Inflammation / Q000097:blood*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016491:Peripheral Vascular Diseases / Q000097:blood* / Q000473:pathology; D012720:Severity of Illness Index; D012907:Smoking
D008055:Lipids; D005340:Fibrinogen; D002097:C-Reactive Protein; D001205:Ascorbic Acid; D001241:Aspirin