title: Antioxidant vitamins C and E improve endothelial function in children with hyperlipidemia: Endothelial Assessment of Risk from Lipids in Youth (EARLY) Trial.
abstract: BACKGROUND
  Hyperlipidemia is associated with endothelial dysfunction, an early event in atherosclerosis and predictor of risk for future coronary artery disease. Epidemiological studies suggest that increased dietary intake of antioxidants reduces the risk of coronary artery disease. The purpose of this study was to determine whether antioxidant vitamin therapy improves endothelial function and affects surrogate biomarkers for oxidative stress and inflammation in hyperlipidemic children.
  
  
  RESULTS
  In a randomized, double-blind, placebo-controlled trial, the effects of antioxidant vitamins C (500 mg/d) and E (400 IU/d) for 6 weeks and the National Cholesterol Education Program Step II (NCEP-II) diet for 6 months on endothelium-dependent flow-mediated dilation (FMD) of the brachial artery were examined in 15 children with familial hypercholesterolemia (FH) or the phenotype of familial combined hyperlipidemia (FCH). Antioxidant vitamin therapy improved FMD of the brachial artery compared with baseline (P<0.001) without an effect on biomarkers for oxidative stress (autoantibodies to epitopes of oxidized LDL, F2-isoprostanes, 8-hydroxy-2'-deoxyguanosine), inflammation (C-reactive protein), or levels of asymmetric dimethylarginine, an endogenous inhibitor of nitric oxide.
  
  
  CONCLUSIONS
  Antioxidant therapy with vitamins C and E restores endothelial function in hyperlipidemic children. Early detection and treatment of endothelial dysfunction in high-risk children may retard the progression of atherosclerosis.
authors.affiliation: University of California, San Francisco, 2 Koret Way, Rm N631, San Francisco, Calif 94143-0610, USA. marguerite.engler@nursing.ucsf.edu
authors.forename: Marguerite M
authors.initials: MM
authors.lastname: Engler
authors.forename: Mary B
authors.initials: MB
authors.lastname: Engler
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Malloy
authors.forename: Elisa Y
authors.initials: EY
authors.lastname: Chiu
authors.forename: Monique C
authors.initials: MC
authors.lastname: Schloetter
authors.forename: Steven M
authors.initials: SM
authors.lastname: Paul
authors.forename: Markus
authors.initials: M
authors.lastname: Stuehlinger
authors.forename: Ken Y
authors.initials: KY
authors.lastname: Lin
authors.forename: John P
authors.initials: JP
authors.lastname: Cooke
authors.forename: Jason D
authors.initials: JD
authors.lastname: Morrow
authors.forename: Paul M
authors.initials: PM
authors.lastname: Ridker
authors.forename: Nader
authors.initials: N
authors.lastname: Rifai
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Miller
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Witztum
authors.forename: Michele
authors.initials: M
authors.lastname: Mietus-Snyder
mesh_terms: D000293:Adolescent; D000328:Adult; D000975:Antioxidants / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000627:therapeutic use*; D001916:Brachial Artery / Q000503:physiopathology; D002648:Child; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D014664:Vasodilation; D014810:Vitamin E / Q000627:therapeutic use*
chemical_list: D000975:Antioxidants; D014810:Vitamin E; D001205:Ascorbic Acid