Erythrocyte, but not plasma, vitamin E concentration is associated with carotid intima–media thickening in asymptomatic men at risk for cardiovascular disease

Epidemiological data regarding the preventive role of vitamin E in the pathogenesis of atherosclerosis have yielded conflicting results, possibly because endpoints considered were clinical events but not detection of atherosclerosis per se. Otherwise, it has been suggested that the measure of the erythrocyte α-tocopherol level may be more suitable to assess the human tocopherol status than its plasma level. We investigated the association between early atherosclerosis in superficial arteries assessed noninvasively and the α-tocopherol status in 261 asymptomatic men at risk for cardiovascular disease. α-Tocopherol concentrations in plasma, HDL, and erythrocytes were determined using a reverse-phase HPLC method. Detection of carotid plaques and measure of carotid intima–media thickness (IMT) were performed using high-resolution B-mode ultrasonography. The main result of this study is the observation of a negative correlation (P<0.01) between carotid IMT and erythrocyte α-tocopherol concentration, independently of conventional cardiovascular risk factors, whereas no such association has been found with plasma (total or HDL) α-tocopherol concentrations. No association has been evidenced between α-tocopherol concentrations and carotid plaques. These results emphasize the primary protective role of vitamin E in the early phases of atherosclerosis and the significance of the erythrocyte α-tocopherol concentration as a marker of atherosclerosis.