Vitamin E levels

Vitamin E or tocopherol is a fat-soluble vitamin that functions as an antioxidant and is important for its role in anti-inflammatory processes, its inhibition of platelet aggregation and its immune-enhancing activity.

The term vitamin E encompasses 8 compounds, four tocopherols and 4 tocotrienols, which occur naturally in foods of plant origin. Tocopherol is the main and most abundant form of vitamin E and can be alpha-tocopherol, beta-tocopherol, gamma-tocopherol and delta-tocopherol.

Humans are not able to synthesize vitamin E, so it is necessary to access it through food, by consuming foods from plant sources, since vitamin E is formed from photosynthetic processes in plants.

Vitamin E is insoluble in water. On the contrary, it is fat-soluble, like vitamins A, D and K. For this reason, the absorption of vitamin E depends on the absorption of lipids in the intestine, requiring pancreatic and biliary secretions. Once bound to the epithelial cells of the intestine, vitamin E is incorporated into chylomicrons, being secreted into the systemic circulation.

Vitamin E is essential for the prevention of oxidative stress by inhibiting the production of reactive oxygen species when fats are oxidized. It also protects the cell membrane and is necessary to maintain proper skeletal muscle homeostasis.

Vitamin E deficiency due to low dietary intake is rare in developed countries. Vitamin E deficiency is usually secondary to disorders that hinder the absorption of vitamin E from fats, such as liver disorders, disorders of fat metabolism and disorders of biliary secretion.

Among the most common causes of vitamin E deficiency are impaired absorption of fatty acids involved in vitamin E metabolism, mutations in the tocopherol transfer protein, patients with cystic fibrosis (a lung disorder that can also affect bile secretion), patients with cystic fibrosis (a lung disorder that can also affect biliary secretion), patients with a history of biliary secretion, and patients with a history of bile secretion.These include patients with cystic fibrosis (a lung disorder that can also affect biliary secretion), patients with intestinal and/or liver syndromes or diseases such as cholestasis or primary biliary cirrhosis, and those with certain inherited monogenic diseases directly or indirectly related to vitamin E, such as abetalipoproteinemia (a digestive disorder characterized by malabsorption of fats).

It is rare for vitamin E levels to be deficient in healthy individuals who include foods with vitamin E in their diet. Vitamin E deficiency may occur due to some pathologies such as cystic fibrosis or due to mutations that affect some process of vitamin E metabolism, such as the absorption of fatty acids on which the absorption of the vitamin itself depends, or other mutations.

Several GWAS studies carried out with the participation of people from different geographical ancestries have identified 7 markers associated with an increased risk of vitamin E deficiency. These markers belong to genes important in the metabolism of the vitamin. Among them we can find the CD36 gene, which produces a glycoprotein important in the uptake and processing of fatty acids; the SCARB1 gene, which produces a receptor involved in the transport of vitamin E from enterocytes into the blood and in the excretion of alpha-tocopherol; and the SCARB1 gene, which produces a receptor involved in the transport of vitamin E from enterocytes into the blood.The gene TTPA, among others, produces an alpha-tocopherol transfer protein (alphaTTP) that regulates the storage of alpha-tocopherol in the liver and its transport between membrane vesicles.

Number of observed variants

13.5 million variants

Number of variants analyzed in the study

7 variants

Bibliography

Galmés S., Serra F., Palou A. Vitamin E Metabolic Effects and Genetic Variants: A Challenge for Precision Nutrition in Obesity and Associated Disturbances. Nutrients. 2018; 10(12): 1919.

Major J.M., Yu K., Wheeler W., et al. Genome-wide association study identifies common variants associated with circulating vitamin E levels. Hum Mol Genet. 2011 Oct 1;20(19):3876-83.

Niforou A, Konstantinidou V, Naska A. Genetic Variants Shaping Inter-individual Differences in Response to Dietary Intakes-A Narrative Review of the Case of Vitamins. Front Nutr. 2020;7:558598.

Wang T, Xu L. Circulating Vitamin E Levels and Risk of Coronary Artery Disease and Myocardial Infarction: A Mendelian Randomization Study. Nutrients. 2019;11(9):2153.

Wright M.E., Peters U., Gunter M.J., et al. Association of variants in two vitamin e transport genes with circulating vitamin e concentrations and prostate cancer risk. Cancer Res. 2009;69(4):1429-38.

Rizvi S., Raza S.T., et al. The Role of Vitamin E in Human Health and Some Diseases. Sultan Qaboos Univ Med J. 2014 May; 14(2): e157–e165.

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