Pharmacogenomics in prevention of diabetic cardiovascular disease: utilization of the haptoglobin genotype in determining benefit from vitamin E

Numerous large clinical trials have been carried out over the past several years testing the ability of the antioxidant vitamin E to prevent diabetic cardiovascular disease. Meta-analysis of these studies has demonstrated that vitamin E does not provide any cardiovascular protection and may be associated with an increase in mortality. However, these studies did not address possible benefit to subgroups with increased oxidative stress. In this review we provide supporting clinical evidence and a mechanistic basis for utilizing a genetic marker, the haptoglobin genotype, in determining whether vitamin E therapy may or may not be beneficial for a given patient with diabetes.