***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND AND AIMS Endothelial dysfunction , insulin resistance and oxidative stress are believed to be central and associated mechanisms in atherogenesis . We aim ed to determine the effect of the antioxidant vitamin E on endothelial function , insulin action and cardiovascular risk markers in young healthy adult offspring of parents with Type 2 diabetes . METHODS Healthy , glucose-tolerant adults ( 18 - 38 years ) , 14 ( 12 male/2 female ) with at least one parent with Type 2 diabetes , and 14 ( 12 male/2 female ) subjects with no family history of diabetes ( controls ) were studied . Insulin action was assessed by euglycaemic hyperinsulinaemic clamp ( 1 mU/kg/min ) . Endothelial function was assessed by forearm blood flow ( FBF ) responses to intra-brachial artery infusions of acetylcholine ( ACh ) ( endothelium-dependent vasodilation ) , sodium nitroprusside ( SNP ) ( endothelium-independent vasodilation ) and N(G)-monomethyl L-arginine ( LNMMA ) ( nitric oxide synthase inhibition ) . Thirteen offspring ( 18 - 38 years , 11 male/2 female , BMI < 30 kg/m2 ) completed a r and omized , double-blind , crossover trial ( 12 weeks vitamin E 800 IU/day or placebo , 6-week washout ) . RESULTS Exogenous glucose infusion rates to maintain euglycaemia were positively associated with response to acetylcholine in offspring ( r = 0.61 , P < 0.05 ) , and were linked with triglycerides .  Vitamin E had no effect on endothelial function , insulin action or cardiovascular risk markers in healthy adult offspring of parents with Type 2 diabetes . CONCLUSIONS Our results support a positive association between insulin action and endothelial-dependent vasodilation in young healthy adult offspring of parents with Type 2 diabetes , but indicate no effect of vitamin E on these parameters Non-alcoholic fatty liver disease ( NAFLD ) has been suggested to be well correlated with altered blood pressure . This study was conducted to determine the effects of symbiotic and vitamin E supplementation on blood pressure and inflammatory indices of patients with NAFLD . This r and omized , double-blind , placebo-controlled trial was performed among 60 NAFLD patients aged 25 to 64 years old . Participants were r and omly divided into four groups to receive a 400 IU alpha-tocopherol and 2 × 108 CFU/g symbiotic supplement for 8 weeks . The anthropometric parameters , systolic blood pressure ( SBP ) and diastolic blood pressure ( DBP ) , serum malondialdehyde ( MDA ) , nitric oxide ( NO ) and tumor necrosis factor α ( TNFα ) were assessed at baseline and after 8 weeks of intervention . After 8 weeks of intervention , combined symbiotic and alpha-tocopherol , symbiotic and alpha-tocopherol alone administration , compared with the placebo , result ed in significant decreases in SBP ( -17.07±2.1 , -16.07±3.56 , -1.73±2.25 and -1.55±3.01 mmHg , P=0.01 ) , serum MDA ( -1.19±0.5 , -0.12±0.65 , 0.14 ± 0.64 and 0.16±0.34 nmol/mL , P<0.001 ) , serum TNFα ( -15.62±13.93 , -9.24±7.12 , -11.44 ± 15.47 and 3.01±1.71 pg/ml , P<0.001 ) concentrations . A significant decrease in serum AST ( -11.36±4.52 , -7.43±8.58 , -5.93±6.61 and 2.5±5.75 μmol/L , P < 0.001 ) , ALT ( -12.79±3.65 , -3.66±6.81 , -6.54±7.66 and 4.16±3.43 μmol/L , P < 0.001 ) and ALP ( -26.8±11.1 , -4.56±9.22 , -14.48±12.22 and 5.19±2.64 μmol/L , P < 0.001 ) was seen . Variations in DBP and serum NO concentration were not significant . Alpha-tocopherol and symbiotic supplementation among patients with NAFLD result ed in decreased SBP , serum MDA , TNFα levels and enzymes liver ; however , they did not affect DBP and serum NO concentration Exercise increases oxygen consumption and causes a disturbance of intracellular pro-oxidant-antioxidant homeostasis . Athletes are exposed to acute and chronic stress that may lead to increased generation of oxidative species . Hence oxidative stress increases in athletes . Administration of antioxidant like alpha-tocopherol as supplementation may reduce the cell damage caused due to oxidative stress . In the present study , our aim was to study the effects of alpha-tocopherol supplementation on the cardiopulmonary fitness in endurance athletes ( cyclists ) and non-athletes . Our study included 40 cyclists who were trained under District Youth Service & Sports Office . 40 controls were r and omly selected from student group of B.L.D.E.A 's Medical College .  Alpha-tocopherol ( Vitamin E ) 200 mg/day for 21 days wasgiven to study group and placebo was given to placebo group . Various physiological parameters like heart rate , blood pressure , respiratory rate were recorded , for assessing cardiopulmonary fitness : Physical Fitness Index ( PFI ) and VO2 max ml/min/kg were recorded before and after supplementation of vitamin E in athletes , and were compared with placebo group before and after supplementation of placebo and also with non-athletes . The results obtained from present study indicate that antioxidant like alpha-tocopherol supplementation did not contribute significantly to improve the cardiopulmonary fitness of endurance athletes There is considerable evidence that chronic moderate-to-high alcohol consumption increases blood pressure . The mechanisms by which this occurs are not clear . Alcohol consumption can induce oxidative stress and cytochrome P450 ( CYP450 ) isoforms that are associated with oxidative stress and may influence vascular tone . To study the role of such mechanisms we examined whether reducing alcohol intake in moderate-to-heavy drinkers ( 40 - 110 g/day ) result ed in changes in urinary excretion of 20-HETE , a CYP450 metabolite of arachidonic acid , and plasma and urinary F(2)-isoprostanes as markers of lipid peroxidation . After a 4-week run-in period during which healthy men maintained their usual drinking pattern they were r and omized to a two-way crossover intervention study . In each of the 4-week treatment periods subjects either substituted their usual alcohol intake with a 0.9 % alcohol beer or maintained their usual alcohol intake .  Plasma and urinary F(2)-isoprostanes and urinary 20-HETE were measured by gas chromatography mass spectrometry , and serum gamma-glutamyl transpeptidase ( gamma-GT ) was measured as a biomarker of alcohol consumption , at the end of each study period . Sixteen healthy men age 51.0+/-2.7 years and with a BMI of 26.4+/-0.61 kg/m(2 ) completed the study . The reductions in alcohol intake ( 72.4+/-5.0 vs 7.9+/-1.6 g/day , p<0.001 ) and serum gamma-GT ( geometric mean 24.4 U/L ( 95 % CI 19.7 , 30.2 ) vs 18.6 U/L ( 95 % CI 15.5 , 22.2 , p<0.01 ) were accompanied by a significant fall in blood pressure as well as urinary 20-HETE excretion ( 158+/-23 vs 109+/-19 pmol/mmol creatinine , p<0.001 ) and plasma F(2)-isoprostanes ( 3438+/-158 vs 2929+/-145 pmol/L , p=0.01 ) . A substantial reduction in alcohol consumption in healthy men lowered plasma F(2)-isoprostanes and urinary 20-HETE . Increased oxidative stress and 20-HETE production may be linked , at least in part , to the pathogenesis of alcohol-related hypertension The aim of this study was to assess the impact of conjugated linoleic acids ( CLAs ) , vitamin E , and combination of these nutrients on serum lipid profiles and blood pressure ( BP ) in patients with active rheumatoid arthritis ( RA ) . In a r and omized , double-blind , placebo-controlled trial , 87 patients with active RA were divided into four groups receiving one of the following daily supplements for three months : Group C : CLAs 2.5 g equivalent to 2 g mixture of cis 9-trans 11 and trans 10-cis12 CLAs in a rate of 50/50 ; Group E : vitamin E : 400 mg ; Group CE : CLAs and vitamin E at above doses : Group P : placebo . After supplementation , SBP levels decreased significantly in the group C in comparison with groups E and P and mean arterial pressure reduced significantly in groups C and CE . There were n’t significant differences in the levels of prostagl and in E2 ( PGE2 ) , triglycerides , cholesterol , low-density lipoprotein cholesterol ( LDL-C ) , high-density lipoprotein cholesterol ( HDL-C ) , LDL/HDL , cholesterol/HDL , fasting blood sugar , C-reactive protein ( CRP ) , arylestrase activity , platelet count and body mass index between groups . CRP dropped nonsignificantly in groups P , C , E and CE ( 19 % , 24 % , 55 % , and 39 % , respectively ) . Erythrocytes sedimentation rate levels decreased in groups C , E and CE ( P ≤ 0.05 , P ≤ 0.05 , P ≤ 0.001 , respectively ) . It is concluded that supplementation of CLAs  decreased BP  and vitamin E  decreased CRP . Therefore cosupplementation of CLAs and vitamin E might be profitable for heart disease prevention in RA patients We examined the effects of high-dosage vitamin E treatment over a 12-month period on the vascular reactivity of micro- and macrocirculation and left ventricular function in diabetic patients . Subjects ( n = 89 ) were r and omized to vitamin E ( 1,800 IU daily ) or placebo and were followed for 12 months . High-resolution ultrasound images were used to measure the flow-mediated dilation ( FMD ; endothelium dependent ) and nitroglycerin-induced dilation ( NID ; endothelium independent ) of the brachial artery . Laser Doppler perfusion imaging was used to measure vascular reactivity in the forearm skin . Left ventricular function was evaluated using transthoracic echocardiogram . At the end of the 6-month period , a worsening in endothelium-dependent skin vasodilation ( P = 0.02 ) and rise in endothelin levels ( P = 0.01 ) were found in the vitamin E compared with the placebo group . At the end of the 12-month period , a worsening was observed in NID ( P = 0.02 ) and a marginal worsening was seen in systolic blood pressure ( P = 0.04 ) and FMD ( P = 0.04 ) in the vitamin E compared with the placebo group . In addition C-reactive protein levels decreased marginally in the vitamin E compared with the placebo group ( P = 0.05 ) . No changes were observed in left ventricular function . We concluded that long-term treatment with 1,800 IU of vitamin E has no beneficial effects on endothelial or left ventricular function in diabetic patients . Because vitamin E-treated patients had a worsening in some vascular reactivity measurements when compared with control subjects , the use of high dosages of vitamin E can not be recommended OBJECTIVES We examined the effects of oral administration of vitamin E , an antioxidant , on endothelium-dependent vasodilation in patients with coronary spastic angina . BACKGROUND We have recently reported that endothelium-dependent vasodilation is impaired in patients with coronary spastic angina ( CSA ) . Furthermore , it is known that oxidative stress may play an important role in the impairment of endothelium-dependent vasodilation in cardiovascular diseases . METHODS With the ultrasound technique , flow-dependent vasodilation of the brachial arteries during reactive hyperemia was examined before and after treatment for a month with either oral administration of vitamin E ( alpha-tocopherol acetate , 300 mg/day ) or placebo , which is r and omly assigned , in patients with CSA ( n=60 ) . RESULTS Before treatment , 
    Output:
    
Overall , there were no significant effects on DBP and MAP .
This meta- analysis suggested that vitamin E supplements decreased only SBP and had no favorable effect on DBP and MAP