Safety and Effectiveness of Empagliflozin in Korean Patients with Type 2 Diabetes Mellitus: Results from a Nationwide Post-Marketing Surveillance

Background@#To evaluate the safety and effectiveness of empagliflozin in routine clinical settings, we collected and assessed the clinical profiles of Korean patients with type 2 diabetes mellitus. @*Methods@#This was a post-marketing surveillance study of empagliflozin 10 and 25 mg. Information on adverse events and adverse drug reactions (ADRs) was collected as safety data sets. Available effectiveness outcomes, including glycosylated hemoglobin (HbA1c) level, fasting plasma glucose, body weight, and blood pressure, were assessed. @*Results@#The incidence rate of ADRs was 5.14% in the safety dataset (n=3,231). Pollakiuria, pruritis genital, and weight loss were the most common ADRs. ADRs of special interest accounted for only 1.18%, and there were no serious events that led to mortality or hospitalization. In the effectiveness data set (n=2,567), empagliflozin significantly reduced the mean HbA1c level and body weight during the study period by –0.68%±1.39% and –1.91±3.37 kg (both P<0.0001), respectively. In addition, shorter disease duration, absence of dyslipidemia, and higher baseline HbA1c levels were identified as the clinical features characteristic of a “responder” to empagliflozin therapy. @*Conclusion@#Empagliflozin is a safe and potent glucose-lowering drug in routine use among Korean patients with type 2 diabetes mellitus. It is expected to have better glycemic efficacy in Korean patients with poorly controlled type 2 diabetes mellitus.

Efficacy and Safety of Pioglitazone versus Glimepiride after Metformin and Alogliptin Combination Therapy: A Randomized, Open-Label, Multicenter, Parallel-Controlled Study

BACKGROUND: There is limited information regarding the optimal third-line therapy for managing type 2 diabetes mellitus (T2DM) that is inadequately controlled using dual combination therapy. This study assessed the efficacy and safety of pioglitazone or glimepiride when added to metformin plus alogliptin treatment for T2DM.METHODS: This multicenter, randomized, active-controlled trial (ClinicalTrials.gov: NCT02426294) recruited 135 Korean patients with T2DM that was inadequately controlled using metformin plus alogliptin. The patients were then randomized to also receive pioglitazone (15 mg/day) or glimepiride (2 mg/day) for a 26-week period, with dose titration was permitted based on the investigator's judgement.RESULTS: Glycosylated hemoglobin levels exhibited similar significant decreases in both groups during the treatment period (pioglitazone: −0.81%, P<0.001; glimepiride: −1.05%, P<0.001). However, the pioglitazone-treated group exhibited significantly higher high density lipoprotein cholesterol levels (P<0.001) and significantly lower homeostatic model assessment of insulin resistance values (P<0.001). Relative to pioglitazone, adding glimepiride to metformin plus alogliptin markedly increased the risk of hypoglycemia (pioglitazone: 1/69 cases [1.45%], glimepiride: 14/66 cases [21.21%]; P<0.001).CONCLUSION: Among patients with T2DM inadequately controlled using metformin plus alogliptin, the addition of pioglitazone provided comparable glycemic control and various benefits (improvements in lipid profiles, insulin resistance, and hypoglycemia risk) relative to the addition of glimepiride.

Experience of taking Oral Contraceptives in Adult Women

PURPOSE: The purpose of this study was to explore essences and meanings of using oral contraceptives among adult women. METHODS: The interview was conducted with 20 adult women who lived in Seoul, Gyeongi Province, Jeolla Province, Chungcheong Province, and Gangwon Province. Participants with the experience of using oral contraceptives for contraception were selected by convenience sampling. Semi-structured interviews were conducted for data collection. The data were analyzed using Colaizzi's method. RESULTS: Five themes revealed: ‘Lack of information and knowledge regarding oral contraceptives’, ‘Inconvenient and difficult purchase process of oral contraceptives’, ‘Pressure and fear regarding other people's reaction’, ‘Self-centered thinking toward the use of oral contraceptives’, ‘A need for a change in public awareness and policy’. CONCLUSION: A change in society's perception about oral contraceptives is required for safe contraceptives use. Therefore, it is necessary to educate the correct usage of oral contraceptives, and to develop a program for changing the paradigm of sex education.

A Case of Fulminant Type 1 Diabetes during Pregnancy / 임상당뇨병

Fulminant type 1 diabetes is characterized by acute onset, no evidence of islet-related autoantibodies, low glycated hemoglobin(HbA1c) level at onset, and metabolic complications such as diabetic ketoacidosis. Fulminant type 1 diabetes development during pregnancy can result in severe maternal and fetal complications. Most of the patients with fulminant type 1 diabetes during pregnancy have been reported in Japan. In Korea, reports of fulminant type 1 diabetes during pregnancy are uncommon. We report a 36-year-old Korean woman with fulminant type 1 diabetes developed at 32 weeks of gestation who demonstrate a good outcome.

Repeated Glucose Deprivation/Reperfusion Induced PC-12 Cell Death through the Involvement of FOXO Transcription Factor

BACKGROUND: Cognitive impairment and brain damage in diabetes is suggested to be associated with hypoglycemia. The mechanisms of hypoglycemia-induced neural death and apoptosis are not clear and reperfusion injury may be involved. Recent studies show that glucose deprivation/reperfusion induced more neuronal cell death than glucose deprivation itself. The forkhead box O (FOXO) transcription factors are implicated in the regulation of cell apoptosis and survival, but their role in neuronal cells remains unclear. We examined the role of FOXO transcription factors and the involvement of the phosphatidylinositol 3-kinase (PI3K)/Akt and apoptosis-related signaling pathways in PC-12 cells exposed to repeated glucose deprivation/reperfusion. METHODS: PC-12 cells were exposed to control (Dulbecco's Modified Eagle Medium [DMEM] containing 25 mM glucose) or glucose deprivation/reperfusion (DMEM with 0 mM glucose for 6 hours and then DMEM with 25 mM glucose for 18 hours) for 5 days. MTT assay and Western blot analysis were performed for cell viability, apoptosis, and the expression of survival signaling pathways. FOXO3/4',6-diamidino-2-phenylindole staining was done to ascertain the involvement of FOXO transcription factors in glucose deprivation/reperfusion conditions. RESULTS: Compared to PC-12 cells not exposed to hypoglycemia, cells exposed to glucose deprivation/reperfusion showed a reduction of cell viability, decreased expression of phosphorylated Akt and Bcl-2, and an increase of cleaved caspase-3 expression. Of note, FOXO3 protein was localized in the nuclei of glucose deprivation/reperfusion cells but not in the control cells. CONCLUSION: Repeated glucose deprivation/reperfusion caused the neuronal cell death. Activated FOXO3 via the PI3K/Akt pathway in repeated glucose deprivation/reperfusion was involved in genes related to apoptosis.

Co-Culture of alpha TC-6 Cells and beta TC-1 Cells: Morphology and Function

BACKGROUND: In vitro experiments using only beta-cell lines instead of islets are limited because pancreatic islets are composed of four different types of endocrine cells. Several recent studies have focused on cellular interactions among these cell types, especially alpha- and beta-cells. Because islet isolation needs time and experience, we tested a simple co-culture system with alpha- and beta-cells. Their morphology and function were assessed by comparison to each single cell culture and pancreatic islets. METHODS: alpha TC-6 cells and beta TC-1 cells were maintained in Dulbecco's Minimal Essential Medium containing 5 mM glucose and 10% fetal bovine serum. Cells were mixed at a 1:1 ratio (5x10(5)) in 6-well plates and cultured for 24, 48, and 72 hours. After culture, cells were used for insulin and glucagon immunoassays and tested for glucose-stimulated insulin secretion (GSIS). RESULTS: alpha TC-6 and beta TC-1 cells became condensed by 24 hours and were more strongly compacted after 48 hours. beta TC-1 cells showed both beta-beta and beta-alpha cell contacts. GSIS increased with increasing glucose concentration in co-cultured cells, which showed lower secreted insulin levels than beta TC-1 cells alone. The increase in the secreted insulin/insulin content ratio was significantly lower for co-cultured cells than for beta-cells alone (P=0.04). Compared to islets, the alpha-/beta-cell co-culture showed a higher ratio of GSIS to insulin content, but the difference was not statistically significant (P=0.09). CONCLUSION: alpha TC-6 and beta TC-1 cells in the co-culture system showed cell-to-cell contacts and a similar stimulated insulin secretion pattern to islets. The co-culture system may be used to better mimic pancreatic islets in in vitro assessments.

Current Status of Prescription in Type 2 Diabetic Patients from General Hospitals in Busan

BACKGROUND: Data regarding the prescription status of individuals with diabetes are limited. This study was an analysis of participants from the relationship between cardiovascular disease and brachial-ankle pulse wave velocity in patients with type 2 diabetes (REBOUND) Study, which was a prospective multicenter cohort study recruited from eight general hospitals in Busan, Korea. We performed this study to investigate the current status of prescription in Korean type 2 diabetic patients. METHODS: Type 2 diabetic patients aged 30 years or more were recruited and data were collected for demographics, medical history, medications, blood pressure, and laboratory tests. RESULTS: Three thousands and fifty-eight type 2 diabetic patients were recruited. Mean age, duration of diabetes, and HbA1c were 59 years, 7.6 years, and 7.2%, respectively. Prevalence of hypertension was 66%. Overall, 7.3% of patients were treated with diet and exercise only, 68.2% with oral hypoglycemic agents (OHAs) only, 5.3% with insulin only, and 19.2% with both insulin and OHA. The percentage of patients using antihypertensive, antidyslipidemic, antiplatelet agents was similar as about 60%. The prevalence of statins and aspirin users was 52% and 32%, respectively. CONCLUSION: In our study, two thirds of type 2 diabetic patients were treated with OHA only, and one fifth with insulin plus OHA, and 5% with insulin only. More than half of the patients were using each of antihypertensive, antidyslipidemic, or antiplatelet agents. About a half of the patients were treated with statins and one third were treated with aspirin.

A Case of Type 2 Diabetes Mellitus Initially Presented as Monochorea Associated with Ketotic Hyperglycemia / 임상당뇨병

Monoballismus-monochorea is abnormal neurologic sign characterized by continuous, involuntary and irregular movement involving one extremity. Hyperglycemic ballism-chorea is predominantly observed in older type 2 diabetic patients and non-ketotic hyperglycemia, and is associated with contralateral striatal hyperintensities (i.e., putamen and caudate) on both brain CT and MRI. Movement disorders as the initial symptoms of diabetes mellitus are rare, especially in ketotic hyperglycemia. Here, we report one of these rare manifestations of transient monoballismus with during an episode of ketotic hyperglycemia without contralateral striatal abnormal findings on brain MRI in newly diagnosed diabetes mellitus.

Low glibenclamide concentrations affect endoplasmic reticulum stress in INS-1 cells under glucotoxic or glucolipotoxic conditions

BACKGROUND/AIMS: beta-Cell apoptosis caused by increased endoplasmic reticulum (ER) stress is an important pathogenic component of type 2 diabetes mellitus. In theory, sulfonylureas, used for the treatment of diabetes, can contribute to ER stress. We assessed changes in ER stress in pancreatic beta-cells under glucotoxic or glucolipotoxic conditions using low concentrations of the sulfonylurea, glibenclamide (GB). METHODS: Low concentrations of GB (10 or 100 nM) were added to INS-1 cells cultured under glucotoxic or glucolipotoxic conditions. The degree of viability, level of apoptosis and levels of markers associated with ER stress were measured. RESULTS: Apoptosis decreased in response to low concentrations of GB under glucolipotoxic but not glucotoxic conditions. Most ER stress markers decreased upon the addition of GB. Under glucotoxic conditions, changes in the levels of ER stress markers were not consistent. However, all decreased significantly under glucolipotoxic conditions. CONCLUSIONS: Low concentrations of GB exerted antiapoptotic effects through the attenuation of ER stress under glucolipotoxic conditions.

Acculturative Stress, Depression and Drinking Problems of Korean International Students in the United States

PURPOSE: The purpose of this study was to identify predictors of drinking problems in Korean international students in the United States. METHODS: The subjects involved this study were 190 Korean international students in the United States. Data were measured using a drinking problems questionnaire, an acculturative stress scale for international student, and the CES-D. The collected data were analyzed using the SPSS/WIN 17.0 program to calculate mean, standard deviation, ANOVA, Sheffe test and pearson's correlation coefficient. and stepwise multiple regression. RESULTS: 1) The mean score of the degree of perceived acculturative stress was 2.15+/-0.63, of depression was 17.67+/-9.85, and of drinking problems was 15.03+/-15.52. 2) There were significant correlations between acculturative stress and drinking problems (r=.506, p<.001), between depression and drinking problems (r=.6726, p<.001), and between acculturative stress and depression (r=.453, p<.001). 3) In stepwise multiple regression analysis the most powerful predictor of drinking problems were acculturative stress (beta=.243, p<.001), and depression (beta=.562, p<.001). CONCLUSION: Based on the results, practical implications for reducing the acculturative stress and improving the psychological well-being of Korean students were discussed.

Thyrotoxic Periodic Paralysis Induced by Dexamethasone

Thyrotoxic periodic paralysis (TPP) is a disease characterized by sudden onset and muscle paralysis. It occurs in the setting of hypokalemia of thyrotoxicosis. Cases of TPP induced by a glucocorticoid such as prednisolone or methylprednisolone have been reported. We report on two patients, each of whom received a dexamethasone injection and subsequently developed TPP. Both patients experienced sudden, flaccid paralysis of both extremities after the injection but recovered completely after receiving a potassium replacement. Laboratory results revealed thyrotoxicosis. The patients were diagnosed with Graves' disease and discharged after receiving treatment with methimazole and propranolol. This report provides the clinical description of TPP induced by dexamethasone injection. These cases suggest that clinicians must consider the presence of hyperthyroid disease in patients who develop acute paralysis after treatment with a glucocorticoid, even in the absence thyrotoxic symptoms. Furthermore, physicians should be aware that TPP can occur even in response to dexamethasone used for treatment of thyrotoxic crisis or Graves' ophthalmopathy.

Validation of Instruments to Classify the Frailty of the Elderly in Community

PURPOSE: This study aimed to validate instruments to classify the frailty of Korean elderly people in community. METHODS: For this study, 632 elders were selected from community-based elderly houses and home visiting registries, and data on frailty were collected using three instruments during November, 2008. The Korean Frail Scale (KFS) was composed of 10 domains with the maximum score of 20. The Edmonton Frail Scale (EFS) had 10 domains with the maximum score of 17. The 25_Japan Frail Scale (25_JFS) was composed of 6 domains with the maximum score of 25. Internal consistency was measured with Cronbach's alpha. Sensitivity, specificity and area under the curve (AUC) of ROC were measured to see validity with long-term care insurance grade as a gold standard. RESULTS: The Cronbach's alpha was .72 for KFS, .55 for EFS, and .80 for 25_JFS. Sensitivity, specificity, and AUC were 70.0%, 83.2%, and .83, respectively, at cutting point 10.5 for the KFS, 50.0%, 80.9%, and .66, respectively, at 8.5 for EFS, and 80.0%, 85.9%, and .86, respectively, at 12.5 for 25_JFS. CONCLUSION: KFS and three JFS showed favorable internal consistency and predictive validity. Further longitudinal studies are recommended to confirm predictive validity.

The Effects of Glyburide on Apoptosis and Endoplasmic Reticulum Stress in INS-1 Cells in a Glucolipotoxic Condition

BACKGROUND: beta-cell death due to endoplasmic reticulum (ER) stress has been regarded as an important pathogenic component of type 2 diabetes. The possibility has been suggested that sulfonylurea, currently being used as one of the main oral hypoglycemic agents of type 2 diabetes, increases ER stress, which could lead to sulfonylurea failure. The authors of the present study examined ER stress of beta-cells in a glucolipotoxic condition using glyburide (GB) in an environment mimicking type 2 diabetes. METHODS: Apoptosis was induced by adding various concentrations of GB (0.001 to 200 microM) to a glucolipotoxic condition using 33 mM glucose, and the effects of varied concentrations of palmitate were evaluated via annexin V staining. The markers of ER stress and pro-apoptotic markers were assessed by Western blotting and semi-quantitative reverse transcription-polymerase chain reaction. Additionally, the anti-apoptotic markers were evaluated. RESULTS: Addition of any concentration of GB in 150 microM palmitate and 33 mM glucose did not increase apoptosis. The expression of phosphorylated eukaryotic initiation factor (eIF-2alpha) was increased and cleaved caspase 3 was decreased by adding GB to a glucolipotoxic condition. However, other ER stress-associated markers such as Bip-1, X-box binding protein-1, ATF-4 and C/EBP-homologous protein transcription factor and anti-apoptotic markers phosphor-p85 phosphatidylinositol 3-kinase and phosphorylation of Akt did not change significantly. CONCLUSION: GB did not show further deleterious effects on the degree of apoptosis or ER stress of INS-1 cells in a glucolipotoxic condition. Increased phosphorylation of eIF-2alpha may attenuate ER stress for adaptation to increased ER protein load.

The Effect of Glucose Fluctuation on Apoptosis and Function of INS-1 Pancreatic Beta Cells / 당뇨병

BACKGROUND: Blood glucose level continuously fluctuates within a certain range in the human body. In diabetes patients, the extent of such fluctuation is large, despite the strict control of blood glucose. Blood glucose fluctuation has been shown to mediate more adverse effects on vascular endothelial cells and diabetes complications than chronic hyperglycemia, which has been explained as due to oxidative stress. As few previous studies have reported the effects of chronic and intermittent hyperglycemia on the apoptosis and function of pancreatic beta cells, this study reported herein was performed to investigate such effects on these cells. METHODS: For chronic hyperglycemia, INS-1 cells were cultured for 5 days with changes of RPMI 1640 medium containing 33 mM glucose every 12 hours. For intermittent hyperglycemia, the medium containing 11 mM glucose was exchanged with the medium containing 33 mM glucose every 12 hours. Apoptosis was assessed by TUNEL assay Hoechst staining and cleaved caspase 3. Insulin secretory capacity was assessed, and the expression of Mn-SOD and Bcl-2 was measured by Western blotting. RESULTS: In comparison to the control group, INS-1 cells exposed to chronic hyperglycemia and intermittent hyperglycemia showed an increase in apoptosis. The apoptosis of INS-1 cells exposed to intermittent hyperglycemia increased significantly more than the apoptosis of INS-1 cells exposed to chronic hyperglycemia. In comparison to the control group, the insulin secretory capacity in the two hyperglycemic states was decreased, and more with intermittent hyperglycemia than with chronic hyperglycemia. The expression of Mn-SOD and Bcl-2 increased more with chronic hyperglycemia than with intermittent hyperglycemia. CONCLUSION: Intermittent hyperglycemia induced a higher degree of apoptosis and decreased the insulin secretory capacity more in pancreatic beta cells than chronic hyperglycemia. This activity may be mediated by the anti-oxidative enzyme Mn-SOD and the anti-apoptotic signal Bcl-2.

Effect of German chamomile oil application on alleviating atopic dermatitis-like immune alterations in mice

Historically, German chamomile (GC) oil has been used for treatment of skin disorders. BALB/c mice were sensitized twice a week with 100 microL of 1% 2,4-dinitrochlorobenzene (DNCB) and challenged twice the following week with 100 microliter of 0.2% DNCB for atopic dermatitis induction. Thereafter, 3% GC oil was applied daily (70 microliter, 6 times week) on the dorsal skin for 4 weeks. Saline or jojoba oil was used for the control mice. Blood was collected after second DNCB challenge, and at 2 and 4 weeks after initiating oil application. Serum IgE levels were significantly lowered in the GC oil application group at the end of the 4-week application period. The GC oil application for 4 weeks resulted in reduction in serum IgG1 level compared with that after 2-week application. The GC oil application group showed a significantly lower serum histamine level than the control group 2 weeks after oil application. Scratching frequency of the GC oil application group was significantly lower than either control groups. This study is to demonstrate GC oil's immunoregulatory potential for alleviating atopic dermatitis through influencing of Th2 cell activation.

Social Support and Acculturative Stress in Migrant Workers

PURPOSE: The purpose of this study was to collect basic data on social support and acculturative stress in migrant workers. METHODS: Between August, 2007 and January, 2008 171 immigrant workers completed data collection using a questionnaire. Workers were recruited from 2 churches, one in Seoul and the other in Gyeonggi Province. Mean and standard deviation, t-test, ANOVA, Pearson correlation coefficients and Stepwise multiple regression were used to analyze the data. RESULTS: The average score for social support was 3.73 (+/-0.65) and for acculturative stress, 2.52 (+/-0.65). There were significant differences acculturative stress according to gender (t=2.152, p=.033), kind of job (t=2.597, p=.040), and have community or not (t=2.899, p=.005). There was a significant negative correlation between social support and acculturative stress (r=-.270, p=.001). Factors influencing acculturative stress were existence of participants having a community of people from their home country or not (R2=.151, p=.002). CONCLUSION: More studies are needed to identify the variables that influence acculturative stress in immigrant workers.

The Relation between Social Support and Loneliness in Migrant Workers

PURPOSE: The purpose of this study was to investigate the actual condition of social support and loneliness and to examine of the relation between social support and loneliness in migrant workers. METHODS: One hundred and thirty migrant workers were sampled from two churches located at Seoul and Gyeonggi-do in order to collect basic data onmigrant workers from August to December, 2007 using a questionnaire. The collected data were analyzed using mean, standard deviation, t-test and ANOVA test. RESULTS: 1) The average scores of social support and loneliness were 3.73 +/- 0.31 and 2.57 +/- 0.31, respectively. 2) With respect to the general characteristics of subjects, there was no statistically significant difference in social support, but there was a significant difference in loneliness according to religion (t=2.586, p=.001). 3) The correlation coefficient between social support and loneliness was not significant (r=-.010, p=.929). CONCLUSION: Social support should be considered in nursing intervention to decrease the level of loneliness in migrant workers. More studies are needed to identify variables influencing social support and loneliness in migrant workers.

Migrant Workers' Quality of Life Related to Health / 성인간호학회지

PURPOSE: The purpose of this study was to collect basic data in the quality of life related to health in migrant workers. METHODS: Data from 133 migrant workers was collected from August to December 2007 using a questionnaire from two free clinics located in Seoul and Gyeonggi-do. The data was scored by mean and standard deviation. Differences were evaluated according to the subjects' general characteristics by the t-test and the ANOVA test. The relationships in the quality of life related to health between the 9 sub-scales were evaluated by the Pearson's correlation coefficient. RESULTS: 1) Total average score of migrant workers' quality of life related to overall health is 61.09 +/- 13.68. The score of the quality of life related to physical health is 64.39 +/- 15.21 and the quality of life related to mental health is 57.80 +/- 16.18. 2) With respect to the general characteristics of subjects, the quality of life related to health was significantly different in age(F=3.852, p=.013), especially in physical health(F=6.868, p=.000). 3) The relationship between physical health and mental health was significant(r=.663, p=.000). CONCLUSION: Program development to improve quality of life related to health for migrant workers is needed.

Cloning of Novel Epidermal Growth Factor (EGF) Plasmid for Gene Therapy on Diabetic Foot Ulcer / 당뇨병

BACKGROUND: Epidermal Growth Factor (EGF) is one of the important growth factors involved in the epithelialization during cutaneous wound healing. Peptide EGF has been used for the treatment of diabetic foot ulcer. But the inferiority of cost-effectiveness and the inconvenience of daily application might have restricted its wide clinical usage. EGF gene therapy could dramatically improve the efficacy and inconvenience through long-term expression and bypassing the EGF degradation by hostile non-specific proteinases expressed in the wound bed. METHODS: EGF DNAs were amplified via PCR. For the more effective secretion from the transfected cell, we inserted furin cleavage site into EGF plasmids. The efficacy of novel plasmid pbeta-EGF was verified by transfection into the various animal cell lines, and the biologic potency of expressed EGF was confirmed via phosphorylation of PI3K and GSK3beta by Western blotting. RESULTS: We tested various kinds of human EGFs. One of the human EGF isoforms, EGF(828) including a membrane-anchoring domain was successfully released as the mature EGF protein in the cell culture media. Also EGF plasmid including furin cleavage site showed more than 2-fold increased EGF expression compared with the sequence without furin cleavage site. CONCLUSION: In conclusion, these findings suggest that mature EGF could be released easily out of cells by modifying EGF DNA sequence. Our novel EGF plasmid DNA could markedly increase the efficiency of non-viral gene therapy for diabetic foot ulcer.

The Effect of Alpha-tocopherol Supplementation on the Improvement of Antioxidant Status and Lymphocyte DNA Damage in Postmenopausal Women

The purpose of this project was to evaluate whether vitamin E supplementation could improve the antioxidant status and lymphocyte DNA damage in Korean postmenopausal women. This was double blinded, placebo-controlled trial. Thirty-five subject were randomized to receive either placebo 400 mg/capsule or natural alpha-tocopherol 400 IU/capsule, 2 times a day for 6 weeks. We measured plasma vitamin C, alpha-tocopherol, gamma-tocopherol, alpha-carotenoid, beta-carotenoid, lycopene concentration and tail length, %DNA in tail, tail moment in lymphocyte DNA damage index. Vitamin E supplementation group had significantly increased plasma vitamin C (p < 0.05), alpha-tocopherol (p < 0.000), whereas gamma-tocopherol (p < 0.000) and tail length (p < 0.05) were significantly decreased. However, placebo supplementation group also had significantly increased plasma vitamin C (p < 0.05). In conclusion, our study shows that vitamin E supplementation to Korean postmenopausal women may partially improve antioxidant status and lymphocyte DNA damage.