Resveratrol in Metabolic Syndrome: Effect on Platelet Hyper-reactivity and HDL Lipid Peroxidation
Metabolic syndrome is a group of risk factors that increase a patient's likelihood for heart attack, stroke and diabetes. Our research is aimed at understanding whether a drug, resveratrol, commonly found in grapes and red wine, would have any benefit in reducing risk factors in patients that have metabolic syndrome. Despite the use of aspirin and cholesterol reducing medications, patients with metabolic syndrome still often have sticky platelets and dysfunctional lipid profile. This is likely due to inflammation and high oxidative state. In animal studies, this drug has reduced platelet stickiness and reduced oxidative stress. However, the effects of this drug have not been researched in patients with metabolic syndrome.
We are interested in studying whether the benefits of resveratrol described in animal models can be translated to patients with metabolic syndrome who display high markers of oxidative stress. We plan to give a short intervention of drug to patients and then determine if the drug successfully:
- Decreases the stickiness of platelets. This is important because sticky platelets are more likely to form clot and contribute to plaque formation.
- Reduce the circulating dysfunctional HDL. HDL and its protein and lipid constituents help to inhibit oxidation, inflammation, activation of the blood vessel wall, coagulation, and platelet aggregation. Dysfunctional HDL, as occurs in metabolic syndrome patients, cannot properly protect against atherosclerosis.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Patients with metabolic syndrome are at increased risk of thrombotic complications, including myocardial infarction and cardiovascular death. A meta-analysis of the studies assessing cardiovascular risk in metabolic syndrome found a pooled relative risk for incident cardiovascular events and death of 1.78. This propensity for thrombotic vascular events is in the context of an increasing prevalence of metabolic syndrome, which in the 2003-2006 NHANES Survey was found in 34% of the US population over the age of 20.
Two important contributors to the development of myocardial infarction and stroke are lipid rich atheromatous plaques and concomitant platelet aggregation in response to the fissuring of these plaques. A growing body of evidence implicates oxidative modification of lipoprotein lipids and apolipoproteins in the genesis of plaques. Platelet hyperactivity and the variable response to antiplatelet therapy are features of the metabolic syndrome. Oxidative modifications of LDL enhance activation of platelets, which themselves are oxidatively stressed. Myeloperoxidase (MPO) initiates lipid peroxidation leading to dysfunctional HDL production. Therefore, the hypotheses for the proposed investigations will address the effects of resveratrol on platelet hyperactivity and HDL protein modifications in patients with metabolic syndrome. Resveratrol, as predicted from its structure, is an electron rich molecule that can reduce free radicals. It has distinctive actions, however, that differ from compounds that are conventionally referred to as "anti-oxidants". It has particular potency as an inhibitor of radical formation by a number of peroxidases that likely participate in the pathophysiology of metabolic syndrome. These include MPO, the peroxidase site of prostaglandin H synthase-1 (PGHS-1; cyclooxygenase-1(COX-1)) and cytochrome c.
We will test the hypothesis that:
- resveratrol reduces platelet activation in patients with metabolic syndrome. and
- that resveratrol reduces the oxidative modification of HDL proteins in patients with metabolic syndrome.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Tennessee
-
Nashville, Tennessee, United States, 37232
- Vanderbilt University
-
-
Texas
-
Houston, Texas, United States, 77004
- Baylor University
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Metabolic Syndrome
Exclusion Criteria:
- Evidence of coronary artery disease
- Indication for use of aspirin for secondary prevention of thrombotic events
- Use of non-steroidal anti-inflammatory drugs or anti-platelet agents
- Pregnancy
- Patients with history of bleeding or gastrointestinal ulcers
- Patients with major illnesses such as ongoing malignancies, infections, cirrhosis
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Basic Science
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Placebo Comparator: Placebo
Placebo capsule given three times daily X 3 weeks
|
1000mg tid placebo
Other Names:
|
|
Experimental: Resveratrol
Resveratrol 1 gram three times daily X 3 weeks
|
1000mg tid
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in parameters of platelet activation
Time Frame: baseline, 3 weeks after intervention
|
Measure platelet-monocyte aggregates by flow cytometry
|
baseline, 3 weeks after intervention
|
|
Change in parameter for platelet oxidative stress
Time Frame: Baseline, 3 weeks after intervention
|
Measure malondialdehyde adducts of platelet proteins
|
Baseline, 3 weeks after intervention
|
|
Change in parameter for platelet oxidation levels
Time Frame: Baseline, 3 week after intervention
|
Measure superoxide production by platelets
|
Baseline, 3 week after intervention
|
|
Serum Thromboxane measurments
Time Frame: Baseline, 3 weeks after intervention
|
Measure thromboxane to assess inflammation
|
Baseline, 3 weeks after intervention
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in oxidative modifications of HDL
Time Frame: baseline, three weeks after intervention
|
Measure change in malondialdehyde adducts in HDL proteins
|
baseline, three weeks after intervention
|
|
Change in plasma oxidative stress
Time Frame: baselines, three weeks after intervention
|
Measure change in plasma isoprostanes
|
baselines, three weeks after intervention
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: John A Oates, MD, Vanderbilt University
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Glucose Metabolism Disorders
- Metabolic Diseases
- Disease
- Insulin Resistance
- Hyperinsulinism
- Syndrome
- Metabolic Syndrome
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Platelet Aggregation Inhibitors
- Protective Agents
- Antioxidants
- Resveratrol
Other Study ID Numbers
Other Study ID Numbers
- 130996
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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