Impact of thioctic acid on glycemic indices and associated inflammatory-induced endothelial dysfunction in patients with type 2 diabetes mellitus: A case control study

Marwa S Al-Nami, Hayder M Al-Kuraishy, Ali I Al-Gareeb, Marwa S Al-Nami, Hayder M Al-Kuraishy, Ali I Al-Gareeb

Abstract

Objective: To evaluate the effects of thioctic acid (TA) add-on metformin therapy on glycemic indices and associated inflammatory reactions induced-endothelial dysfunction (ED) in patients with type 2 diabetes mellitus (T2DM).

Methods: In this case-control clinical study, a total number of 70 patients with T2DM compared with 30 healthy controls were divided into three groups: Group A (n = 30), healthy controls; Group B (n = 36), T2DM patients on metformin and Group C (n = 34), T2DM patients on metformin plus TA 600 mg/day. Anthropometric measurements, lipid profile, and routine biochemical variables were estimated. Serum human vascular cell adhesion molecule-1 (VCAM-1) and E-selectin were measured before and after 10 consecutive week's therapy with metformin and/or TA.

Results: Metformin therapy led to significant reduction of fasting insulin and insulin resistance (IR) with an increment in the insulin sensitivity (P < 0.01). Metformin therapy improved lipid profile compared to the baseline (P < 0.01) with significant reduction of atherogenic index. Metformin plus TA therapy reduced fasting blood glucose, glycated hemoglobin, and IR and showed increment in the insulin sensitivity (P < 0.01) with insignificant effect on fasting insulin (P = 0.09) compared with metformin monotherapy. sVCAM-1 level was high in patients with T2DM (3.74 ± 1.34 ng/ml) at baseline, which decreased by metformin monotherapy to 2.32 ± 0.67 ng/ml or metformin plus TA to 1.98 ± 0.31 ng/ml (P < 0.01), but metformin plus TA illustrated insignificant difference compared to metformin alone (P = 0.29).

Conclusion: TA add on metformin therapy improves glycemic indices and associated inflammatory mediators in patients with T2DM through modulation of IR , IS , and direct direct anti-inflammatory effect.

Keywords: Diabetes mellitus; endothelial dysfunction; metformin; thioctic acid.

Conflict of interest statement

There are no conflicts of interest.

Copyright: © 2020 International Journal of Critical Illness and Injury Science.

Figures

Figure 1
Figure 1
Consort flow diagram of the study
Figure 2
Figure 2
Effects of metformin and/or TA on the biomarkers of endothelial dysfunction in patients with type 2 diabetes mellitus *P< 0.01 versus baseline; #P< 0.05 versus metformin

References

    1. Al-Kuraishy HM, Al-Gareeb AI, Waheed HJ, Al-Maiahy TJ. Differential effect of metformin and/or glyburide on apelin serum levels in patients with type 2 diabetes mellitus: Concepts and clinical practice. J Adv Pharm Technol Res. 2018;9:80–6.
    1. Al-Kuraishy HM, Al-Gareeb AI. Erectile dysfunction and low sex drive in men with type 2 DM: The potential role of diabetic pharmacotherapy. J Clin Diagn Res. 2016;10:FC21–26.
    1. Kadhim SS, Al-Windy SA, Al-Kuraishy HM, Al-Gareeb AI. Endothelin-1 is a surrogate biomarker link severe periodontitis and endothelial dysfunction in hypertensive patients: The potential nexus. Journal of International Oral Health. 2019;11:369–76.
    1. Kim MJ, Kim T, Suh GJ, Kwon WY, Kim KS, Jung YS, et al. Association between the simultaneous decrease in the levels of soluble vascular cell adhesion molecule-1 and S100 protein and good neurological outcomes in cardiac arrest survivors. Clin Exp Emerg Med. 2018;5:211–8.
    1. Brevetti G, Martone VD, de Cristofaro T, Corrado S, Silvestro A, Di Donato AM, et al. High levels of adhesion molecules are associated with impaired endothelium-dependent vasodilation in patients with peripheral arterial disease. Thromb Haemost. 2001;85:63–6.
    1. Telen MJ. Cellular adhesion and the endothelium: E-selectin, L-selectin, and pan-selectin inhibitors. Hematol Oncol Clin North Am. 2014;28:341–54.
    1. Al-Kuraishy HM, Al-Gareeb AI. Co-administration effects of α-lipoic acid and nucleo CMP on arousal and sensory cortical activity. J Young Pharma. 2016;8:12–7.
    1. Scaramuzza A, Giani E, Redaelli F, Ungheri S, Macedoni M, Giudici V, et al. Alpha-lipoic acid and antioxidant diet help to improve endothelial dysfunction in adolescents with type 1 diabetes: A pilot trial. J Diabetes Res. 2015;2015:474561.
    1. World Medical Association. World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA. 2013;310:2191–4.
    1. Alkuraishy HM, Al-Gareeb AI. New insights into the role of metformin effects on serum omentin-1 levels in acute myocardial infarction: Cross-sectional study. Emerg Med Int. 2015;2015:283021.
    1. Alkuraishy HM, Al-Gareeb AI, Waheed HJ. Lipoprotein-associated phospholipase A2 is linked with poor cardio-metabolic profile in patients with ischemic stroke: A study of effects of statins. J Neurosci Rural Pract. 2018;9:496–503.
    1. Al-Kuraishy HM, Al-Gareeb AI. Effects of rosuvastatin alone or in combination with Omega-3 fatty acid on adiponectin levels and cardiometabolic profile. J Basic Clin Pharm. 2016;8:8–14.
    1. Koh EH, Lee WJ, Lee SA, Kim EH, Cho EH, Jeong E, et al. Effects of alpha-lipoic Acid on body weight in obese subjects. Am J Med. 2011;124:85.e1–8.
    1. Kim MS, Park JY, Namkoong C, Jang PG, Ryu JW, Song HS, et al. Anti-obesity effects of alpha-lipoic acid mediated by suppression of hypothalamic AMP-activated protein kinase. Nat Med. 2004;10:727–33.
    1. Zhou L, Liu H, Wen X, Peng Y, Tian Y, Zhao L. Effects of metformin on blood pressure in nondiabetic patients: A meta-analysis of randomized controlled trials. J Hypertens. 2017;35:18–26.
    1. McMackin CJ, Widlansky ME, Hamburg NM, Huang AL, Weller S, Holbrook M, et al. Effect of combined treatment with alpha-lipoic acid and acetyl-L-carnitine on vascular function and blood pressure in patients with coronary artery disease. J Clin Hypertens (Greenwich) 2007;9:249–55.
    1. Yang Z, Tian Y, Berr SS, French BA. Therapeutic efficacy of alpha-lipoic acid against acute myocardial infarction and chronic left ventricular remodeling in mice. Cardiol Res Pract. 2020;2020:ID 6759808.
    1. Diaz-Morales N, Rovira-Llopis S, Bañuls C, Lopez-Domenech S, Escribano-Lopez I, Veses S, et al. Does metformin protect diabetic patients from oxidative stress and leukocyte-endothelium interactions? Antioxid Redox Signal. 2017;27:1439–45.
    1. Kamenova P. Improvement of insulin sensitivity in patients with type 2 diabetes mellitus after oral administration of alpha-lipoic acid. Hormones (Athens) 2006;5:251–8.
    1. Dworacka M, Chukanova G, Iskakova S, Kurmambayev Y, Wesołowska A, Frycz BA, et al. New arguments for beneficial effects of alpha-lipoic acid on the cardiovascular system in the course of type 2 diabetes. Eur J Pharm Sci. 2018;117:41–7.
    1. Jin P, Min HU, Zhou X, Zhang J, Jie LI. Metformin improves glucose metabolism and serum levels of lipoprotein derived hormones in obese children with hyperinsulinemia. Chin J Biochem Pharma. 2017;37:213–4.
    1. Targonsky ED, Dai F, Koshkin V, Karaman GT, Gyulkhandanyan AV, Zhang Y, et al. α-Lipoic acid regulates AMP-activated protein kinase and inhibits insulin secretion from beta cells. Diabetologia. 2006;49:1587–98.
    1. Nobakht-Haghighi N, Rahimifard M, Baeeri M, Rezvanfar MA, Moini Nodeh S, Haghi-Aminjan H, et al. Regulation of aging and oxidative stress pathways in aged pancreatic islets using alpha-lipoic acid. Mol Cell Biochem. 2018;449:267–76.
    1. Al-Kuraishy HM, Al-Gareeb AI, Shams HA, Al-Mamorri F. Endothelial dysfunction and inflammatory biomarkers as a response factor of concurrent coenzyme Q10 add-on metformin in patients with type 2 diabetes mellitus. Journal of Laboratory Physicians. 2019;11:317–22.
    1. Suganya N, Bhakkiyalakshmi E, Sarada DV, Ramkumar KM. Reversibility of endothelial dysfunction in diabetes: Role of polyphenols. Br J Nutr. 2016;116:223–46.
    1. Bretón-Romero R, Feng B, Holbrook M, Farb MG, Fetterman JL, Linder EA, et al. Endothelial dysfunction in human diabetes is mediated by Wnt5a-JNK signaling. Arterioscler Thromb Vasc Biol. 2016;36:561–9.
    1. Al-Rubeaan K, Nawaz SS, Youssef AM, Al Ghonaim M, Siddiqui K. IL-18, VCAM-1 and P-selectin as early biomarkers in normoalbuminuric Type 2 diabetes patients. Biomark Med. 2019;13:467–78.
    1. Rasheed HA, Al-Kuraishy HM, Al-Gareeb AI, Hussien NR, Al-Nami MS. Effects of diabetic pharmacotherapy on prolactin hormone in patients with type 2 diabetes mellitus: Bane or Boon. Journal of advanced pharmaceutical technology & research. 2019;10:163–69.
    1. Ahuja S, Uniyal A, Akhtar A, Sah SP. Alpha lipoic acid and metformin alleviates experimentally induced insulin resistance and cognitive deficit by modulation of TLR2 signalling. Pharmacol Rep. 2019;71:614–23.
    1. Tromba L, Perla FM, Carbotta G, Chiesa C, Pacifico L. Effect of alpha-lipoic acid supplementation on endothelial function and cardiovascular risk factors in overweight/obese youths: A double-blind, placebo-controlled randomized trial. Nutrients. 2019;11:pii: E375.
    1. Mohammadi V, Khorvash F, Feizi A, Askari G. Does alpha-lipoic acid supplementation modulate cardiovascular risk factors in patients with stroke? A randomized, double-blind clinical trial. Int J Prev Med. 2018;9:34.
    1. Porasuphatana S, Suddee S, Nartnampong A, Konsil J, Harnwong B, Santaweesuk A. Glycemic and oxidative status of patients with type 2 diabetes mellitus following oral administration of alpha-lipoic acid: A randomized double-blinded placebo-controlled study. Asia Pac J Clin Nutr. 2012;21:12–21.

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit