Abstract 13035: A Potent Protective Vascular Endothelium Property of Garcinia mangostana L. Extract in High-Risk Framingham Score Patients With Type 2 Diabetes: A Prospective Randomized Control Trial

Abstract

Background: Endothelial dysfunction is the hallmark of vascular complications in cardiovascular disease with type 2 diabetes as the comorbid. Garcinia mangostana L., or mangosteen, has been known as the queen of fruits from Southeast Asia that owns anti-inflammatory and anti-oxidant properties for years. Objective: This study was aimed to evaluate the role of G. mangostana extract as a potent protective vascular endothelium in patients with type 2 diabetes and high-risk Framingham score. Method: This is a prospective, randomized, single blind, placebo-controlled trial in subjects with type 2 DM and high-risk Framingham score. Subjects were randomly divided into two groups: the treatment group of G. mangostana extract, administered 2,175 mg/day in divided dosage for 90 days, and control group receiving placebo. The primary endpoint was the changes in endothelial progenitor cells (EPCs) and circulating endothelial cells (CECs) levels. We also evaluated the levels of NO, IL-1, IL-6, TNF-α, fasting blood glucose and HbA1c. Study had been approved by local ethics committee. Statistical analysis was done and p<0.05 was considered significant. Results: From 90 subjects with high-risk Framingham score, there were 49 (54.4%) subjects with type 2 diabetes, which randomly divided into two groups. The treatment group (n=23) received G. mangostana extract and control group (n=26) received placebo. Statistical analysis showed that increase of EPC and decrease of CEC levels were significant in treatment group, compared to control (p=0.000 and p=0.002, respectively). The levels of NO increased significantly (p=0.027) and levels of IL-1, IL-6, TNF-α decreased significantly in comparison to placebo (p=0.003, p=0.002, p=0.000, respectively). Analysis also showed that HbA1c decreased significantly (p=0.002) compared to placebo; however, it was insignificant for fasting blood glucose reduction (p=0.336). Conclusion: Garcinia mangostana L. extract, as an adjuvant therapy, plays a role in improving endothelial dysfunction by significant increase in EPCs and decrease in CECs, in patients with type 2 diabetes and high-risk Framingham score.