CARDIOVASCULAR AUTONOMIC NEUROPATHY: ALPHA-LIPOIC ACID, INSULIN RESISTANCE AND INFLAMMATORY PARAMETERS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Victoria Serhiyenko,Alexandr Serhiyenko,Oksana Snytinska,Marta Hotsko

doi:10.51582/interconf.21-22.04.2021.037

Abstract

This paper presents the results obtained during the study of possible alpha-lipoic acid (ALA) impact on the state of insulin resistance (IR), the content of some pro- and anti-inflammatory factors in patients with type 2 diabetes mellitus (T2DM) and cardiovascular autonomic neuropathy (CAN). Our study involved 33 persons with diagnosed T2DM and CAN, which were allocated to one of two groups. The control group (15 patients) received standard hypoglycemic treatment, whereas the intervention group (18 patients) received ALA 600 mg in film-coated tablets/q.d. in addition to standard therapy. Treatment period was 3 mos in duration. Levels of glycated hemoglobin A1c, glucose, immunoreactive insulin (IRI), leptin, interleukin (IL) IL-6 and IL-8, high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-alpha) in the blood were measured. TNF-alpha/IL-10 ratio and Homeostasis model assessment IR (HOMA-IR) were calculated. The significant reduction in glucose, IRI, leptin concentration and HOMA-IR parameters; decrease in the hs-CRP, TNF-alpha, IL-6 and IL-8 levels, TNF-alpha/IL-10 ratio, with no changes in IL-10 content after 3 mos of treatment was found. The results of our study demonstrated the decrease in the pro-inflammatory link activity after treatment and allow us to consider ALA as one of the promising drug for complex treatment of CAN in patients with T2DM.

Highlights

Diabetic cardiovascular autonomic neuropathy (CAN) is an independent risk factor for major cardiovascular events, development of heart arrhythmias, silent myocardial ischaemia, sudden cardiac death and cardiovascular mortality [1,2,3,4]
Our study focused on determining whether alpha-lipoic acid (ALA) has a potential impact on inflammation, glycemic control, insulin resistance (IR) parameters in patients with type 2 diabetes mellitus (T2DM) and CAN
A total of 33 T2DM patients with CAN aged between 50-59 yrs, DM duration between 1-6 yrs, with glycated hemoglobin A1c (HbA1c) level of 7.03 0.13% and median body mass index (BMI) 27.1±0.32 kg/m2 were enrolled

Summary

Introduction

Diabetic cardiovascular autonomic neuropathy (CAN) is an independent risk factor for major cardiovascular events, development of heart arrhythmias, silent myocardial ischaemia, sudden cardiac death and cardiovascular mortality [1,2,3,4]. Our study focused on determining whether ALA has a potential impact on inflammation, glycemic control, insulin resistance (IR) parameters in patients with type 2 diabetes mellitus (T2DM) and CAN. A total of 33 T2DM patients with CAN aged between 50-59 yrs, DM duration between 1-6 yrs, with glycated hemoglobin A1c (HbA1c) level of 7.03 0.13% and median body mass index (BMI) 27.1±0.32 kg/m2 were enrolled. For pursoses of the study patients were allocated to two groups: the control group (15 patients) received standard hypoglycemic treatment, whereas the intrevention group (18 patients) received ALA (Thioctic Acid) 600 mg in film-coated tablets/q.d. in addition to standard therapy. Treatment period was 3 mos in duration. All involved patients did not take ALA and was on stable regime of hypoglycemic and antihypertensive treatment for 6 mos

Results

Discussion

Conclusion