Abstract
Endothelial dysfunction is recognized as an early sign of systemic atherosclerosis, and it represents a therapeutic target to prevent long-term cardiovascular (CV) consequences. Alpha-lipoic acid (ALA) is a commonly used dietary supplement exerting anti-oxidant and anti-inflammatory effects. We investigated whether a three-month treatment with ALA improves endothelial function, as assessed by flow-mediated dilation (FMD) of the brachial artery, and clinical and metabolic risk factors in overweight/obese youths. We enrolled 67 overweight/obese children, and 22 normal-weight metabolically healthy controls. Overweight/obese youths were randomly allocated in a double-blinded manner to receive ALA (n = 34) or placebo (n = 33). Of these, 64 (32 ALA, 32 placebo) completed the follow-up. At baseline, in ALA and placebo groups, FMD was similar, but lower as compared with that in controls (p = 0.045). At three months, within the ALA and placebo groups, FMD did not change significantly. However, the basal and peak diameter of brachial artery significantly increased after ALA treatment as compared to placebo (p = 0.036 and p = 0.01, respectively). There were no significant within- and between-group changes for anthropometric and metabolic variables. The results show that ALA supplementation improves vascular tone and may have a beneficial effect on CV health in overweight/obese youths.
Highlights
With over two billion subjects with overweight/obesity expected worldwide by 2030, atherosclerotic cardiovascular disease (CVD) and premature death will undoubtedly continue to represent relevant public health challenges [1]
In a double-blind, parallel-group, placebo-controlled randomized trial, we investigated, in children and adolescents with overweight/obesity, the impact of three-month Alpha-lipoic acid (ALA) supplementation on endothelial function, as assessed by flow-mediated arterial dilation (FMD), and CVD risk factors
Patients were eligible for the study if they had the following characteristics at enrolment: (1) age between 8 and 16 years; and (2) body mass index (BMI) >85th percentile according to age- and gender-specific percentiles of BMI [22]
Summary
With over two billion subjects with overweight/obesity expected worldwide by 2030, atherosclerotic cardiovascular disease (CVD) and premature death will undoubtedly continue to represent relevant public health challenges [1]. Recent reports in children with obesity demonstrated that they may exhibit early signs of cardiovascular dysfunction as a result of excessive. Nutrients 2019, 11, 375 adiposity [4], suggesting the problem is one of future or long-term CVD risk, and one requiring immediate attention in childhood to prevent progressive CV damage [5]. Impairment of endothelial function represents a very early step in the development of atherosclerosis, appearing long before clinical symptoms arise, and might qualify as a surrogate endpoint for obesity-associated CVD risk [6]. Endothelial dysfunction is recognized as an early sign of systemic atherosclerosis, and it represents a therapeutic target to prevent long-term CV consequences
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