Influence of alpha-lipoic acid on the metabolic and adipocytokine status in patients with type 2 diabetes mellitus and chronic pancreatitis

Abstract

Objective — to analyze the effects of the proposed therapy regimen with the use of alpha‑lipoic acid on the dynamics of the adipokines’ levels: vaspin, TNF‑a, parameters of carbohydrate and lipid metabolism and the thickness of the intima‑media complex of the common carotid artery in patients with type 2 diabetes mellitus and chronic pancreatitis.Materials and methods. The investigation involved 60 patients (38 women and 22 men, aged 53 to 61 years, the mean age 56.7 years) with type 2 diabetes mellitus combined with chronic pancreatitis. The parameters of lipid and carbohydrate metabolism, the functional state of the pancreas, levels of c‑reactive protein and adipocytokines — vaspin and tumor necrosis factor‑a, have been evaluated. The condition of the wall of the common carotid artery was assessed by the ultrasound method. All parameters were assessed twice, before and after completion of the therapy (after 3 months), which included hypoglycemic and hypolipidemic therapy and an alpha‑lipoic acid. All drugs were used at an individually adjusted dosage, except for alpha‑lipoic acid, which was administered at a dose of 600 mg per day for 3 months.Results. Against the therapy background, the positive dynamics of the main parameters of carbohydrate and lipid metabolism and the main laboratory indices of pancreas execratory dysfunction has been established. In patients administered alpha‑lipoic acid, the significant increase in the vaspin levels and decrease in TNF‑a levels have been revealed, as well the improvement of parameters of functional pancreas state. In patients with and without atherosclerotic plague who were taken alpha‑lipoic acid, a tendency was established towards a decrease in the thickness of the IMC CA (1.17 ± 0.09 mm vs 1.11 ± 0.08 mm) and (1.26 ± 0, 08 vs 1.22 ± 0.05 mm), respectively.Conclusions. The effects of the proposed treatment scheme with the use of alpha‑lipoic acid have been established in terms of activation of the compensatory mechanisms of the reduction in the levels of insulin resistance, TNF‑a, activity of inflammatory process and improvement of sensibilization to the endogenous insulin resulting from the increased vaspin levels.