The effects of alpha-lipoic acid supplementation on fasting glucose and lipid profiles among patients with stroke: a systematic review and meta-analysis of randomized controlled trials.

Abstract

Stroke is a devastating condition with long-term comorbidities including metabolic abnormalities. Alpha lipoic acid (ALA), with its antioxidant properties, might improve metabolic status of patients, though current evidence is still inclusive. This systematic review of randomized controlled trials (RCTs) was conducted to summarize the existing evidence regarding the effects of ALA supplementation on fasting glucose and lipid profiles among patients with stroke. We searched Cochrane Library, EMBASE, MEDLINE, and Web of Science from 1990 until April 5th, 2018. The relevant randomized-controlled articles, based on defined key words, were included in the analyses. Two independent researchers investigated study eligibility, extracted data, and assessed the risk of bias for included studies. Heterogeneity among included studies was tested using Q-test and I2 statistics. Random-effects models were applied to pool the data and standardized mean differences (WMD) were considered as summary effect size. A total of five studies (140 patients in each intervention group) were included in our meta-analysis. The findings showed that ALA supplementation significantly decreased fasting glucose levels (WMD -36.93mg/dL; 95% CI, -65.58, -8.28; P = 0.01; I2= 85.0%) in patients with stroke. We found no significant effect of ALA supplementation on triglycerides (WMD -7.45mg/dL; 95% CI, -51.35, 36.45; P = 0.739; I2= 83.9%), total cholesterol (WMD -23.23mg/dL; 95% CI, -48.07, 1.62; P = 0.067; I2= 80.5%), LDL-cholesterol (WMD -10.46mg/dL; 95% CI, -21.01, 0.09; P = 0.052; I2= 47.4%) and HDL-cholesterol levels (WMD -3.02mg/dL; 95% CI, -20.18, 14.14; P = 0.730; I2= 85.8%). This meta-analysis suggested the beneficial impacts of ALA supplementation in improving fasting glucose of patients diagnosed with stroke.