DOES ALPHA-LIPOIC ACID SUPPLEMENTATION MODULATE CARDIOVASCULAR RISK FACTORS AS CAROTID INTIMA MEDIA THICKNESS AND FLOW MEDIATED DILATION IN PATIENTS EXPERIENCED STROKE; A RANDOMIZED, DOUBLE BLIND, PLACEBO-CONTROLLED CLINICAL TRIAL

Background and Aim: This study was designed to evaluate the possible effects of ALA supplementation on some cardiovascular risk factors in stroke patients.Methods: Stroke as a devastating condition is a major cause of death worldwide and accountable for long time disability with high personal and social cost in adults. The 2012 BRFSS (CDC) data indicated that 2.9% of men and 2.9% of women ≥18 years of age had a history of stroke. In addition, projections show that by 2030, an additional 3.4 million people aged ≥18 years will have had a stroke, a 20.5% increase in prevalence from 2012. Metabolic syndrome, diabetes, hypertension and obesity are well known risk factors of coronary artery disease, stroke, and mortality. Hyperlipidemia plays an important role in atherothrombosis, which is the precursor to stroke. One way for decreasing the risk of stroke is treatment of risk factors. Alpha-lipoic acid (ALA) or thiocitic acid is an eight-carbon, sulfur-containing compound. Traditionally, it is recognized as a cofactor in the multienzyme complexes that are responsible for the oxidative decarboxylation of α-ketoacids. A general agreement exists about the antioxidant properties of ALA, which is thought to function by clearing free radicals directly, chelating metallic ions, enhancing intracellular glutathione (GSH), and activating endogenous antioxidant systems. Besides the antioxidant properties of ALA, nitric oxide synthesis can be increased by ALA, which may improve endothelial function. Several animal and humanstudies investigated the effect of ALA on blood pressure and some introduced it as a potential BP regulator. Inanition evidence suggests that ALA can reduce blood glucose by increasing GLUT-4 transportation to muscle and fat cell membranes and increasing glucose uptake. In addition, ALA is effective in protecting against hypercholesterolemia and hepatic fat accumulation and reduces body weight, changes other anthropometric indices and regulate food intake by suppressing appetite and increasing metabolism.Patients and Methods: This study is a randomized, double-blind, placebo-controlled clinical trial. sixty-seven patients with stroke were enrolled into two groups; receiving 600 mg alpha-lipoic acid (n = 33) or placebo (n = 34) for 12 weeks. Indicators of cardiovascular performance (Carotid intima media thickness, Flow mediated dilation measured by doppler ultrasound), biochemical parameters(IL-6, TNF-α, hs-CRP, FBS, fasting insulin level, triglyceride, total cholesterol, LDL-cholesterol, and HDL-cholesterol), anthropometric indices (based on standard methods), blood pressure and dietary intake were measured. Data and nutritional analysis were performed using SPSS16 and N4 softwares, respectively.Results: At the end of the study, changes in CIMT and FMD, hs-CRP, triglycerides, total cholesterol, LDL- cholesterol and HDL- cholesterol, FBS, blood pressure, waist circumference and dietary intake were statistically significant. Changes in the levels of TNF-α, IL-6, fasting insulin and weight changes after controlling energy intake were non-significant.Conclusion: This study results indicate that ALA supplementation in patients with stroke may improve cardiovascular performance indicators, blood pressure, lipid profile, fasting blood sugar and adjusted anthropometric parameters and food intake.

Keywords:

alpha lipoic acid , stroke , carotid intima madia thickness , flow-mediated dilation , inflammatory markers , blood pressure