Aged garlic extract improves adiponectin levels in subjects with metabolic syndrome: a double-blind, placebo-controlled, randomized, crossover study.

BACKGROUND: Garlic (Allium sativum) has been shown to have important benefits in individuals at high cardiovascular risk. The aim of the present study was to evaluate the effects of the administration of aged garlic extract (AGE) on the risk factors that constitute the cluster of metabolic syndrome (MS). METHODS AND DESIGN: Double-blind, crossover, randomized, placebo-controlled clinical trial to assess the effect of 1.2 g/day of AGE (Kyolic), for 24 weeks of treatment (12 weeks of AGE and 12 weeks of placebo), on subjects with MS. RESULTS: The administration of AGE increased the plasma levels of adiponectin (P = 0.027). No serious side effects associated with the intervention were reported. CONCLUSION: The present results have shown for the first time that the administration of AGE for 12 weeks increased plasma adiponectin levels in patients with MS. This suggests that AGE might be a useful, novel, nonpharmacological therapeutic intervention to increase adiponectin and to prevent cardiovascular (CV) complications in individuals with MS.

Oxidative stress and inflammation, a link between chronic kidney disease and cardiovascular disease.

Patients with chronic kidney disease (CKD) show a high cardiovascular morbidity and mortality. This seems to be consequence of the cardiovascular risk factor clustering in CKD patients. Non traditional risk factors such as oxidative stress and inflammation are also far more prevalent in this population than in normal subjects. Renal disease is associated with a graded increase in oxidative stress markers even in early CKD. This could be consequence of an increase in reactive oxygen species as well as a decrease in antioxidant defence. This oxidative stress can accelerate renal injury progression. Inflammatory markers such as C reactive protein and cytokines increase with renal function deterioration suggesting that CKD is a low-grade inflammatory process. In fact, inflammation facilitates renal function deterioration. Several factors can be involved in triggering the inflammatory process including oxidative stress. Statin administration is accompanied by risk reduction in all major vascular events in patients with CKD that are considered high-risk patients. These beneficial effects seem to be consequence of not only their hypolipidemic effect but especially their pleitropic actions that involve modulation of oxidative stress and inflammation.

Oxidative stress in uremia: the role of anemia correction.

Patients with chronic kidney disease (CKD) are prone to develop cardiovascular disorders. Numerous reports have shown the association between uremia and oxidative stress, which increases patients' risk for cumulative injury to multiple organs. Anemia is a common and disabling feature of CKD and seems to be a main cause of oxidative stress; correction of anemia represents an effective approach to reduce oxidative stress and, consequently, cardiovascular risk. There is increasing evidence that correction of anemia with erythropoiesis-stimulating agents could protect from oxidative stress in patients with CKD and ESRD. However, iron deficiency frequently complicates anemia in patients with CKD, and ferrous iron cation is a co-factor that is needed for hydroxyl radical production, which can promote cytotoxicity and tissue injury. This has raised a justifiable concern that prescription of intravenous iron may exacerbate oxidative stress and, hence, endothelial dysfunction, inflammation, and progression of cardiovascular disease, which are widely known consequences of CKD. Correction of anemia represents an effective approach to reduce oxidative stress and, consequently, cardiovascular risk. Iron deficiency is a common cause of resistance to erythropoiesis-stimulating agents, and the overall risk-benefit ratio favors use of intravenous iron to treat iron deficiency in patients with CKD. Consecutive or combined treatment with intravenous iron and erythropoiesis-stimulating agents clearly is beneficial for patients with CKD and iron deficiency, and anemia and could contribute to prevent the risk for cardiovascular events in these patients.

A sodium-rich carbonated mineral water reduces cardiovascular risk in postmenopausal women.

This study was designed to investigate the possible beneficial effects of consuming a sodium-rich carbonated mineral water on lipoprotein metabolism and to determine whether consumption of this water influences endothelial dysfunction (ED) in postmenopausal women. Women included in the study were amenorrheic (>1 y), healthy, and not obese (BMI < 30 kg/m(2)). The subjects did not take estrogen replacement therapy; supplements of vitamins, minerals, and phytoestrogens; or other medications known to affect bone and lipid metabolism. The study consisted of 2 intervention periods of 2 mo each, during which women drank 1 L/d of a control mineral water (low mineral content) for 2 mo followed by the carbonated mineral water, rich in sodium, bicarbonate, and chloride, for 2 mo. Body weight, height, and blood pressure were measured, and BMI was calculated. Blood samples were taken from fasting subjects and serum was analyzed for total cholesterol, HDL-cholesterol, LDL-cholesterol, triacylglycerols, apolipoprotein AI, apolipoprotein B, soluble intercellular cell adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), and glucose. Blood pressure levels did not change throughout the study. Carbonated water intake decreased total cholesterol and LDL-cholesterol levels by 6.8% (P = 0.001) and 14.8% (P < 0.0001), respectively, whereas HDL-cholesterol concentration increased by 8.7% (P = 0.018), compared to the control period. Therefore, cardiovascular disease (CVD) risk indexes (total cholesterol/HDL-cholesterol and LDL-cholesterol/HDL-cholesterol) were markedly reduced (both P < 0.0001). Soluble ICAM-1 and sVCAM-1 levels decreased by 8.4% (P = 0.007) and 14.8% (P = 0.015), respectively. Fasting serum glucose concentration decreased by 6.7% (P < 0.0001). Triacylglycerol levels did not change. Consumption of this sodium rich carbonated water can play a beneficial role in the prevention of CVD and the metabolic syndrome.

Platelet aggregation, thromboxane production and thrombogenic ratio in postmenopausal women consuming high oleic acid-sunflower oil or palmolein.

BACKGROUND: Saturated fatty acids exert controversial effects on platelet aggregation and eicosanoid production. AIM: To investigate the effect of a dietary exchange between palmitic acid and oleic acid on both platelet aggregation and thromboxane B2 (TXB(2)) production, and on urine TXB(2), prostacyclin I2 (PGI(2) as 6-keto-protaglandin F(1)alpha), and the thrombogenic ratio (TXB(2)/6-keto-protaglandin F(1)alpha) in fourteen postmenopausal women. EXPERIMENTAL DESIGN: Women were assigned to two consecutive 28-d dietary periods that were high in cholesterol (~400 mg/d) and fat (~46%en). In the first period all subjects followed an oleic acid-rich diet prepared with high oleic acidsunflower oil. This was followed by a second period rich in palmitic acid in the form of palmolein. DETERMINATIONS: Nutrient intakes, ADP-platelet aggregation, platelet TXB(2) production, urine TXB(2) and 6-keto-protaglandin F(1)alpha were measured during two dietary periods and the results obtained correlated to serum cholesterol, lipoproteincholesterol and peroxides, apolipoproteins and plasma tocopherol. RESULTS: The palmolein diet led to an increase in the platelet aggregation rate (p < 0.05) and in the time for the maximal aggregation rate (p < 0.02). No significant differences were observed in platelet TXB(2) production. Palmolein increased urine TXB(2) in pg/mL (p < 0.05) and pg/min (p < 0.01), whereas the thrombogenic ratio (TXB(2)/6-keto-protaglandin F(1)alpha) did not change. Most changes were related to oil change, few to serum cholesterol level (< or > or = 6.2 mmol/L) or age (< or > or = 65 yr). CONCLUSIONS: Palmolein diet activates platelet aggregation more in normocholesterolemics. Though palmolein increased thromboxane and tended to increase prostacyclin in urine in normo- and hypercholesterolemic women, the thrombogenic ratio did not change. These effects were related to the LDL and HDL concentration increases and to the absence of change in the total cholesterol/HDL-cholesterol ratio found following the dietary intervention.