Daily glycocalyx-mimetic supplementation significantly reduced the urinary peptidomic risk score for future heart failure (mean Δ -0.58; 95% CI -0.83 to -0.33; P<0.001), whereas FMD and placebo did not.
RCT (n=44)
Randomly allocated
Does an oral glycocalyx-mimetic supplement or fasting-mimicking diet improve urinary peptidomic classifiers of cardiovascular and kidney risk in South-Asian Surinamese adults with type 2 diabetes?
An oral glycocalyx-mimetic supplement improved a urinary peptidomic signature associated with heart failure risk in adults with type 2 diabetes, suggesting a potential role in reducing vascular risk.
Effect estimate: mean Δ -0.58 (95% CI -0.83 to -0.33)
p-value: p=<0.001
AIMS: Following up on a prior placebo-controlled trial (NCT03889236), we examined the effects of an oral glycocalyx-mimetic supplement and a fasting-mimicking diet (FMD) on three urinary peptidomic-based classifiers, which indicate future heart failure (HF2), coronary artery disease (CAD160), and chronic kidney disease (CKD273) risk in South-Asian Surinamese adults with type 2 diabetes mellitus. METHODS: Forty-four participants were randomly allocated to one of three 12-week interventions: daily glycocalyx-mimetic capsules (n = 18), placebo (n = 14), or a five-day FMD repeated every four weeks (n = 12). Baseline and week-12 urine were profiled via capillary electrophoresis-mass spectrometry (CE-MS). The pre-validated support vector machine (SVM) classifiers (HF2, CAD160, CKD273) produced risk scores that were evaluated through paired t-tests for each group. Peptide-level changes were analyzed using paired Wilcoxon signed-rank tests, and all p-values were Benjamini-Hochberg corrected (α = 0.05). RESULTS: Glycocalyx-mimetic supplementation significantly reduced HF2 scores (mean Δ = -0.58, 95 % CI -0.83 to -0.33, adjusted p < 0.001) and altered the abundance of 17 peptides, primarily decreasing collagen-derived fragments, suggesting improved extracellular-matrix turnover. The risk scores for CAD160 and CKD273 remained unchanged. FMD and placebo did not produce any meaningful changes in classifier scores. CONCLUSIONS: In this cohort, glycocalyx-mimetic supplementation improved the urinary peptidomic signature associated with heart-failure risk, whereas an FMD did not. Urinary peptidomics offers a sensitive molecular method for monitoring the effects of (dietary) interventions.
Biglari et al. (Sun,) conducted a rct in Type 2 diabetes mellitus (n=44). Glycocalyx-mimetic supplement and fasting-mimicking diet (FMD) vs. Placebo was evaluated on Urinary peptidomic-based classifiers for future heart failure (HF2), coronary artery disease (CAD160), and chronic kidney disease (CKD273) risk (mean Δ -0.58, 95% CI -0.83 to -0.33, p=<0.001). Daily glycocalyx-mimetic supplementation significantly reduced the urinary peptidomic risk score for future heart failure (mean Δ -0.58; 95% CI -0.83 to -0.33; P<0.001), whereas FMD and placebo did not.