Key result
Salsalate increased brachial artery flow-mediated dilation from 4.0% to 6.6% (P<0.001) in nondiabetic overweight or obese middle-aged and older adults.
Why the study?
Does salsalate improve vascular endothelial function in overweight and obese middle-aged and older adults?
RCT (n=14)
double-blind
randomized
Does salsalate improve vascular endothelial function in overweight and obese middle-aged and older adults?
Absolute Event Rate: 6.6% vs 4%
p-value: p=<0.001
Short-term NF-κB inhibition with salsalate significantly improves vascular endothelial function in overweight and obese older adults, highlighting the role of inflammation and oxidative stress in endothelial dysfunction.
Salsalate may improve endothelial function in obese older adults; hypothesis-generating for NF-κB targeting, needs larger trials before practice change.
BACKGROUND: We tested the hypothesis that nuclear factor-kappaB (NF-kappaB) activity contributes to vascular endothelial dysfunction with aging and obesity in humans. METHODS AND RESULTS: We conducted a randomized, double-blind, placebo-controlled crossover study in 14 nondiabetic overweight or obese (body mass index > or =25 kg/m(2)) middle-aged and older (age 52 to 68 years) adults. Salsalate (nonacetylated salicylate, 4500 mg/d), a compound that inhibits NF-kappaB activity, or placebo was administered for 4-day periods. Plasma salicylate concentrations reached the midtherapeutic range (21.8+/-1.1 mg/100 mL, P< or =0.0001 versus placebo) by day 4 of salsalate treatment. Salsalate increased expression of the inhibitor of NF-kappaB and reduced total and nuclear expression of NF-kappaB in endothelial cells obtained from the subjects (all P<0.05). Salsalate increased brachial artery flow-mediated dilation by 74% (from 4.0+/-0.4% to 6.6+/-0.5%, P<0.001) but did not affect endothelium-independent dilation (P=0.83). The change in brachial artery flow-mediated dilation with salsalate was inversely related to baseline flow-mediated dilation (r=-0.77, P<0.01). Infusion of vitamin C increased brachial artery flow-mediated dilation during placebo (P<0.001) but not after salsalate (P=0.23). Salsalate reduced nitrotyrosine (P=0.06) and expression of NADPH oxidase p47(phox) (P<0.05) in endothelial cells obtained from the subjects but did not influence circulating or endothelial cell inflammatory proteins. CONCLUSIONS: Our findings provide the first direct evidence that NF-kappaB, in part via stimulation of oxidative stress, plays an important role in mediating vascular endothelial dysfunction in overweight and obese middle-aged and older humans.
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Pierce et al. (2009) conducted an RCT in overweight or obesity (n=14). Salsalate vs. placebo was evaluated on brachial artery flow-mediated dilation (p=<0.001). Salsalate increased brachial artery flow-mediated dilation from 4.0% to 6.6% (P<0.001) in nondiabetic overweight or obese middle-aged and older adults.
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