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Recent data have revealed that oxidative products and inflammatory mediators are increased in the insulin-resistant states of obesity and type 2 diabetes mellitus (T2DM). Obese patients with impaired glucose tolerance (IGT) are at high risk for developing T2DM and have high incidence of dyslipidemia. α-Lipoic acid (ALA) is a potent antioxidant with insulin sensitizing activity. However, it is not clear whether ALA is effective on lipid parameters in humans. This study has investigated 22 obese subjects with IGT (obese-IGT), 13 of whom underwent 2-week ALA treatment, 600 mg intravenously once daily. Before and after the treatment, euglycemic-hyperinsulinemic clamps were used to measure insulin sensitivity. Meanwhile, plasma lipids, oxidative products, and chronic inflammatory markers were measured. After treatment of ALA in obese-IGT patients, insulin sensitivity was improved, insulin sensitivity index (ISI) impressively enhanced by 41%. Plasma levels of free fatty acids (FFAs), triglyceride (TG), total cholesterol (T-Chol), low density lipoprotein-cholesterol (LDL-Chol), small dense LDL-Chol (sd-LDL), oxidized LDL-Chol (ox-LDL-Chol), very low density lipoprotein-cholesterol (VLDL-Chol) were all significantly decreased (P < 0.01). At the same time, both plasma oxidative products (malondialdehyde (MDA), 8-iso-prostaglandin) and inflammatory markers (tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6)) were remarkably decreased (P < 0.01), while adiponectin was increased (P < 0.01). There are significant negative correlations between ISI and plasma FFAs, sd-LDL-Chol, ox-LDL-Chol, MDA, 8-iso-prostaglandin, TNF-α, and IL-6, and positive correlations with HDL-Chol and adiponectin in obese-IGT patients. The results indicate that short-term treatment with ALA can improve insulin sensitivity and plasma lipid profile possibly through amelioration of oxidative stress and chronic inflammatory reaction in obese patients with IGT.
Zhang et al. (Thu,) studied this question.