Pleiotropic Benefit of Monomeric and Oligomeric Flavanols on Vascular Health - A Randomized Controlled Clinical Pilot Study

BackgroundCardiovascular diseases are expanding to a major social-economic burden in the Western World and undermine man's deep desire for healthy ageing. Epidemiological studies suggest that flavanol-rich foods (e.g. grapes, wine, chocolate) sustain cardiovascular health. For an evidenced-based application, however, sound clinical data on their efficacy are strongly demanded. MethodsIn a double-blind, randomized, placebo-controlled intervention study we supplemented 28 male smokers with 200 mg per day of monomeric and oligomeric flavanols (MOF) from grape seeds. At baseline, after 4 and 8 weeks we measured macro- and microvascular function and a cluster of systemic biomarkers for major pathological processes occurring in the vasculature: disturbances in lipid metabolism and cellular redox balance, and activation of inflammatory cells and platelets. ResultsIn the MOF group serum total cholesterol and LDL decreased significantly (P≤0.05) by 5% (n = 11) and 7% (n = 9), respectively in volunteers with elevated baseline levels. Additionally, after 8 weeks the ratio of glutathione to glutathione disulphide in erythrocytes rose from baseline by 22% (n = 15, PP≤0.05). ConclusionOur integrative multi-biomarker approach unveiled the pleiotropic vascular health benefit of an 8 weeks supplementation with 200 mg/d MOF in humans. Trial RegistrationClinicalTrials.gov NCT00742287研究背景：心血管疾病在西方世界已演变为重大社会经济负担，同时动摇了人类对健康老龄化的深切期盼。流行病学研究显示，富含黄烷醇（flavanol）的食物（如葡萄、葡萄酒、巧克力）可维持心血管健康。然而，若要实现基于循证医学的临床应用，亟需获取其功效的可靠临床数据。 研究方法：本研究开展一项双盲、随机、安慰剂对照的干预试验，为28名男性吸烟者每日补充200毫克葡萄籽来源的单体与寡聚体黄烷醇（MOF）。我们在基线状态、干预4周及8周后，分别检测了大血管与微血管功能，以及与血管系统主要病理过程相关的一系列系统性生物标志物：包括脂质代谢紊乱、细胞氧化还原平衡失调，以及炎症细胞与血小板活化。 研究结果：在基线血脂水平升高的受试者中，MOF干预组的血清总胆固醇与低密度脂蛋白（LDL）分别较基线显著下降5%（n=11）和7%（n=9），差异具有统计学意义（P≤0.05）。此外，干预8周后，红细胞内谷胱甘肽与氧化型谷胱甘肽的比值较基线升高22%（n=15，P≤0.05）。 研究结论：本研究采用整合式多生物标志物分析策略，证实了每日补充200mg/d MOF、持续8周可对人类血管健康产生多效性益处。 试验注册：ClinicalTrials.gov NCT00742287