Effects of alpha-lipoic acid supplementation on human diabetic nephropathy: A systematic review and meta-analysis

2021 ◽  
Vol 17 ◽  
Author(s):  
Elena Vakali ◽  
Dimitrios Rigopoulos ◽  
Andres E. Carrillo ◽  
Andreas D. Flouris ◽  
Petros C. Dinas
Keyword(s):  
Systematic Review ◽  
Diabetic Nephropathy ◽  
Lipoic Acid ◽  
Excretion Rate ◽  
Meta Analysis ◽  
Alpha Lipoic Acid ◽  
Creatinine Ratio ◽  
Biological Indices ◽  
Urine Albumin ◽  
Patients With Diabetes

Background: Diabetic nephropathy (DN) is a kidney dysfunction, which occurs due to elevated urine albumin excretion rate and reduced glomerular filtration rate. Studies in animals have shown that alpha-lipoic acid (ALA) supplementation can reduce the development of DN. Objectives: We performed a systematic review and meta-analysis to examine the effects of ALA supplementation on biological indices (albumin, creatinine etc.) indicative of human DN. Methods: The searching procedure included the databases PubMed Central, Embase, Cochrane Library (trials) and Web of Science, (protocol registration: INPLASY 202060095). Results: We found that ALA supplementation decreased urine albumin 24h excretion rate in patients with diabetes [standardized mean difference=-2.27; confidence interval (CI)=(-4.09)–(-0.45); I2=98%; Z=2.44; p=0.01]. A subgroup analysis revealed that the studies examining only ALA, did not differ from those examined ALA in combination with additional medicines (Chi-squared=0.19; p=0.66; I2=0%), while neither ALA nor ALA plus medication had an effect on urine albumin 24h excretion rate (p>0.05). Also, ALA supplementation decreased urine albumin mg/l [mean difference (MD)=-12.95; CI=(-23.88)–(-2.02); I2=44%; Z=2.32; p=0.02] and urine albumin to creatinine ratio [MD=-26.96; CI=(-35.25)–(-18.67); I2=0%; Z=6.37; p<0.01] in patients with diabetes. When the studies that examined ALA plus medication were removed, ALA supplementation had no effect on urine albumin mg/l (p>0.05), but did significantly decrease urine albumin to creatinine ratio [MD=-25.88, CI=(34.40–(-17.36), I2=0%, Z=5.95, p<0.00001]. Conclusion: The available evidence suggests that ALA supplementation does not improve biological indices that reflect DN in humans. Overall, we identified limited evidence and therefore, the outcomes should be considered with caution.

scholarly journals Urinary N-Acetyl-β-d-glucosaminidase (uNAG) as an Indicative Biomarker of Early Diabetic Nephropathy in Patients with Diabetes Mellitus (T1DM, T2DM): A Systematic Review and Meta-Analysis

Diabetology ◽  
2021 ◽  
Vol 2 (4) ◽  
pp. 272-285
Author(s):  
Arlinda R. Driza ◽  
Georgia V. Kapoula ◽  
Pantelis G. Bagos
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Diabetic Nephropathy ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Diabetic Patients ◽  
Pool Data ◽  
Patients With Diabetes ◽  
Pubmed Search ◽  
Renal Tubular

Diabetic nephropathy (DN) is the main cause of chronic kidney disease in patients with type 1 (T1DM) and type 2 diabetes mellitus (T2DM). Renal tubular lysosomal enzyme activities like N-acetyl-β-d-glucosaminidase (NAG) have been shown to increase in patients developing DN. The aim of this systematic review and meta-analysis is to evaluate the diagnostic accuracy of NAG, as a preventional biomarker in the early stages of DN in patients with diabetes mellitus. Two impartial reviewers conducted a complete PubMed search until July 2021. A 2 × 2 contingency table was created for each trial and sensitivity and specificity were estimated using a bivariate random effects model. To pool data and estimate the area under the curve (AUC), the hierarchical summary ROC (hsROC) approach was utilized. Deek’s test was used to estimate publication bias. The meta-analysis included 21 studies that evaluated 2783 patients with T1DM and T2DM, as well as 673 healthy individuals. The AUC of urinary NAG (uNAG) ranged from 0.69 (95% CI: 0.65–0.73) to 0.89 (95% CI: 0.86–0.92). According to the results, NAG in urine can be considered as a potential and effective biomarker for predicting DN in diabetic patients (T1DM, T2DM).

The effect of Alpha‐lipoic acid supplementation on endothelial function: A systematic review and meta‐analysis

2020 ◽  
Author(s):  
Yahya Jalilpiran ◽  
Maryam Hajishafiee ◽  
Masoud Khorshidi ◽  
Hamid Rezvani ◽  
Mohsen Mohammadi‐Sartang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Endothelial Function ◽  
Lipoic Acid ◽  
Meta Analysis ◽  
Alpha Lipoic Acid ◽  
Acid Supplementation

An updated systematic review and dose-response meta-analysis of the randomized controlled trials on the effects of Alpha-Lipoic acid supplementation on inflammatory biomarkers

2021 ◽  
pp. 1-14
Author(s):  
Mahdi Vajdi ◽  
Mahsa Mahmoudi-Nezhad ◽  
Mahdieh Abbasalizad Farhangi
Keyword(s):  
Systematic Review ◽  
Lipoic Acid ◽  
Dose Response ◽  
Subgroup Analysis ◽  
Inflammatory Markers ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Alpha Lipoic Acid ◽  
Randomized Controlled ◽  
Tnf Α

Abstract. Data about the effects of alpha-lipoic acid (ALA) supplementation on inflammatory markers are inconsistent. This systematic review and dose-response meta-analysis of randomized controlled trials was performed to summarize the effects of ALA supplementation on inflammatory markers such as C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in adults. A comprehensive literature search was conducted in the electronic databases of PubMed, Web of Science, ProQuest, Embase, and SCOPUS from inception to February 2020. Among all of the eligible studies, 20 articles were selected. The weighted mean differences (WMD) and 95% confidence intervals (CI) were calculated to evaluate the pooled effect size. Between-study heterogeneity was evaluated using Cochran’s Q test and I2. Subgroup analysis was done to evaluate the potential sources of heterogeneity. The dose-response relationship was evaluated using fractional polynomial modeling. Twenty eligible studies with a total sample size of 947 participants were included in the current meta-analysis. The findings of the meta-analysis showed that ALA supplementation significantly reduced CRP (WMD: −0.69 mg/L, 95% CI: −1.13, −0.26, P=0.002), IL-6 (WMD: −1.83 pg/ml, 95% CI: −2.90, −0.76, P=0.001), and TNF-α concentrations (WMD: −0.45 pg/ml, 95% CI: −0.85, −0.04, P=0.032). No evidence of departure from linearity was observed between dose and duration of the ALA supplementation on serum CRP, IL-6 and TNF-α concentration. In subgroup analysis, ALA dosage, baseline concentrations of the parameter, sample size, and gender were considered as possible sources of heterogeneity. In summary, ALA supplementation improves inflammatory markers without any evidence of non-linear association to dose or duration of the trial.

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