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Can alpha lipoic acid help manage metabolic diseases?

We've previously covered a meta-analysis looking at ALA's impact on weight. But how much of an impact does it make on cholesterol and glycemic control?

Study under review: The effects of alpha-lipoic acid supplementation on glucose control and lipid profiles among patients with metabolic diseases: A systematic review and meta-analysis of randomized controlled trials.

Introduction

The cluster of issues that arise from a disordered metabolism (e.g., impaired glucose tolerance, elevated triglycerides and LDL-cholesterol) is often referred to as metabolic syndrome[1]. Metabolic syndrome increases the risk of several chronic diseases, specifically type 2 diabetes[2] (T2DM) and cardiovascular disease [3](CVD).

Currently, there are several approaches to managing the markers of metabolic disease, including both lifestyle modification[4] and pharmacological therapies. The primary efficacious lifestyle interventions involve caloric restriction through dietary modifications and implementation of exercise. Additionally, exercise alone can directly improve glucose and lipid metabolism. Pharmacological interventions, such as metformin and statins, are considered standard-of-care for many diseases, including T2DM and CVD.

There are additional non-pharmacological interventions that may improve markers of metabolic disease. Among these non-pharmacological interventions, alpha-lipoic acid (ALA) may have antioxidant[5], glucose lowering[6], and lipid lowering properties[7]. Furthermore, two meta-analyses have examined ALA’s effects on bodyweight[8] (which we covered in Study Deep Dives 35v1) and inflammatory markers[9]. Their results are summarized in Figure 1.

Figure 1: Effects of ALA found in previous meta-analyses

References: Kucukgoncu et al. Obes Rev. 2017 May.
Akbari et al. Nutr Metab (Lond). 2018 Jun.

To date, there have also been numerous randomized controlled trials (RCTs) examining the effect of ALA on glucose and lipid metabolism in people with diseases of disordered metabolism, such as T2DM[10] and polycystic ovarian syndrome (PCOS)[11]. While some ALA trials have shown a benefit on glucose and lipid metabolism, others have shown no benefit. The present study is a systematic review and meta-analysis of RCTs on the effect of ALA on glucose and lipid metabolism among participants with diseases related to disordered metabolism.

Metabolic disturbances, primarily impaired glucose tolerance and dyslipidemia, increase the risk of metabolic disease, such as T2DM and CVD. ALA is a non-pharmaceutical intervention that displays some glucose-lowering and lipid-lowering effects. The present study is a systematic review and meta-analysis on the effect of ALA on glucose and lipid metabolism.

Who and what was studied?

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The big picture

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Other Articles in Issue #48 (October 2018)