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Vascular function and atherosclerosis progression after 1 y of flavonoid intake in statin-treated postmenopausal women with type 2 diabetes: a double-blind randomized controlled trial.
Am J Clin Nutr 2013; 97(5):936-42AJ

Abstract

BACKGROUND

In healthy participants, short-term flavan-3-ol and isoflavone intakes improve vascular function; however, the potential combined benefit of these compounds on atherosclerosis progression remains unclear for those at elevated risk of cardiovascular disease.

OBJECTIVE

The objective was to examine whether combined isoflavone and flavan-3-ol intake alters vascular function in postmenopausal women with type 2 diabetes mellitus (T2DM).

DESIGN

A double-blind, parallel-design, placebo-controlled 1-y trial was conducted in postmenopausal T2DM patients randomly assigned to a split dose of 27 g flavonoid-enriched chocolate/d [850 mg flavan-3-ols (90 mg epicatechin) + 100 mg isoflavones (aglycone equivalents)/d] or matched placebo. Intima-media thickness of the common carotid artery (CCA-IMT), pulse wave velocity (PWV), augmentation index, blood pressure (BP), and vascular biomarkers were assessed.

RESULTS

A total of 93 patients completed the trial. Overall, the flavonoid intervention did not significantly change CCA-IMT, augmentation index, or BP, but pulse pressure variability improved (flavonoid: -0.11 ± 0.07 mm Hg/min; placebo: 0.10 ± 0.11 mm Hg/min; P = 0.04). In a subgroup with PWV data, net improvements were observed [flavonoid (n = 18): -0.07 ± 0.38 m/s; placebo (n = 17): 0.68 ± 0.25 m/s; P = 0.01], which equated to a 10% CV risk reduction. Equol producers (n = 17) had larger reductions in diastolic BP, mean arterial pressure, and PWV (-2.24 ± 1.31 mm Hg, -1.24 ± 1.30 mm Hg, and -0.68 ± 0.40 m/s, respectively; P < 0.01) compared with non-equol producers (n = 30).

CONCLUSIONS

Although the 1-y intervention did not change CCA-IMT or BP, clinically relevant improvements in arterial stiffness were observed; equol producers were particularly responsive. Flavonoids may augment existing therapeutic strategies to reduce cardiovascular disease risk in postmenopausal T2DM patients, and longer studies are needed to examine the effects on atherosclerosis progression. This trial was registered at clinicaltrials.gov as NCT00677599.

Authors+Show Affiliations

Departments of Nutrition and Radiology Department, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23553151

Citation

Curtis, Peter J., et al. "Vascular Function and Atherosclerosis Progression After 1 Y of Flavonoid Intake in Statin-treated Postmenopausal Women With Type 2 Diabetes: a Double-blind Randomized Controlled Trial." The American Journal of Clinical Nutrition, vol. 97, no. 5, 2013, pp. 936-42.
Curtis PJ, Potter J, Kroon PA, et al. Vascular function and atherosclerosis progression after 1 y of flavonoid intake in statin-treated postmenopausal women with type 2 diabetes: a double-blind randomized controlled trial. Am J Clin Nutr. 2013;97(5):936-42.
Curtis, P. J., Potter, J., Kroon, P. A., Wilson, P., Dhatariya, K., Sampson, M., & Cassidy, A. (2013). Vascular function and atherosclerosis progression after 1 y of flavonoid intake in statin-treated postmenopausal women with type 2 diabetes: a double-blind randomized controlled trial. The American Journal of Clinical Nutrition, 97(5), pp. 936-42. doi:10.3945/ajcn.112.043745.
Curtis PJ, et al. Vascular Function and Atherosclerosis Progression After 1 Y of Flavonoid Intake in Statin-treated Postmenopausal Women With Type 2 Diabetes: a Double-blind Randomized Controlled Trial. Am J Clin Nutr. 2013;97(5):936-42. PubMed PMID: 23553151.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vascular function and atherosclerosis progression after 1 y of flavonoid intake in statin-treated postmenopausal women with type 2 diabetes: a double-blind randomized controlled trial. AU - Curtis,Peter J, AU - Potter,John, AU - Kroon,Paul A, AU - Wilson,Paddy, AU - Dhatariya,Ketan, AU - Sampson,Mike, AU - Cassidy,Aedín, Y1 - 2013/04/03/ PY - 2013/4/5/entrez PY - 2013/4/5/pubmed PY - 2013/6/19/medline SP - 936 EP - 42 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 97 IS - 5 N2 - BACKGROUND: In healthy participants, short-term flavan-3-ol and isoflavone intakes improve vascular function; however, the potential combined benefit of these compounds on atherosclerosis progression remains unclear for those at elevated risk of cardiovascular disease. OBJECTIVE: The objective was to examine whether combined isoflavone and flavan-3-ol intake alters vascular function in postmenopausal women with type 2 diabetes mellitus (T2DM). DESIGN: A double-blind, parallel-design, placebo-controlled 1-y trial was conducted in postmenopausal T2DM patients randomly assigned to a split dose of 27 g flavonoid-enriched chocolate/d [850 mg flavan-3-ols (90 mg epicatechin) + 100 mg isoflavones (aglycone equivalents)/d] or matched placebo. Intima-media thickness of the common carotid artery (CCA-IMT), pulse wave velocity (PWV), augmentation index, blood pressure (BP), and vascular biomarkers were assessed. RESULTS: A total of 93 patients completed the trial. Overall, the flavonoid intervention did not significantly change CCA-IMT, augmentation index, or BP, but pulse pressure variability improved (flavonoid: -0.11 ± 0.07 mm Hg/min; placebo: 0.10 ± 0.11 mm Hg/min; P = 0.04). In a subgroup with PWV data, net improvements were observed [flavonoid (n = 18): -0.07 ± 0.38 m/s; placebo (n = 17): 0.68 ± 0.25 m/s; P = 0.01], which equated to a 10% CV risk reduction. Equol producers (n = 17) had larger reductions in diastolic BP, mean arterial pressure, and PWV (-2.24 ± 1.31 mm Hg, -1.24 ± 1.30 mm Hg, and -0.68 ± 0.40 m/s, respectively; P < 0.01) compared with non-equol producers (n = 30). CONCLUSIONS: Although the 1-y intervention did not change CCA-IMT or BP, clinically relevant improvements in arterial stiffness were observed; equol producers were particularly responsive. Flavonoids may augment existing therapeutic strategies to reduce cardiovascular disease risk in postmenopausal T2DM patients, and longer studies are needed to examine the effects on atherosclerosis progression. This trial was registered at clinicaltrials.gov as NCT00677599. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/23553151/Vascular_function_and_atherosclerosis_progression_after_1_y_of_flavonoid_intake_in_statin_treated_postmenopausal_women_with_type_2_diabetes:_a_double_blind_randomized_controlled_trial_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.112.043745 DB - PRIME DP - Unbound Medicine ER -