Alpha-lipoic acid supplement in obesity treatment: A systematic review and meta-analysis of clinical trials

Summary What is known and objective Non‐alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver injury. Some animal studies suggest that alpha‐lipoic acid (ALA) can improve disease outcome. The aim of this study was to investigate the effects of ALA supplementation on liver enzymes and inflammatory markers in obese patients with NAFLD. Methods In the current randomized, double‐blind, placebo‐controlled clinical trial, 50 obese patients with NAFLD were randomly allocated to either “ALA”(received 1200 mg ALA as two capsules per day plus 400 mg vitamin E) or “placebo”(received placebo containing starch, as two capsules per day plus 400 mg vitamin E) groups for 12 weeks. Body composition and anthropometric measures, serum levels of liver enzymes, adiponectin, interleukin‐6 (IL‐6), monocyte chemoattractant protein‐1 (MCP‐1) and ferritin were measured at baseline and the end of the study. Results and discussion A total number of 45 patients completed the study (ALA group = 23; placebo group = 22). The serum concentration of IL‐6 decreased significantly in ALA group in comparison with the placebo group, at end of the study (P = 0.049). Furthermore, ALA intake resulted in a significant increase in serum adiponectin levels compared to placebo (P = 0.008). A significant improvement was observed in liver steatosis grade of the patients in both groups, compared to baseline (P < 0.05). However, there was no difference between the two groups for the changes in liver steatosis, by the end of the study. Body composition and anthropometric measures, liver enzymes, MCP‐1 and ferritin serum levels were not significantly different between the study groups, neither at the baseline nor at the end of the study. What is new and conclusion Collectively, ALA supplementation improved serum adiponectin and IL‐6 levels, without changing serum liver enzymes and liver steatosis in obese patients with NAFLD.

Background: Weight gain is common after breast cancer (BC) treatment and may increase the risk of disease recurrence. Complementary medicine (CM) use is high amongst BC patients. This paper describes the use of CM from a cross-sectional self-administered survey on prevalence and management of weight after BC. Methods: Use of CM was assessed using a question modified from the I-CAM Questionnaire. Participants were asked to rate perceived effectiveness, advantages and disadvantages, and which CM they were willing to use for weight management if there was evidence for effectiveness. The survey was emailed to members of the Breast Cancer Network Australia Survey and Review Group, the largest consumer advocacy group in Australia for people with breast cancer. Results: There were a total of 309 responses. Three quarters had used CM in the past 12 months. One third had tried CM for weight loss. Yoga, meditation and pilates were perceived to be effective for weight loss. Perceived advantages of CMs for weight loss were the ability to improve general wellbeing, relaxation, and being nonpharmacological while disadvantages were financial cost, finding a reliable practitioner, and lack of research for effectiveness. Three quarters would be willing to try CM for weight loss if there was evidence for effectiveness, with the most popular CMs being acupuncture, relaxation, yoga, supplements, and meditation. Conclusions: The high use of CM in this group is consistent with previous research. Our research suggests that BC survivors would use acupuncture, meditation, supplements and yoga for weight loss if supported by scientificallycredible evidence. Research into the effectiveness of these treatments on weight loss after BC is warranted.

Lipoprotein-associated phospholipase A 2 (Lp-PLA2) is a new specific vascular inflammation biomarker that is carried by the lipoproteins in the blood and plays a prominent role in the pathogenesis of atherosclerosis. Increased Lp-PLA2 levels and impaired Lp-PLA2 distribution across high-density lipoprotein (HDL) and non-HDL lipoproteins have been reported in diabetic patients, which is associated with the increase in cardiovascular disease (CVD) risk. This study is aimed at investigating the effect of alpha lipoic acid (ALA), as an antioxidant with potential cardioprotective properties, on the Lp-PLA2 mass and its distribution in diabetic patients. In a double-blind, randomized, placebo-controlled clinical trial, seventy diabetic patients were randomly allocated to ALA (1200 mg ALA as two 600 mg capsules/day) and placebo (two maltodextrin capsules/day) groups. The serum levels of total Lp-PLA2 mass, HDL-Lp-PLA2, oxidized low-density lipoproteins (ox-LDL), apolipoprotein A1 (apo A1), lipid profiles, fasting blood sugar (FBS), and insulin were measured, and apolipoprotein B-(apoB-) associated Lp-PLA2 and homeostasis model of assessment index (HOMA-IR) were calculated at the baseline and after 8 weeks of intervention. ALA significantly decreased the ox-LDL, total Lp-PLA2 mass, apoB-associated Lp-PLA2, and percent of apoB-associated Lp-PLA2 and triglyceride and increased the percent of HDL-Lp-PLA2 compared with the placebo group but had no significant effect on HDL-Lp-PLA2 mass, apo A1, lipid profiles, and glycemic indices. There was a positive correlation between the reduction in the ox-LDL level and total Lp-PLA2 mass in the ALA group. In conclusion, ALA may decrease the CVD risk by reducing the ox-LDL and Lp-PLA2 mass and improving the Lp-PLA2 distribution among lipoproteins in type 2 diabetic patients.