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口服α-环糊精对血脂影响的随机双盲临床试验。

Randomized double blind clinical trial on the effect of oral α-cyclodextrin on serum lipids.

作者信息

Amar Marcelo J A, Kaler Maryann, Courville Amber B, Shamburek Robert, Sampson Maureen, Remaley Alan T

机构信息

Lipoprotein Metabolism Section, Cardio-Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Building 10, Room 8 N-228, 10 Center Drive MSC 1666, Bethesda, MD, USA.

出版信息

Lipids Health Dis. 2016 Jul 12;15(1):115. doi: 10.1186/s12944-016-0284-6.

Abstract

BACKGROUND

This single center, double-blinded, cross-over, placebo controlled clinical trial investigated the effect of oral α-cyclodextrin (α-CD), a soluble dietary fiber, on blood lipid and lipoprotein levels in healthy human subjects. α-CD, a cyclical polymer containing 6 glucose subunits, is currently sold as an over the counter food supplement and is also a common additive in many foods. α-CD forms a hydrophobic central cavity that binds lipids and has been shown in animal studies and in previous clinical trials to alter plasma lipid levels.

METHODS

We screened for healthy subjects, males and females, between ages 18 to 75. Out of total 103 subjects interviewed, 75 subjects completed the study. Qualified individuals in each gender group were randomized into two groups in terms of which treatment arm they received first (placebo vs. α-CD, receiving 6 grams P.O. a day, for 12-14 weeks with a 7 day wash out between arms). The primary outcome variable, plasma total cholesterol, as well as other tests related to lipids and lipoprotein and glucose metabolism, were measured at baseline and at the end of each arm of the study.

RESULTS

α-CD was well tolerated; no serious adverse events related to α-CD were observed. Approximately 8 % of the subjects on α-CD complained of minor gastrointestinal symptoms versus 3 % on placebo (p = 0.2). Small-LDL particle number decreased 10 % (p < 0.045) for subjects on α-CD versus placebo. Fasting plasma glucose (1.6 %, p < 0.05) and Insulin resistance index (11 %, p < 0.04) were also decreased when on α-CD versus placebo.

CONCLUSION

α-CD treatment appears to be safe and well tolerated in healthy individuals and showed a modest reduction in small LDL particles, and an improvement in glucose related parameters.

TRIAL REGISTRATION

NCT01131299.

摘要

背景

这项单中心、双盲、交叉、安慰剂对照的临床试验研究了口服α-环糊精(α-CD)(一种可溶性膳食纤维)对健康人体受试者血脂和脂蛋白水平的影响。α-环糊精是一种含有6个葡萄糖亚基的环状聚合物,目前作为非处方食品补充剂出售,也是许多食品中的常见添加剂。α-环糊精形成一个结合脂质的疏水中心腔,在动物研究和先前的临床试验中已显示其可改变血浆脂质水平。

方法

我们筛选了年龄在18至75岁之间的健康受试者,包括男性和女性。在总共采访的103名受试者中,75名受试者完成了研究。每个性别组中的合格个体根据他们首先接受的治疗组(安慰剂与α-环糊精,每天口服6克,持续12 - 14周,两组之间有7天的洗脱期)随机分为两组。在基线以及研究的每个治疗组结束时,测量主要结局变量血浆总胆固醇以及与脂质、脂蛋白和葡萄糖代谢相关的其他指标。

结果

α-环糊精耐受性良好;未观察到与α-环糊精相关的严重不良事件。服用α-环糊精的受试者中约8%抱怨有轻微胃肠道症状,而服用安慰剂的受试者中这一比例为3%(p = 0.2)。与安慰剂相比,服用α-环糊精的受试者小LDL颗粒数量减少了10%(p < 0.045)。与安慰剂相比,服用α-环糊精时空腹血糖(1.6%,p < 0.05)和胰岛素抵抗指数(11%,p < 0.04)也有所降低。

结论

α-环糊精治疗在健康个体中似乎是安全且耐受性良好的,并显示出小LDL颗粒略有减少以及与葡萄糖相关参数有所改善。

试验注册

NCT01131299。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ad4/4941029/c3f85636e59c/12944_2016_284_Fig1_HTML.jpg

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