Improvement of endothelial function and insulin sensitivity with vitamin C in patients with coronary spastic angina

Hirashima, Osamu; Kawano, Hiroaki; Motoyama, Takeshi; Hirai, Nobumitsu; Ohgushi, Masamichi; Kugiyama, Kiyotaka; Ogawa, Hisao; Yasue, Hirofumi

doi:10.1016/s0735-1097(00)00616-1

Cited by 101 publications

(71 citation statements)

References 37 publications

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“…Consistent with this hypothesis, intravenous infusion of ascorbic acid to glucose intolerant subjects and smokers improved FMD and insulin sensitivity while reducing plasma thiobarbituric acid-reactive substances, an index of lipid peroxidation. 42 Similarly, Hirashima et al 43 reported that in patients with vasospastic angina, a condition associated with reductions in insulin sensitivity 44 and NO status, 45 ascorbic acid infusion normalized FMD and reduced insulin resistance.…”

Section: Discussionmentioning

confidence: 98%

Cocoa Reduces Blood Pressure and Insulin Resistance and Improves Endothelium-Dependent Vasodilation in Hypertensives

Grassi

Necozione²,

Lippi³

et al. 2005

Hypertension

491

393

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Abstract-Consumption of flavanol-rich dark chocolate (DC) has been shown to decrease blood pressure (BP) and insulin resistance in healthy subjects, suggesting similar benefits in patients with essential hypertension (EH). Therefore, we tested the effect of DC on 24-hour ambulatory BP, flow-mediated dilation (FMD), and oral glucose tolerance tests (OGTTs) in patients with EH. After a 7-day chocolate-free run-in phase, 20 never-treated, grade I patients with EH (10 males; 43.7Ϯ7.8 years) were randomized to receive either 100 g per day DC (containing 88 mg flavanols) or 90 g per day flavanol-free white chocolate (WC) in an isocaloric manner for 15 days. After a second 7-day chocolate-free period, patients were crossed over to the other treatment. O bservational studies suggest dietary flavonoids decrease the risk of death from coronary heart disease, 1 cancer, 1 and stroke. 2 Flavonoid-rich foods include fruits and vegetables as well as tea, red wine, and chocolate. 3 The high flavonoid content, particularly in flavanols (ie, catechins) and their procyanidin oligomers, of these foods may contribute to some of their putative cardiovascular benefits. 4,5 The antioxidant protection afforded by flavonoids in the vascular endothelium may reduce the risk for atherosclerosis, including their action of inhibiting the oxidative conversion of NO to peroxynitrite. 6 Accordingly, cocoa flavonoids decreased oxidant-induced peroxynitrite production in vitro 7 and increased NO synthase (NOS) expression and NO-dependent vasorelaxation in rabbit aortic rings. 8 In healthy adults, drinking flavanol-rich cocoa increased NO-dependent vasorelaxation in finger arteries, 9 and eating flavanol-rich dark chocolate (DC) improved flow-mediated dilation (FMD) in brachial arteries in association with an increase in plasma epicatechin. 10 Impaired NO-dependent vasorelaxation also contributes to a dysregulation of blood pressure (BP) 11 and a decrement of insulin-mediated glucose uptake. 12 In contrast, increased endothelial NOS expression and NO bioavailability ameliorate endothelial dysfunction, and thereby have the potential to decrease BP, increase insulin sensitivity, and slow down atherogenetic processes. In this regard, the anthocyanin cyanidin-3-glucoside was able to increase NOS expression and NO bioavailability in vascular endothelial cells. 13 We recently demonstrated decrements in BP and increments in insulin sensitivity in healthy volunteers after 15 days of DC intake. 14 Thus, we studied patients with essential hypertension (EH) to evaluate the effects of flavanol-rich DC on 24-hour ambulatory BP monitoring (ABPM), endotheliumdependent vasorelaxation via FMD of the brachial artery, insulin sensitivity via oral glucose tolerance tests (OGTTs), and 2 serum biomarkers of vascular inflammation: highsensitive C-reactive protein (hsCRP) and intercellular adhesion molecule-1 (ICAM-1).

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Section: Discussionmentioning

confidence: 98%

Cocoa Reduces Blood Pressure and Insulin Resistance and Improves Endothelium-Dependent Vasodilation in Hypertensives

Grassi

Necozione²,

Lippi³

et al. 2005

Hypertension

491

393

View full text Add to dashboard Cite

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“…Enhanced insulin sensitivity has been demonstrated by treatment with LA [84], vitamin E [87], and vitamin C [88] in small-sized, short-term trials. However, these results have not been confirmed in other studies.…”

Section: Therapeutic Approaches To Reduce Oxidative Stressmentioning

confidence: 99%

Oxidative Stress, Nitric Oxide, and Diabetes

Pitocco¹,

Zaccardi²,

Stasio³

et al. 2010

Rev Diabet Stud

288

194

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■ AbstractIn the recent decades, oxidative stress has become focus of interest in most biomedical disciplines and many types of clinical research. Increasing evidence from research on several diseases show that oxidative stress is associated with the pathogenesis of diabetes, obesity, cancer, ageing, inflammation, neurodegenerative disorders, hypertension, apoptosis, cardiovascular diseases, and heart failure. Based on this research, the emerging concept is that oxidative stress is the "final common pathway", through which risk factors of several diseases exert their deleterious effects. Oxidative stress causes a complex dysregulation of cell metabolism and cell-cell homeostasis. In this review, we discuss the role of oxidative stress in the pathogenesis of insulin resistance and beta-cell dysfunction. These are the two most relevant mechanisms in the pathophysiology of type 2 diabetes, and in the pathogenesis of diabetic vascular complications, the leading cause of death in diabetic patients.

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“…Insulin sensitivity, assessed by steady state plasma glucose method, was impaired in patients with coronary spastic angina as compared with control subjects. Antioxidants, such as vitamin C, can improve the insulin sensitivity and endothelial function in patients with coronary spastic angina (69). Thus, reactive oxygen species and/or decreased nitric oxide bioactivity may play a significant role in the genesis of both endothelial dysfunction and insulin resistance in patients with coronary spasm.…”

Section: Coronary Spasm and Insulin Sensitivitymentioning

confidence: 99%

Endothelial Function and Coronary Spastic Angina

Kawano

Ogawa

2005

Intern. Med.

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Coronary spasm plays an important role in the pathogenesis of not only variant angina but also coronary heart disease in general including acute coronary syndromes, especially in the Japanese population. The vascular endothelium has been reported to be a multifunctional organ whose integrity is essential for normal vascular physiology. Vascular endothelial dysfunction can be a critical factor in the pathogenesis of ischemic heart disease. Acetylcholine and methacholine cause vasodilation by endothelium-derived relaxing factor when the endothelium is functioning normally, whereas they cause vasoconstriction when the endothelium is removed or damaged.

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Improvement of endothelial function and insulin sensitivity with vitamin C in patients with coronary spastic angina

Abstract: Vitamin C improves both endothelial function and insulin sensitivity in patients with CSA. Thus, reactive oxygen species and/or decreased nitric oxide bioactivity may play an important role in the genesis of both endothelial dysfunction and insulin resistance in patients with CSA.

Cited by 101 publications

References 37 publications

Cocoa Reduces Blood Pressure and Insulin Resistance and Improves Endothelium-Dependent Vasodilation in Hypertensives

Cocoa Reduces Blood Pressure and Insulin Resistance and Improves Endothelium-Dependent Vasodilation in Hypertensives

Oxidative Stress, Nitric Oxide, and Diabetes

Endothelial Function and Coronary Spastic Angina

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