Rice bran oil could favorably ameliorate atherogenicity and insulin resistance indices among men with coronary artery disease: post hoc analysis of a randomized controlled trial

Abstract

Background Despite recent advances in recognizing more reliable indicators to estimate the coronary artery disease (CAD) patients’ response to treatment and prognosis, less attention has been paid to evaluating them in clinical trials. Hence, the present research was conducted to study the impact of rice bran oil (RBO) versus sunflower oil (SFO) on various atherogenicity and insulin resistance markers. Methods In the present 8-week randomized controlled trial, 40 CAD men with an average age of 56 years were allocated randomly into the intervention or control group to use RBO or SFO (30 g/day) plus a standardized dietary plan. As a further analysis, eight atherosclerosis-related indices were calculated before and after the study. Results Analysis of covariance test in which potential confounders and baseline levels were considered, indicated that using RBO compared to SFO reduced Castelli’s risk index I and II (adjusted means:3.29, 1.52 vs. 4.61, 2.20, respectively), atherogenic coefficient (2.29 vs. 3.61), lipoprotein combine index (6.54 vs. 17.53), and cholesterol index (0.46 vs. 1.20) after the trial (P-value ≤ 0.002). Also, the RBO group yielded significantly lower triglyceride glucose index (8.73 vs. 9.13) (P-value = 0.010). Further, marginally significant amelioration in triglyceride/HDL ratio and atherogenic index of plasma (1.48 and 0.13 vs. 1.86 and 0.24 respectively) were noted (P-value = 0.07). Spearman correlation analysis detected significant positive correlations between alterations in TNF-α serum levels (ng/L) and the majority of evaluated indices (P-value < 0.05). Conclusion Taken together, incorporating 30 g of RBO into the patient’s usual diet appeared effective in ameliorating atherogenicity and insulin resistance indicators among men with CAD, probably in relation to its anti-inflammatory properties. Trial registration The protocol of the current trial was retrospectively recorded in the Iranian clinical trial registration system (IRCT) with the registration number of IRCT20190313043045N1 (URL: https://en.irct.ir/trial/38346; Registration date: 2019-04-27).

Evaluating the use of novel atherogenicity indices and insulin resistance surrogate markers in predicting the risk of coronary artery disease: a case‒control investigation with comparison to traditional biomarkers

“…Of note, sdLDL-C, an LDL-C subcomponent that tends to have greater potential for being oxidized and making foam cells, has been indicated to better represent the progression of atherosclerotic lesions in CAD. However, due to difficulties in the routine assessment of sdLDL-C, particularly in clinical practice, the use of AIP as a reliable surrogate indicator of sdLDL-C has gained considerable attention in recent years [ 23 , 42 , 48 , 49 , 51 , 60 , 61 ]. In addition, hypertriglyceridemia, hyperglycemia, and subsequent insulin resistance further modulate the progression of atherosclerosis [ 8 , 9 , 19 ].…”

“…However, routine use of this test is costly and time consuming, especially in the clinical setting. Therefore, several attempts have been made to identify more efficient methods for measuring insulin resistance [ 23 , 44 , 56 , 62 ]. In this context, the TyG index has also been mentioned as a reliable and convenient indicator of insulin resistance [ 23 , 44 , 56 ].…”

“…Therefore, several attempts have been made to identify more efficient methods for measuring insulin resistance [ 23 , 44 , 56 , 62 ]. In this context, the TyG index has also been mentioned as a reliable and convenient indicator of insulin resistance [ 23 , 44 , 56 ]. TyG was revealed to capture the status of lipotoxicity and glucotoxicity [ 44 , 56 ].…”

“…Detecting perturbed levels of biomarkers indicative of the main pathophysiological disturbances associated with atherosclerosis and CAD, including dyslipidemia, dysglycemia and insulin resistance, may be potentially effective in decreasing the risk of developing more serious CV events. Conventionally, the measurement of serum levels of atherogenic cardiometabolic factors, such as total cholesterol, fasting blood sugar (FBS), triglycerides, and low-density lipoprotein-cholesterol (LDL-C), and anti-atherogenic biomarkers, such as high-density lipoprotein-cholesterol (HDL-C), has been applied to both research and clinical settings to predict the progression of atherosclerotic lesions [ 23 ]. However, these ‘conventional’ markers may not be capable of portraying the extent of atherosclerosis severity, and therefore CAD treatment targets based on the levels of these biomarkers may be suboptimal [ 23 ].…”

“…Conventionally, the measurement of serum levels of atherogenic cardiometabolic factors, such as total cholesterol, fasting blood sugar (FBS), triglycerides, and low-density lipoprotein-cholesterol (LDL-C), and anti-atherogenic biomarkers, such as high-density lipoprotein-cholesterol (HDL-C), has been applied to both research and clinical settings to predict the progression of atherosclerotic lesions [ 23 ]. However, these ‘conventional’ markers may not be capable of portraying the extent of atherosclerosis severity, and therefore CAD treatment targets based on the levels of these biomarkers may be suboptimal [ 23 ]. For instance, reaching a target goal for LDL-C was thought to be associated with adequate prevention of CV events.…”