Supportive treatment of vascular dysfunction in pediatric subjects with obesity: the OBELIX study

Abstract

Introduction Overweight or obese children develop abnormal endothelial cell dysfunction and arterial intima–media thickening with increased vasomotor tone and inflammation. Curcumin, resveratrol, zinc, magnesium, selenium, and vitamin D have shown beneficial effects on endothelial function. We test, among overweight and obese pediatric subjects, the effects on the endothelium of a combination of curcumin, resveratrol, zinc, magnesium, selenium, and vitamin D. Methods Forty-eight subjects (6–17 years) were randomized into two groups (placebo vs treatment) attended three visits at 0, 3, and 6 months (±15 days). Endothelial function was assessed by means of a post-occlusive release hyperemic (PORH) test for estimation of delta flow (DF) and hyperemic AUC index, and a heat provocation test (HPT) to measure DF HPT (DFHPT). Results Significant DF difference was noted at 6 months in both groups (p < 0.001). Overall time trend was significantly different between baseline, 3 months, and 6 months both in placebo (p < 0.05) and treatment (p < 0.001) groups and their comparison (p < 0.001). No differences were noted in hyperemic AUC index (3 and 6 months), whilst there were significant differences in time trends of rreatment (p < 0.001) and placebo (p < 0.05) groups and their comparison (p < 0.001). DFHPT difference between groups was significant at 3 and 6 months (p < 0.05). The overall time trend was significant exclusively in Treatment group between 3 and 6 months (p < 0.05). Correlation with anthropometrics was found for DF and body mass index (r = 0.677 6 months, p < 0.05), as well as for hyperemic AUC index and males (r = 0.348, p < 0.05), while DFHPT showed no correlation. Conclusion Curcumin, resveratrol, zinc, magnesium, selenium, and vitamin D appear to be promising in enhancing endothelial function by improvement of both DF in the PORH test and DF in the HPT, lowering the risk of developing cardiovascular diseases in overweight and obese pediatric subjects.

Effects of micronutrient and phytochemical supplementation on cardiovascular health in obese and overweight children: a narrative review

“…Delta flow difference at heat provocation test (DF-HPT) was significant at 6 months of treatment (78.5 [72.0-94.0] vs. 63.0 [53.0-78.0], respectively, treatment and control, p < 0.001). No differences were noted in the Hyperemic Area Under Curve (AUC) index [15]. These results appear to be promising in enhancing endothelial function in this subset of subjects, but it is well known that the technique used to evaluate the endothelial function is used only in research and it is not easy to assess the effect of the singular micronutrients in this combined supplementation.…”

“…We can assess that after this lifestyle program microvascular reactivity endothelium-dependent increased only in the group with supplementation, reaching values comparable to that of controls, this suggesting the potential to attenuate microvascular dysfunction in this subgroup [14 && ]. Recently we tested, among a group of 48 subjects, who were randomized into two groups (treatment vs placebo) the effects on the endothelium of a combination of vitamin D (1000 UI per day) and other micronutrients (curcumin, resveratrol, zinc, magnesium and selenium) [15]. Endothelial function was assessed by means of a postocclusive release hyperemic test (PORH) and a heat provocation test, attended at 0, 3 and 6 months of treatment.…”

Progress in the Preclinical and Clinical Study of Resveratrol for Vascular Metabolic Disease

“…In another double-blind randomized crossover trial, RSV (150 mg/day, 34 days) could not reduce arterial inflammation as measured with 18F-fluorodeoxyglucose PET in subjects at risk of developing type 2 diabetes mellitus [ 117 ]. Unfortunately, although the beneficial effects of RSV on CAD patients with potential dyslipidemia (mentioned in the previous section) and pediatric obese subjects [ 118 ] had been reported in some studies, some clinical studies about the effects of RSV on NAFLD or obese subjects’ vascular function showed passive results. These studies indicated that RSV supplementation had no effect on the levels of plasm-soluble adhesion molecules, inflammatory markers, and biomarkers of endothelial function [ 119 , 120 , 121 ].…”

Childhood obesity and curcumin: a possible effective anti-obesity adjunct

“…4 It may also have a role to play in lowering the risk of developing cardiovascular diseases in overweight and obese pediatric subjects. 47 while improving biomarkers of oxidative stress and inflammation in conditions of obesity, and type 2 diabetes, 29 and nonalcoholic fatty liver disease, visceral fat, and abdominal obesity. 48,49 Safari et al 50 concur that available studies do tend to indicate that curcumin has beneficial impacts on various anthropometric indices, such as body weight and BMI, 17,51 even if disputed by some [eg.…”