ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 P175

Long term N-acetylcysteine and L-arginine administration reduces endothelial activation and systolic blood pressure in hypertensive patients with type 2 diabetes mellitus

Andi Masha1, Valentina Ramella Gigliardi1, Loredana Brocato1, Enzo Manzato3, Arrigo Berchio1, Paola Massarenti1, Fabio Settanni1, Stefania Bergamini2, Anna Iannone2 & Valentino Martina1

1University of Torino, Torino, Italy; 2University of Modena and Reggio Emilia, Modena, Italy; 3University of Padova, Padova, Italy.

Objective: Reactive oxygen species and nitric oxide (NO) have recently been considered involved in the cardiovascular complications of patients with type 2 diabetes as NO is supposed to loose its physiological beneficial effects, due to the presence of oxygen radicals. For this reason, we tested the effects of L-arginine (ARG) and N-acetylcisteine (NAC) administration with the aim to increase NO physiological production reducing free radical formation.

Research design: A double-blind study was performed on 24 male patients with type 2 diabetes and hypertension, divided in 2 groups of 12 patients, which received randomly an oral supplementation of placebo or NAC+ARG (1200+1660 mg/die, respectively), for 6 months.

Results: The NAC+ARG treatment caused a reduction of the mean arterial blood pressure, both systolic (143.3±4.0 vs 151.5±3.5 mmHg, P<0.05) and diastolic (84.4±2.0 vs 88.2±0.7 mmHg, P<0.05), total-cholesterol (P<0.01), LDL-cholesterol (P<0.005), oxidized-LDL (P<0.05), hsRCP (P<0.05), ICAM (P<0.05), VCAM (P<0.01), nitrotyrosine (P<0.01), fibrinogen (P<0.01), PAI-1 (P<0.05) and intima-media thickness (P<0.02) during endothelial post-ischemic vasodilation. The HDL-cholesterol level increased (P<0.05). No changes in the others parameters were observed.

Conclusions: The NAC+ARG administration seems to be a potential well-tolerated antiatherogenic therapy since it improves the endothelial function in hypertensive patients with type 2 diabetes by improving NO availability reducing the oxidative stress. Our study’s results give prominence to its potential use in the primary and secondary cardiovascular prevention in these patients. Further, clinical studies on a larger scale are needed to support our experimental data.