Abstract
Background:
N-acetylcysteine (NAC), the acetylated variant of amino acid
Methods:
An open-label pilot study was conducted at diabetes outpatient clinic. Thirty-five patients (aged ≥18 years) fulfilling the NCEP-ATP III diagnostic criteria for MetS were recruited and allocated to NAC tablets as 600 mg (twice a day) along with their ongoing therapeutic regimen. Blood pressure (BP), body mass index, lipid profile, fasting plasma glucose and insulin, insulin resistance estimated by homeostatic model assessment (HOMA-IR), high-sensitivity C-reactive proteins (hsCRP), nitrite, and thiobarbituric acid reactive substances (TBARS) were measured after 6 weeks treatment.
Results:
HOMA-IR, hsCRP and systolic BP were decreased significantly from 4.74 ± 0.30% to 3.86 ± 0.21%; 5.66 ± 0.27 to 4.92 ± 0.18 mg/L; and 133.2 ± 1.84 to 128.3 ± 1.52 mmHg, respectively. Among dyslipidemic variables, there was decrease in triglycerides from 194.20 ± 5.03 to 188.04 ± 4.93 mg/dL, but increase in HDL from 33.32 ± 0.19 to 36.29 ± 1.16 mg/dL. Nitrite levels were significantly increased from 6.25 ± 0.20 to 7.92 ± 0.18 μmol/L (P = 0.04), while TBARS levels were decreased from 14.65 ± 0.32 to 13.68 ± 0.33 nmol/L (P = 0.05). It was found from correlation analysis that hsCRP was the main culprit, that is, inflammation was perpetuator of endothelial dysfunction, IR, oxidative stress, hypertension, and vice-versa.
Conclusion:
This study has provided a new approach of management of MetS with NAC beyond controlling the disease with various drug therapies. NAC may reduce the risk burden via multiple antioxidant, anti-inflammatory, and vasodilatory effect.
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