| BackgroundAtherosclerosis is the most common cause of mortality in Western and is becoming the main cause of ischemic vascular disease and mortality in China,especially in elders.Atherosclerosis plaques result in ischemic events and sudden death.Then,how to deal with it is a difficult task in clinic and is a hot topic in the recent aspects of cardiovascular research. Grape seed polyphenols(GSP), the main effective components in extracts of grape seeds,have been confirmed exert an antiatherosclerosis effect by scavenging free radicals,antioxidation, anti-inflammatory,protecting endothelial,et al.Even so,the cliniacl uses of GSP,especially for elder patients with atherosclerosis,have not been reported by now.ObjectiveThe main aim of this study is to observe the effect of GSP on elder patient with peripheral vessel-atherosclerosis in clinical use,providing a scientific basis for treatment of atherosclerosis.Methods1study populationThe participants were older than61years old (including 61-year-old) without hypercholesterolemia diagnosised with asymptomatic carotid and femoral artery plaques or thickened MCIMT and MFIMT by ultrasonography. All of the study population were randomly divided into two groups:the control group and the GSP group.In the control group, all the patients were only given intervention in lifestyle. In addition to the same lifestyle intervention the patients in GSP group received GSP400mg×4everyday (800mg,bid).To observe the different antiatherosclerosis effects of GSP in different ages,the GSP group was divided into3subgroup:61-70years,71-80years,more than81years old.The whole study lasted12months.2History investigation and physical examinationA full clinical histry and physical examination of all patients were collected by a professional physician. Essential information was investigated completely,including sex,age,BMI(body mass index),systolic pressure,combined disease(such as hypertension,diabetic mellitus)and current medications.3Laboratory ExaminationAt the begining and the end of this study, peripheral venous blood samples of all patients were collected after a12-hours fast.Serum lipidrtotal cholestrol (TC), triglyceride (TG), low density lipoprotein-cholesterol (LDL-C) and hight density lipoprotein-cholesterol (HDL-C) were tested by standard equipment in Qilu Hospital of Shandong Univesity.4Carotid and Femoral B ultrasonic ExaminationHigh resolution color doppler ultrasonography of carotid and femoral artery were performed by a color doppler ultrasound diagnostic instrument with a linear arry5-10Hz transducer.Mean carotid intima-media thickness(MCIMT), mean femoral intima-media thickness (MFIMT), the plaque scores of carotid and femoral artery were detected as indicators of GSP’s clinical effect by the same professional physician.5Pulse wave velocity measurementThe carotid-femoral pulse wave velocity (C-F PWV) is another indicator in this study.It was measured by an expert pulse wave velocity detector (Comnlior SP, Franch) at the begining and the end of the study.6Statistic analysisAll the analysis were carried by SPSS13.0sofftware.Enumeration data were summarized as percentages and compared usingchi-square analysis. Numberical data are expressed as mean±SD(x±s). The significance of the differences in various parameters within each group between baseline and after treatment was tested by a paired-scample t test.The significance of the differences between groups in these parameters was tested using a single factor analysis of variance.All P values were two-tailed and statistical significance was set at P<0.05.Results1. All the96patients completed the study.There was no significant difference between the two group in all the basic demographic characteristics.The basic characteristics of three subgroups in GSP group also had no differences(P>0.05).All the46patients in GSP group completed the protocol,16cases in61-70age group,15in71-80age group and15in≥81age group.There were no differences in sex ratio, blood pressure, blood serum biochemical indicators and past history among this three subgroups.2. The differences of sreum lipid level (TC,TG,LDL-C,HDL-C) were not obvious between groups before receiving different treaments. In GSP group, the serum TC,TG level decreased after12months (P>0.05) with no significant change; serum LDL-C level decreased obviously (P<0.05); while,serum HDL-C increased significantly. In control group, there was no significant change on serum lipid profile(P>0.05).All the serum TC,TG,LDL-C level of three subgroups in GSP group decreased unconspicuously (P>0.05), and HDL-C increased conspicuously (P<0.05).There were no significant differences in sreum lipid profile among three subgroups after12-months treatment(P>0.05).After12-month intervention treatment, serum TC and LDL-C levels all unconspicuous decreased, TG in71-80age group patients were significantly reduced (P<0.05); while HDL-C levels were significantly increased (P<0.05). There were no significant difference in serum lipid levels among three subgroups after12months tresment (P>0.05).3. GSP resulted in significant reduction in MCIMT progression (4.2%decreased,P<0.001) and plaque score (8.6%decreased,P<0.001) While,the MCIMT and plaque score were stable and even increased in control group.After treatment,the differences between GSP and control groups in MCIMT and plaque score were obvious (P<0.05)After GSP treatment, the MCIMT and plaque score of three subgroups were all significantly reduced (P<0.05), without obvious differences among them (P>0.05)4. There were significant reduction in MFIMT progression (5.7%decreased,P<0.01) and plaque score (16.3%decreased,P<0.001) in GSP group. While,the MFIMT and plaque score were stable and even increased in control group (P<0.01). After treatment, the differences between GSP and control groups in MFIMT and plaque score were obvious (P<0.05)Obvious reduction of MFIMT (P<0.05) and plaque score (P<0.05) were resulted after12-month treatment of GSP in the three subgroups.And the differences among these groups were not obvious(P>0.05). 5. There were no significant difference in C-F PWV between GSP and control groups (P>0.05) at first. After the treatment, GSP reduced the C-F PWV by5.3%(P<0.001),while patients in control group had a4.1%increase (P<0.001). There was an obvious difference between the two groups in the end of the study.Obvious differences of the C-F PWV value existed among the three subgroups in GSP group, because of the relevance to age. And all of the value decreased evidently (P<0.001). The changes of C-F PWV (APWV) were semblable among the subgroups (P>0.05).ConclusionAccording to the study, GSP can regulate the serum lipid levels,inhibit the progression of cartoid and femoral intima-media thickness, regress the cartoid and femoral plaques,reduce the stiffness and increase the elasticity of arterise,decrase the incidence of clinical cardiocerebrovascular events significantly. As natural active constituents, GSP have significant antiatherosclerotic effect to elder patients,without obvious differences among difference ages.We can speculate that GSP could be an effective candidate for the primary prevention to the atherosclerotic patients without clinical symptoms. |
PDF Full Text Request