Endocrine Connections (Sep 2022)
Efficacy and safety of oral alpha-lipoic acid supplementation for type 2 diabetes management: a systematic review and dose– response meta-analysis of randomized trials
Abstract
Objective: To examine the dose-dependent influence of oral alpha-lipoic ac id (ALA) supplementation on cardiometabolic risk factors in patients wit h type 2 diabetes (T2D). Design: We followed the instructions outlined in the Cochrane Handbook for Systematic Reviews of Interventions and the Grading of Recommendations, Assessment, Development, and Evaluation Handbook to conduct our systematic review. The protocol of the study was registered in PROSPERO (CRD42021260587). Method: We searched PubMed, Scopus, and Web of Science to May 2021 for trials of oral ALA supplementation in adults with T2D. The primary outcomes we re HbA1c, weight loss, and LDL cholesterol (LDL-C). Secondary outcomes included fasting plasma glucose (FPG), triglyceride (TG), C-reactive protein (CRP), and blood p ressure. We conducted a random-effects dose–response meta-analysis to calculate the mean difference (MD) and 95% CI for each 500 mg/day oral ALA supplementation. We perform ed a nonlinear dose– response meta-analysis using a restricted cubic spline. Results: We included 16 trials with 1035 patients. Each 500 mg/day incr ease in oral ALA supplementation significantly reduced HbA1c, body weight, CR P, FPG, and TG. Dose–response meta-analyses indicated a linear decrement in bod y weight at ALA supplementation of more than 600 mg/day (MD600 mg/day: −0.30 kg, 95% CI: −0.04, −0.57). A relatively J-shaped effect was seen for HbA1c (MD: −0.32%, 95% CI: −0.45, −0.18). Levels of FPG and LDL-C decreased up to 600 mg/day ALA intake. The point estimates were below minimal clinically important difference thresholds fo r all outcomes. Conclusion: Despite significant improvements, the effects of oral ALA supple mentation on cardiometabolic risk factors in patients with T2D were not clin ically important.
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