1. Introduction
chronic heart failure, hepatic and renal outcomes, ASCVD, diabetes mellitus, prediabetes, arterial stiffness, Diabetes, atherosclerosis, T2DM
ATHEROSCLEROTIC CARDIOVASCULAR DISEASE, ASCVD, REACTIVE HYPEREMIA, VASCULAR COMPLICATIONS, CHRONIC HEART FAILURE, ENDOTHELIAL DYSFUNCTION, DIABETES MELLITUS, PREDIABETES, ARTERIAL STIFFNESS, DIABETES, ATHEROSCLEROSIS, TYPE 2 DIABETES MELLITUS, COMPLICATIONS, ENDOTHELIAL DYSFUNCTION
Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality in patients with prediabetes and type 2 diabetes mellitus (T2DM). Carnosine has been suggested as a potential approach to reduce ASCVD risk factors. However, there is a paucity of human data. Hence, we performed a 14-week double-blind randomized placebo-controlled trial to determine whether carnosine compared with placebo improves vascular and metabolic outcomes in individuals with prediabetes and T2DM. In total, 49 patients with prediabetes and T2DM with good glycemic control were randomly assigned either to receive 2 g/day carnosine or matching placebo. We evaluated endothelial dysfunction, arterial stiffness, lipid parameters, blood pressure, heart rate, hepatic and renal outcomes before and after the intervention. Carnosine supplementation had no effect on heart rate, peripheral and central blood pressure, endothelial function (logarithm of reactive hyperemia (LnRHI)), arterial stiffness (carotid femoral pulse wave velocity (CF PWV)), lipid parameters, liver fibroscan indicators, liver transient elastography, liver function tests, and renal outcomes compared to placebo. In conclusion, carnosine supplementation did not improve cardiovascular and cardiometabolic risk factors in adults with prediabetes and T2DM with good glycemic control. Therefore, it is improbable that carnosine supplementation would be a viable approach to mitigating the ASCVD risk in these populations. The trial was registered at clinicaltrials.gov (NCT02917928).Type 2 diabetes mellitus (T2DM) and its related complications are a leading cause of morbidity and mortality. Diabetes affects 537 million adults globally, estimated to rise to 783 million in the next 22 years [Endothelial dysfunction is important in the development of atherosclerosis and is commonly seen in prediabetes [Carnosine (β-alanyl-L-histidine) is an emerging therapeutic agent that can potentially contribute to the management of T2DM and its vascular complications [There has been a small number of human trials evaluating the effect of carnosine on cardiometabolic health. In patients with chronic heart failure who were under conventional therapy, carnosine supplementation improved exercise performance and quality of life [