title: A randomized, placebo-controlled, double-blind study on the effects of (-)-epicatechin on the triglyceride/HDLc ratio and cardiometabolic profile of subjects with hypertriglyceridemia: Unique in vitro effects.
abstract: BACKGROUND
  Cardiometabolic disruptions such as insulin resistance, obesity, high blood pressure, hyperglycemia, and dyslipidemias, are known to increase the risk for cardiovascular and metabolic diseases such as type 2 diabetes mellitus and atherosclerosis. Several screening tools for assessing cardiometabolic risk have been developed including the TG/HDLc ratio, which has been, demonstrated to possess a strong association with insulin resistance and coronary disease. Dietary modifications, together with regular moderate exercise have proven to be effective in attenuating cardiometabolic disruptions. However, they often exhibit poor long-term patient compliance. Nutraceutics, including (-)-epicatechin (EPI), have gained increasing interest as coadjuvant effective and safe therapies that are able to attenuate hypertension, hyperglycemia, hyperinsulinemia, hypertriglyceridemia and hypoalphalipoproteinemia.
  
  
  METHODS
  The aims of this study were: 1) to compare the in vitro effect of EPI vs. (+)-catechin on fructose induced triglyceride accumulation and mitochondrial function in Hep2 cells in culture, 2) to evaluate the efficacy of EPI treatment in reducing fasting blood triglycerides and improving the TG/HDLc ratio in hypertriglyceridemic patients with a total daily dose of 100mg of EPI. Secondary clinical variables included total cholesterol, LDLc, fructosamine, glucose, insulin, and high sensitivity C-reactive protein blood levels.
  
  
  CONCLUSIONS
  Our results provide preliminary evidence as to favorable effects of EPI on glycemia homeostasis, lipid profile and systemic inflammation such bioactive actions are not class-effects (i.e. limited to their antioxidant potential) but instead, may result from the specific activation of associated downstream signaling pathways since catechin has no effects.
authors.affiliation: Laboratorio de Investigación Integral Cardiometabólica, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Gutiérrez-Salmeán
authors.affiliation: Laboratorio de Investigación Integral Cardiometabólica, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Meaney
authors.affiliation: University of Colorado at Denver, United States.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Lanaspa
authors.affiliation: University of Colorado at Denver, United States.
authors.forename: Christina
authors.initials: C
authors.lastname: Cicerchi
authors.affiliation: University of Colorado at Denver, United States.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Johnson
authors.affiliation: Cardero Therapeutics, Inc., United States.
authors.forename: Sundeep
authors.initials: S
authors.lastname: Dugar
authors.affiliation: Department of Medicine, University of California San Diego, United States.
authors.forename: Pam
authors.initials: P
authors.lastname: Taub
authors.affiliation: Laboratorio de Investigación Integral Cardiometabólica, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico; Department of Medicine, University of California San Diego, United States.
authors.forename: Israel
authors.initials: I
authors.lastname: Ramírez-Sánchez
authors.affiliation: Department of Medicine, University of California San Diego, United States.
authors.forename: Francisco
authors.initials: F
authors.lastname: Villarreal
authors.affiliation: Cardero Therapeutics, Inc., United States.
authors.forename: George
authors.initials: G
authors.lastname: Schreiner
authors.affiliation: Laboratorio de Investigación Integral Cardiometabólica, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico. Electronic address: gceballosr@ipn.mx.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Ceballos
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000097:blood / Q000188:drug therapy / Q000209:etiology*; D002392:Catechin / Q000627:therapeutic use*; D002478:Cells, Cultured; D008076:Cholesterol, HDL / Q000097:blood*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000188:drug therapy / Q000209:etiology*; D008875:Middle Aged; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides; D002392:Catechin
keywords: Cardiometabolic risk; Epicatechin; Metabolic syndrome; Nutraceutics; Plasma triglycerides; Triglyceride-HDL ratio