(DCP074) INCREASED PLASMA OXIDISED LOW-DENSITY APOLIPOPROTEIN B RESPONSIVENESS TO FLAXSEED LIGNAN COMPLEX IN OLDER TYPE 2 DIABETES PATIENTS THUS FAR FAILS TO DICTATE PLASMA C-REACTIVE PROTEIN REDUCTION

Background: Plasma oxidised low-density apolipoprotein B (PLDL-Box) contributes to inflammation (as measured by plasma C-reactive protein (PCRP)) which exacerbates type 2 diabetes (T2D). The objective was to test the novel hypothesis that progressively increased PLDL-Box’s reduction responsiveness to antioxidant-containing flaxseed lignan complex (FLC) consumption relative to placebo would contribute to a progressive PRCP level reduction response in older type 2 diabetes patients (OT2DP).

METHODS AND RESULTS: Sixteen patients with T2D (mean age = 66 years) completed this double-blind, randomised, cross-over, placebo-controlled study. Patients consumed four FLC capsules/day (600 mg secoisolariciresinol diglucoside/day) or placebo for 3 months followed by a three-month wash-out period (no exposure to FLC or placebo) followed by three months on that (FLC or placebo) to which they had not been previously exposed in this study. A repeated measures analysis of variance was done. Data is reported as mean (SEM). In the 16 patients, PLDL-Box ((52.2 (5.2) (start) - 45.2 (4.6) (finish) (FLC) vs 57.0 (5.8) (start) - 52.8 (4.8) U/L (finish) (placebo) and PCRP (2.4) (1.1) (start) - 1.9 (0.7) (finish) (FLC) vs 2.7 (1.2) (start) -2.7 (1.1) mg/L (finish) (placebo) were unchanged (p > 0.05)). However, from N = 15 to N = 9 of the top PLDL-Box responders, PLDL-Box progressively dropped significantly and PCRP progressively trended downward. When the top 9 PLDL-Box responders to FLC were analysed, PLDL-Box decreased significantly ((55.8 (6.8) (start) - 41.2 (5.0) (finish) (FLC) vs 52.5 (7.1) (start) - 56.2 (6.7) U/L (finish) (placebo) (p=0.021)) while PCRP trended downward (3.4 (1.9) (start)-2.2 (1.1) (finish) (FLC) vs 3.7 (2.0) (start) - 3.5 (1.9) mg/L (finish) (placebo) (p=0.099)). Statistical analysis where N was less than 9 of the top PLDL-Box responders revealed no significantly lower PLDL-Box and PCRP or a trend toward decreased PCRP. Lifestyle patterns (LP) (diet (including alcohol), smoking, medication (dose and type), and exercise) were unchanged during the study.

Conclusion: From N = 15 to N = 9 of the top PLDL-Box responders, progressively increased PLDL-Box reduction responsiveness to FLC (relative to placebo) contributed to a progressive trend toward decreased PCRP. Unchanged LP did not affect outcomes. In conclusion, progressively increased PLDL-Box’s reduction responsiveness to FLC consumption contributed to a trend toward progressively decreased PCRP but did not result in significantly decreased PCRP levels in OT2DP in the current small study. A larger study with OT2DP may reveal FLC-induced progressively increased PLDL-Box reduction responsiveness contributing to a progressive PRCP level reduction response.