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Uric Acid Metabolism, Endothelial Function and Oxidative Stress in Vegans and Omnivores.

Completed
Conditions
Diet Modification
Healthy
Interventions
Other: Endothelial function and inflammation
Registration Number
NCT03849677
Lead Sponsor
Erasme University Hospital
Brief Summary

50 vegans and 50 omnivores will be recruited at the Erasme Hospital, Brussels.

Hypothesis

* Relative induced-hyperuricemia by the vegan diet is not associated with impaired endothelial function if vitamin B12 and folic acid levels are normal.

* Quantification of xanthine oxidoreductase (XOR) isoforms varies according to the diet. Omnivores present more xanthine oxidase (XO) than vegans in which the xanthine dehydrogenase (XD) isoform is more prevalent.

* The vegan group has more favorable oxidant, metabolic and inflammatory profiles than the omnivore group.

Detailed Description

Non-meat eaters rise widely worldwide. This choice answers ideological, ecological or health concerns. Several vegetarian diets exist and the vegan diet is the most restricted one as it excludes all animal products, eggs and dairy.

Beside benefits on health and particularly on the cardiovascular system (blood pressure, weight, lipid profile), some authors described less favorable lipid and oxidative profiles and others described an impairment in endothelial function markers in 'vegans'. These effects were attributed to low vitamin B12 and folate levels and high homocystein levels. However, vitamin B12 supplementation improved these parameters. Epidemiological studies also showed that 'vegans' disclose higher uric acid levels than other vegetarians or omnivores. Uric acid acts as an antioxidant in the plasma but can be deleterious for vascular cells leading to endothelial dysfunction. The main enzyme involved in uric acid metabolism is xanthine oxidoreductase which exists under two interconvertible isoforms. Xanthine dehydrogenase is the main form and uses nicotinamide adenine dinucleotide (NAD+) as electron acceptor and does not produce reactive oxygen species (ROS). In contrast, the other isoform xanthine oxidase uses oxygen as an electron acceptor and produces reactive oxygen species (ROS). The investigators wish to test the hypothesis that it is not uric acid per se, but which isoform of xanthine oxidoreductase which alters endothelial function. This is why the investigators wish to determine if regular 'vegans' (with normal vitamin B12 and folate levels) disclose increased uric acid levels in the presence of a reduced inflammation, oxidative stress and improved endothelial function, as compared to matched 'omnivores'.

50 vegans and 50 omnivores will be recruited at the Erasme Hospital, Brussels.

Hypothesis

* Relative induced-hyperuricemia by the vegan diet is not associated with impaired endothelial function if vitamin B12 and folic acid levels are normal.

* Quantification of oxidoreductase (XOR) isoforms varies according to the diet. Omnivores present more xanthine oxidase (XO) than vegans in which the xanthine dehydrogenase (XD) isoform is more prevalent.

* The vegan group has more favorable oxidant, metabolic and inflammatory profiles than the omnivore group.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
103
Inclusion Criteria
  • Vegan or omnivore diet for at least one year (matched for age, gender, BMI, socio-economic status and weight)
  • Healthy
Exclusion Criteria
  • Smoking
  • Chronic treatment
  • No allowed drugs taking
  • Excessive alcohol consumption

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
OmnivoreEndothelial function and inflammation-
VeganEndothelial function and inflammation-
Primary Outcome Measures
NameTimeMethod
Measure of the perfusion of the microcirculation of the skin2 hours

Endothelial function assessment will be performed through analyse of the perfusion of the microcirculation of the skin in the forearm will be assessed by means of a laser Doppler imager and iontophoresis of acetylcholine and sodium nipride. Heating-induced hyperemia will be assessed after iontophoresis of inhibitor of NO synthase and saline. Units are perfusion unit.

Iontophoresis is a non-invasive tool which permits to infuse molecules in the first micrometers of the skin. The used molecules are vasodilative, saline or NO synthase inhibitor.

Secondary Outcome Measures
NameTimeMethod
Measure of white blood cells, red blood cells and platelets2 hours

cells/µl of blood

Measure of renin, aldosterone, angiotensin 2, angiotensin converting enzyme2 hours
Measure of blood pressure2 hours

Systolic and diastolic blood pressure

Measure of augmentation index2 hours

Assessment of the arterial stiffness

Diet questionary2 hours

Diet History Questionnaire third version provides estimation of one year consumption of proteins, carbohydrates, lipids, micronutrient and vitamines

Concentration of Uric acid2 hours

Uric acid (mg/dL or SI)

Measure of glomerular filtration rate2 hours

ml/min

Measure of allantoin, homocitrulline/lysine, chloro-tyrosine/tyrosine, Il-8, myeloperoxidase2 hours

Mass spectrometry and Elisa Kits

Measure of main proteomes and metabolomes in cells incubated with sera from participants2 hours

Sera will be used for cell cultures. Theses cells will be lysed and used to analyse and compare the different proteomes / metabolomes according to the groups. We will be able to understand which protein groups are reduced or enhanced according to the diet.

Concentration of xanthine oxidase and xanthine dehydrogenase in blood2 hours

western blot

Measure of sodium, potassium, chlore, phosphor, calcium, magnesium, HbA1c, omega 3 et 62 hours

mmol/l

Measure of heart rate2 hours

finometer

Measure of pulse wave velocity2 hours

Assessment of the arterial stiffness

Measure of hemoglobin2 hours

g/l

Measure of urea, creatinine, bilirubin, albumine, prealbumin, LDL, HDL, lp(a), total cholesterol, triglyceride, apolipoprotein A and B2 hours

mg/dl

Measure of gamma-glutamyltransferase, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, creatin phosphokinase, insulin, TSH2 hours

u/l

Measure of glycemia, vitamine and iron status (B3, B6, B12, C, D, E, B9, Zn, Cu, Selenium, iron, ferritin), c-reactive protein, homocystein2 hours

mg/dl

Measure of baroreflex sensitivity2 hours

finometer

Trial Locations

Locations (1)

Erasme Hospital

🇧🇪

Brussels, Belgique, Belgium

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