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Introduction: The α-lipoic acid (ALA) has been used as a treatment to reduce oxidative damage in Systemic Arterial Hypertension (SAH), but there are no in vivo studies reporting the effect of its mechanism of action on iron metabolism. Objective: To evaluate the antioxidant effect of α-lipoic acid on Blood cell count (CBC) and iron metabolism in hypertensive subjects with or without anemia. Method: Double-blind, randomized, placebo-controlled clinical trial. The sample consisted of 60 hypertensive patients that were randomly divided into treatment group (n = 32), receiving 600 mg / day of ALA for twelve weeks and control group (n = 28), receiving placebo for the same period. Blood cell count, serum iron, ferritin, Latent Iron-Binding Capacity (LIBC), Total Iron-Binding Capacity (TIBC), Transferrin Saturation Index (TSI) and transferrin were assessed before and after intervention. To assess changes between groups, the Student t-test and ANOVA were used, adopting a significance level of 5%. Results: After intervention, ALA supplementation showed a statistically significant (p < 0.05) association with the reduction of total leukocytes, increase in the number of neutrophils and reductions in the serum levels of iron and TSI. Conclusion: Oral administration of ALA as a therapeutic adjuvant changes the hematologic response of white blood cells and reduces the absorption of iron. It is observed that the mechanism of metals chelation by lipoic acid may be responsible for these changes and, consequently, could trigger a condition of iron deficiency anemia in hypertensive individuals. Introducción: El Ácido α-Lipóico (ALA) ha sido utilizado como recurso terapéutico para reducir daño oxidativo en la Hipertensión Arterial Sistémica (HAS), pero aún no existen estudios in vivo que reporten sobre su mecanismo de acción en el metabolismo del hierro. Objetivo: Evaluar el efecto antioxidante del ácido Alfa-Lipóico sobre el hemograma y metabolismo del hierro en individuos hipertensos con o sin anemia. Métodos: Estudio clínico doble-ciego, randomizado y controlado con placebo. La muestra fue constituida por 60 individuos hipertensos, distribuidos aleatoriamente en grupo tratamiento (n = 32), que recibió 600 mg/día del ALA por doce semanas y grupo control (n = 28), que recibió el placebo por el mismo período. Fueron analizados antes y después de la intervención, los parámetros del hemograma, Hierro Sérico, Ferritina, Capacidad Latente de Enlace del hierro, Capacidad Total de Enlace del Hierro, Índice de Saturación de la Transferrina (ISI) y Transferrina. Para evaluar las alteraciones entre los grupos, se utilizó el teste t de Student y el análisis de varianza ANOVA, adoptándose el nivel de significación de 5%. Resultados: Después de la intervención, el suplemento con el ALA demostró una asociación estadísticamente significativa (p < 0,05) con la reducción de los leucocitos totales, aumento del número de neutrófilos y reducciones en los niveles de Hierro Sérico e ISI. Conclusión: La administración oral del ALA como un adyuvante terapéutico, altera la respuesta hematológica del leucograma y reduce la absorción del hierro. Cabe señalar que el mecanismo de quelación de metales por el ácido lipoico puede ser responsable de estos cambios y, en consecuencia, podría desencadenar una condición de anemia ferropénica en individuos hipertensos.

Introduction: The α-lipoic acid (ALA) has been used as a treatment to reduce oxidative damage in Systemic Arterial Hypertension (SAH), but there are no in vivo studies reporting the effect of its mechanism of action on iron metabolism. Objective: To evaluate the antioxidant effect of α-lipoic acid on Blood cell count (CBC) and iron metabolism in hypertensive subjects with or without anemia. Method: Double-blind, randomized, placebo-controlled clinical trial. The sample consisted of 60 hypertensive patients that were randomly divided into treatment group (n = 32), receiving 600 mg / day of ALA for twelve weeks and control group (n = 28), receiving placebo for the same period. Blood cell count, serum iron, ferritin, Latent Iron-Binding Capacity (LIBC), Total Iron-Binding Capacity (TIBC), Transferrin Saturation Index (TSI) and transferrin were assessed before and after intervention. To assess changes between groups, the Student t-test and ANOVA were used, adopting a significance level of 5%. Results: After intervention, ALA supplementation showed a statistically significant (p < 0.05) association with the reduction of total leukocytes, increase in the number of neutrophils and reductions in the serum levels of iron and TSI. Conclusion: Oral administration of ALA as a therapeutic adjuvant changes the hematologic response of white blood cells and reduces the absorption of iron. It is observed that the mechanism of metals chelation by lipoic acid may be responsible for these changes and, consequently, could trigger a condition of iron deficiency anemia in hypertensive individuals.

Submitted by Jean Medeiros (jeanletras@uepb.edu.br) on 2016-04-14T13:14:48Z No. of bitstreams: 1 PDF - Paula Renata Florêncio Mendes.pdf: 1876064 bytes, checksum: b655a2a07f272d2eb47ba836a00b9768 (MD5) Approved for entry into archive by Secta BC (secta.csu.bc@uepb.edu.br) on 2016-06-13T20:30:34Z (GMT) No. of bitstreams: 1 PDF - Paula Renata Florêncio Mendes.pdf: 1876064 bytes, checksum: b655a2a07f272d2eb47ba836a00b9768 (MD5) Made available in DSpace on 2016-06-13T20:30:43Z (GMT). No. of bitstreams: 1 PDF - Paula Renata Florêncio Mendes.pdf: 1876064 bytes, checksum: b655a2a07f272d2eb47ba836a00b9768 (MD5) Previous issue date: 2013-08-28 The etiology of systemic arterial hypertension (SAH) has been linked to oxidative stress and excess or deficiency of iron, which can also cause disturbance in the antioxidant system. The α-lipoic acid (ALA) is used as a treatment to reduce oxidative damage in SAH, but there are no in vivo studies reporting the effect of its mechanism of action on iron metabolism. AIM: To study the effect of alpha-lipoic acid as antioxidant supplement used in the treatment of various noncommunicable chronic diseases and its new applications and evaluate the effect of ALA on blood cell count and iron kinetics in hypertensive patients with or without anemia, comparing the results between treatment group and control group. METHOD: Double-blind, randomized, placebo-controlled trial conducted from October/2012 to January/2013. Participants were 60 hypertensive patients with or without Diabetes Mellitus and distributed into treatment group (n = 32), receiving 600 mg / day of ALA for twelve weeks and control group (n = 28), receiving placebo for the same period. Blood cell count, serum iron, ferritin, Latent Iron-Binding Capacity (LIBC), Total Iron-Binding Capacity (TIBC), Transferrin Saturation Index (TSI) and transferrin were assessed before and after intervention. Intervention was prospectively evaluated by comparing results within and between groups using the paired Student t-test and ANOVA. The standardized coefficient of Cohen (d) was used to estimate the clinical effect adopting a significance level of 5%. RESULTS: The therapeutic action of ALA in the treatment of various diseases with oxidative potential has been proven through clinical trials, but there is still need for further studies to prove its effectiveness in relation to its various sites of action. The majority of patients were older than 60 years, and 75.0% were female. Only 3.3% of the sample showed changes in blood count compatible with Iron Deficiency Anemia. After intervention, the blood cell count in the treatment group showed a statistically significant increase in the number of neutrophils and reduction in the number of monocytes (p