N -Acetyl-Cysteine Reduces Homocysteine Plasma Levels After Single Intravenous Administration by Increasing Thiols Urinary Excretion

Ventura, Paolo; Panini, Rossana; Pasini, Marco; Scarpetta, G.

doi:10.1006/phrs.1999.0519

Cited by 62 publications

(60 citation statements)

References 25 publications

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“…Thus, our results suggest that both sulfhydryl group and carboxyl group are required for eliciting the hypohomocysteinemic effect of cysteine. On the other hand, the fact that NAC had a hypohomocysteinemic effect (15)(16)(17)(18)(19)(20)(21)(22)(23) suggests that an amino group is not required for the effect of cysteine, although it cannot be ignored that NAC is easily hydrolyzed to cysteine and acetate.…”

Section: Discussionmentioning

confidence: 99%

Hypohomocysteinemic Effect of Cysteine Is Associated with Increased Plasma Cysteine Concentration in Rats Fed Diets Low in Protein and Methionine Levels

Kawakami

Ohuchi

Morita

et al. 2009

J Nutr Sci Vitaminol

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Summary Rats were fed diets with and without 0.5% L -cysteine supplement for 14 d or shorter periods to clarify the mechanism by which dietary cysteine elicits its hypohomocysteinemic effect. Cysteine supplementation significantly decreased plasma homocysteine concentration with an increase in plasma cysteine concentration in rats fed 10% casein diet (10C) or 15% soybean protein diet (15S) but not in rats fed 25% casein diet (25C) or 25% soybean protein diet. Cysteine supplementation also significantly suppressed hyperhomocysteinemia induced by choline-deprived 10C with an increase in plasma cysteine concentration but not that induced by 25C ϩ 0.65% methionine or 25C ϩ 0.4% guanidinoacetic acid. Hepatic S -adenosylmethionine (SAM) and homocysteine concentrations were significantly decreased by cysteine supplementation of 15S. These decreases in plasma homocysteine concentration and hepatic SAM and homocysteine concentrations due to cysteine supplementation disappeared when 15S was fortified with 0.3% methionine. The plasma homocysteine concentration significantly decreased with an increase in plasma cysteine concentration only 1 d after diet change from 15S to cysteine-supplemented 15S, while hepatic cystathionine ␤ -synthase and betaine-homocysteine S -methyltransferase activities were not altered. Unlike cysteine, cysteic acid and 2-mercaptoethylamine did not decrease plasma homocysteine concentration. These results indicate that cysteine markedly decreases plasma homocysteine concentration only when added to diets low in both protein and methionine levels and suggest that increased plasma cysteine concentration and decreased flow of methionine toward homocysteine formation, but not alteration of homocysteine-metabolizing enzyme activities, are associated with the hypohomocysteinemic effect of cysteine. Key Words hypohomocysteinemic effect, cysteine, homocysteine, low protein diet, low methionine diet Homocysteine is an intermediate in the metabolism of methionine (Fig. 1) ( 1 ), but a number of studies have suggested that an elevated plasma homocysteine concentration is an independent risk factor for cardiovascular disease ( 2 -4 ). It is thought that elevated plasma homocysteine concentrations cause arterial damage by several mechanisms, e.g., endothelial cell injury, platelet activation, and increased oxidizability of low-density lipoproteins ( 4 ). In humans, the normal range of plasma homocysteine concentration is 5 to 15 M , and a 5-M increase in the concentration of this amino acid is associated with a 60-80% increased risk of coronary heart disease ( 3 ). The plasma homocysteine concentration is affected by various factors, such as nutritional, physiological, hormonal, pharmacological, lifestyle, disease, and genetic factors ( 2 -4 ). Of these factors, genetic and nutritional factors are thought to have a greater influence on plasma homocysteine concentration. Many studies have been conducted in humans to investigate the effect of dietary treatments on plasma homocysteine concentration. However, studie...

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Section: Discussionmentioning

confidence: 99%

Hypohomocysteinemic Effect of Cysteine Is Associated with Increased Plasma Cysteine Concentration in Rats Fed Diets Low in Protein and Methionine Levels

Kawakami

Ohuchi

Morita

et al. 2009

J Nutr Sci Vitaminol

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“…Nacetyl cysteine reduces plasma homocysteine level (Ventura P et al). 4 Metformin is an oral antidiabetic drug in the biguanide class. It is an insulin sensitizer and works by suppressing glucose production by the liver.…”

Section: Introductionmentioning

confidence: 99%

A study of N-acetyl cysteine, metformin and vitamin D3 with calcium on clinical and metabolic profile in PCOS

Gupta

Chaurasia

Khatoon

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Polycystic ovarian syndrome (PCOS) is characterized by the combination of hyperandrogenism, chronic anovulation and polycystic ovaries. Objective of present study was to compare the effects of N-acetyl cysteine, metformin and vitamin D3 with calcium on clinical and metabolic profile in PCOS.Methods: 66 women were randomly assigned into three equal treatment groups. Group 1 received N-acetyl cysteine, 600 mg three times a day. Group 2 metformin hydrochloride, 500 mg two times a day for 1 week, then three times a day for rest of the study and Group 3 Vit-D3 60,000 IU weekly with calcium 1500mg daily. Clinical and metabolic assessment was done at baseline and after three months of treatment.Results: After 12 weeks of treatment improvement of symptoms was seen in all the three groups, however better improvement in oligomenorrhea and hirsutism was seen in metformin group than others two groups. The clinical parameters like weight, BMI, waist hip ratio, biochemical markers of insulin resistance, fasting glucose, fasting insulin, fasting glucose/insulin ratio were significantly decreased in N-acetyl cysteine group than others two groups.Conclusions: N-acetyl cysteine had better improvement in clinical, and metabolic profile than metformin and vitamin D3 with Calcium group in PCOS patients. It can be used as a substitute for insulin reducing medications in treatment of PCOS patients, considering its limited adverse effects.

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“…NAC reduces plasma homocysteine levels. 29 Therefore, the present study was planned to compare the metabolic effects of metformin and NAC in PCOS patients as both are insulin sensitizers and can be beneficial in PCOS patients in ameliorating the long-term complications. Also, NAC can substitute metformin as it has no side effects and can be safe for long term treatment.…”

mentioning

confidence: 99%

Comparison of metformin and N-acetylcysteine on metabolic parameters in women with polycystic ovarian syndrome

Ali

Radhakrishnan

Singh

2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONPolycystic ovary syndrome (PCOS) is a common disease that affects up to 10% of women of reproductive age, in which hyperandrogenism (HA), enlarged cystic ovaries, and chronic anovulation often coexist with obesity, dyslipidemia and insulin resistance (IR).1 The etiology of the syndrome has remained unknown although it has been revealed that IR lies at the core of its pathophysiology. 2,3 Obesity in women with PCOS is rather high, ranging from 30% to 60%, whereas hyperinsulinemia is present in more than 50% of patients with PCOS. 4,5 Furthermore, although about 70% of obese women with PCOS exhibit an exaggerated insulin secretion, this feature is also present in 20%-40% of lean PCOS. [6][7][8] Chronic hyperinsulinemia results in different pathologies such as diabetes mellitus type 2, hypertension, cardiovascular diseases and metabolic syndrome.1,9 Risk factors of cardiovascular diseases tend to accumulate in these women even at their young age and dyslipidemia in these patients is correlated with IR. [10][11][12] It has been proven ABSTRACT Background: Polycystic ovary syndrome (PCOS) is a common disease that affects up to 10% of women of reproductive age, in which hyperandrogenism (HA), enlarged cystic ovaries, and chronic anovulation often co-exist with obesity, dyslipidemia and insulin resistance (IR). There is a need for an alternative to metformin with minimal side effects to improve insulin sensitivity and correct dyslipidemia in PCOS patients. Methods: It was a prospective, Randomized controlled clinical trial. 116 PCOS patients, 58 each in two groups received either Metformin 500 mg TDS or N-acetylcysteine (NAC) 600 mg TDS for 3 months. Clinical and biochemical parameters contributing to metabolic syndrome (MS) and insulin resistance (fasting blood sugar (FBS), fasting insulin (FI), FBS:FI, HOMA-IR and QUICKI) were assessed at the start and end of the study. Results were compared between the two groups. Results: Both treatment modalities resulted in a significant reduction in number of cases with IR (p=0.001) and MS. Fasting hyperinsulinemia improved in 15 % (p=0.12) and 30% (p=0.001) of patients while 12% (p=0.23) and 18% (p=0.049) improvement was seen in FBS:FI in MET and NAC group respectively. Similarly, improvement in HOMA-IR was 12% (p=0.30) and 32% (p=0.001) in MET and NAC group which is significant with NAC. QUICKI and impaired glucose tolerance showed significant improvement in both the groups with a p-value of 0.04 and 0.006, 0.035 and 0.046 respectively. Significant reduction was seen in triglycerides (p=0.048) in NAC group. Conclusions: NAC is equally efficacious as metformin in improving parameters of insulin resistance and metabolic syndrome with minimal occasional side effects ensuring better compliance for a long-term therapy.

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N -Acetyl-Cysteine Reduces Homocysteine Plasma Levels After Single Intravenous Administration by Increasing Thiols Urinary Excretion

Cited by 62 publications

References 25 publications

Hypohomocysteinemic Effect of Cysteine Is Associated with Increased Plasma Cysteine Concentration in Rats Fed Diets Low in Protein and Methionine Levels

Hypohomocysteinemic Effect of Cysteine Is Associated with Increased Plasma Cysteine Concentration in Rats Fed Diets Low in Protein and Methionine Levels

A study of N-acetyl cysteine, metformin and vitamin D3 with calcium on clinical and metabolic profile in PCOS

Comparison of metformin and N-acetylcysteine on metabolic parameters in women with polycystic ovarian syndrome

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