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Randomized Controlled Trial
. 2023 Summer;29(3):1-13.
doi: 10.46292/sci22-00033. Epub 2023 Aug 16.

Salsalate Improves Postprandial Glycemic and Some Lipid Responses in Persons With Tetraplegia: A Randomized Clinical Pilot Trial With Crossover Design

Jochen Kressler  1   2 , Armando Mendez  3 , Luisa Betancourt  1 , Mark Nash  1   4   5   6
Affiliations
Randomized Controlled Trial

Salsalate Improves Postprandial Glycemic and Some Lipid Responses in Persons With Tetraplegia: A Randomized Clinical Pilot Trial With Crossover Design

Jochen Kressler et al. Top Spinal Cord Inj Rehabil. 2023 Summer.

Abstract

Objectives: To investigate the effects of salsalate on fasting and postprandial (PP) glycemic, lipidemic, and inflammatory responses in persons with tetraplegia.

Methods: This study was a randomized, double-blind, cross-over design. It was conducted at a university laboratory. Ten males aged 25 to 50 years with SCI at C5-8 levels for ≥1 year underwent 1 month of placebo and salsalate (4 g/day) treatment. Blood samples were drawn before and 4 hours after breakfast and lunch fast-food meal consumption.

Results: Descriptive statistics indicate that fasting and PP glucose values were reduced with salsalate (pre-post mean difference, 4 ± 5 mg/dL and 8 ± 8 mg/dL, respectively) but largely unchanged with placebo (0 ± 6 mg/dL and -0 ± 7 mg/dL, respectively). Insulin responses were generally reciprocal to glucose, however less pronounced. Fasting free fatty acids were significantly reduced with salsalate (191 ± 216 mg/dL, p = .021) but not placebo (-46 ± 116 mg/dL, p = .878). Results for triglycerides were similar (25 ± 34 mg/dL, p =.045, and 7 ± 29 mg/dL, p = .464). Fasting low-density lipoprotein (LDL) levels were higher after salsalate (-10 ± 12 mg/dL, p = .025) but not placebo (2 ± 9 mg/dL, p = .403) treatment. Inflammatory markers were largely unchanged.

Conclusion: In this pilot trial, descriptive values indicate that salsalate decreased fasting and PP glucose response to fast-food meal challenge at regular intervals in persons with tetraplegia. Positive effects were also seen for some lipid but not for inflammatory response markers. Given the relatively "healthy" metabolic profiles of the participants, it is possible that salsalate's effects may be greater and more consistent in people with less favorable metabolic milieus.

Keywords: metabolic; postprandial; salsalate.

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Conflict of interest statement

Conflicts of Interest The authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Metabolic and inflammatory response markers response to meal challenges. Values are change scores from pre-post intervention within a treatment condition at the same time point expressed as mean ± SD. (A) Glucose, (B) insulin, (C) free fatty acids (FFA), (D) total cholesterol, (E) high-density lipoprotein (HDL) cholesterol, (F) total to HDL cholesterol ratio, (G) low-density lipoprotein (LDL) cholesterol, (H) triglycerides (TG), (I) C-reactive protein (CRP), (J) interleukin 6 (IL-6). Solid boxes = salsalate; open boxes = placebo.
Figure 2.
Figure 2.
Metabolic and inflammatory response markers area under the curve (AUC) following meal challenges. Values are mean ± SD in thousands. (A) Glucose and insulin; (B) free fatty acids (FFA), triglycerides (TG), and low-density lipoprotein (LDL) cholesterol; (C) interleukin 6 (IL-6) and C-reactive protein (CRP). Pla = placebo; Sal = salsalate.
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Grants and funding

Financial Support This study was funded by the Craig H. Neilsen Foundation award #124683.