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2018. Volume 7. Issue 4. Article CID e0414 _DOI: 10.15275/rusomj.2018.0414_
Research letter
Red wines countering the metabolic syndrome
Vladimir I. Mizin 1, Vladimir V. lezhov 2, Nikita A. Severin 2, Anatolij Ya. Yalaneckyy 3
1 Academic Scientific Research Institute of Physical Methods of Treatment, Medical Climatology and Rehabilitation n.a. I.M. Sechenov, Yalta, Russia
2 Crimean Federal University n.a. V.I. Vernadsky, Yalta, Russia 3 Russian National Scientific Research Institute of Viticulture and Wine-Making "Magarach" of Russian Academy of Science, Yalta, Russia
Received 21 December 2017, Revised 28 February 2018, Accepted 14 April 2018
© 2017, Mizin V.I., Iezhov V.V., Severin N.A., Yalaneckyy A.Ya. © 2017, Russian Open Medical Journal
Abstract: Aim is to evaluate effectiveness of red wines as a part of medical rehabilitation in coronary heart disease (CHD) patients with metabolic syndrome (MS).
Material and Methods — Analysis of effectiveness of table dry red wine "Cabernet" (DW) and liquor red wine "Cahors" (LW) as parts of the spa resort treatment, was carried out in group of 119 patients with CHD (36 patients with MS).
Results — In patients without MS in main group (with wine consumption) the domain dynamics demonstrate more beneficial changes in comparison with control group. In patients with MS in main group (with wine consumption) the domain dynamics demonstrate no more beneficial changes in comparison with control group.
Conclusion — The moderate consumption of red wines can be recommended to patients with coronary heart disease rather as a preventive measure to developing metabolic syndrome.
Keywords: metabolic syndrome, medical rehabilitation, red wine.
Cite as Mizin VI, Iezhov VV, Severin NA, Yalaneckyy AYa. Red wines countering the metabolic syndrome. Russian Open Medical Journal 2018; 7: e0414.
Correspondence to Vladimir I. Mizin. Address: Muchin str. ,10/3, Yalta, 298613, Russia. E-mail: [email protected]. Phone/Fax: +7 3654 323073. Mob.: +7 978 7075330.
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Preventive Medicine
Introduction
The researches on therapeutic and prophylactic properties of wine primarily connected with its antioxidant action against reactive oxygen species (ROS), which play an important role in the development of coronary heart disease (CHD) [1-5]. Numerous studies point out an important role of wines in prevention of various cardiovascular diseases and metabolic syndrome (MS) [19]. Rational argument for the inclusion of red wine in the medical rehabilitation in patients with CHD may be MS protecting effect.
The aim of this study is to evaluate effectiveness of red wines as a part of medical rehabilitation in CHD patients with MS.
Material and Methods
Analysis of effectiveness of red wines as part of spa resort treatment was carried out in group of 119 patients with CHD (36 patients with MS). All patients received individual spa resort treatment, which involves the use of all necessary medical factors and pharmaceuticals (climatic- and spa-therapy, remedial gymnastics, massage, baths, physiotherapy, supporting medication, etc.). Characteristics of treatment program in all four groups were not significantly different (except for the wine consumption).
Main characteristics of table dry red wine "Cabernet" (DW), produced by classical technology from red grape of Cabernet-Sauvignon variety, and liquor red wine "Cahors" (LW), produced by
classical technology from couple of red grape of Cabernet-Sauvignon and Saperavi varieties, are: alcohol content (% by volume) is 10.6 and 16.0 accordingly; sugar (mass concentration based on invert, g/l) is 0.0 and 160.0 accordingly; titrated acids (mass concentration in terms of tartaric acid, g/l) is 8.3 and 6.8 accordingly; total phenolic compounds (mass concentration, mg/l) is 1717.0 and 2080.0 accordingly; including anthocyanin (mass concentration, mg/l) is 255.0 and 162.0 accordingly. Reception of wine was carried out once a day in the afternoon. Daily doses in core groups were 200 ml of DW (consist of 21.2 ml of ethanol and 343.4 mg of total phenolic compound) and 100 ml of LW (consist of 16.0 ml of ethanol and 164.2 mg of total phenolic compound). Methods of investigation included an assessment of functional state of the leading physiological systems by 20 domains of International Classification of Functioning, Disability and Health (ICF) [10, 11]. All the objective, laboratory and functional investigations were conducted by standard procedures. The estimation of the ICF domain values was carried out according to the procedure [12].
All studies were performed twice, with fixation of the results (M±m) before and after the treatment. At the same time, we also evaluated domain value dynamics A as: A = (domain value at initial state of treatment) - (domain value at the end of treatment) and pair correlation coefficient (r) of A with course dose of wine components. The statistics significance of A and r were estimated at p<0.050 or less.
2018. Volume 7. Issue 4. Article CID e0414 DOI: 10.15275/rusomj.2018.0414_
Preventive Medicine
Table 1. The ICF domain value dynamics (A) and pair correlation coefficient with component of consumed wine (r) that indicate influence of red wine in CHD patients with or without associated MS
ICF domains ICF domain value dynamics, & (in points) and pair correlation coefficient with component of consumed wine, r
Patients with MS Patients without MS
Core group 1A (n=14) Control group IB (n=22) Core group 2A (n=38) Control group 2B (n=45)
A r A A r A
1 2 3 4 5 6 7
b2401 Dizziness 1.00±0.14*$ 0.68±0.12* 0.79±0.07*$ E, r=0.329 PC, r=0.366 A, r=0.376 0.53±0.10*
b280 Sensation of pain 0.82±0.13* W, r=0.474 E, r=0.520 PC, r=0.542 A, r=0.549 0.9310.10*$ 0.99±0.06*§ W, r=0.490 E, r=0.561 PC, r=0.585 A, r=0.586 0.65±0.06*§$
b28010 Pain in head and neck 1.00±0.14*$ 0.93±0.14*& 0.60±0.10*$ E, r=0.280 PC, r=0.313 A, r=0.323 0.53±0.11*&
b28011 Pain in chest - heartache 0.64±0.16* W, r=0.532 E, r=0.585 PC, r=0.611 A, r=0.619 0.93±0.11* 1.02±0.11* W, r=0.516 E, r=0.562 PC, r=0.566 A, r=0.558 0.81±0.09*
b410 Heart functions 0.21±0.08 0.20±0.07* 0.19 0.04* 0.13±0.04
b4100 Heart rate 0.00±0.00 0.00±0.09 0.00±0.03 W, r=0.380 E, r=0.349 PC, r=0.303 A, r=0.278 0.00±0.08
b420 Blood pressure functions 1.00±0.19*$ 1.03±0.23* 0.44±0.09*§ $ 0.88±0.15*§
b430 Haematological system -0.03±0.17 -0.06±0.07 -0.15 ±0.07* -0.03±0.10
functions
b4303 Clotting functions -0.14±0.27 -0.12±0.18 -0.38±0.13* -0.07±0.20
b4550 General physical endurance 0.35±0.13 0.25±0.11 0.39±0.08* 0.18±0.08
b4551 Aerobic capacity -0.12±0.29 E, r=-0.440 PC, r=-0.466 A, r=-0.475 0.25±0.21 0.39±0.14 W, r=0.290 0.45±0.13
b4552 Fatiguability 0.92±0.12* W, r=0.506 E, r=0.486 PC, r=0.466 A, r=0.458 0.93±0.06* 0.89±0.09* 0.75±0.09*
b540 General metabolic functions 0.91±0.29*$ E, r=-0.452 PC, r=-0.504 A, r=-0.523 0.86±Ô.2Î*& 6.04±Ô.Ô9*$ W, r=0.328 E, r=0.283 0.20±0.08&
b5403 Fat metabolism 0.32±0.28 0.28±0.14 0.11±0.14* 0.27±0.13
b5408 General metabolic functions, 1.57±0.38*$ W, r=-0.584 1.06±0.23*& 0.02±0.02$ 0.06±0.04&
other specified - MS E, r=-0.651 PC,r=-0.685 A, r=-0.696
d2408 Handling stress and other 0.17±0.15 0.52±0.21 0.20±0.10 A, r=0.316; 0.57±0.16*
physiological demands, other
specified
All controlled domains 0.42±0.06* 0.38±0.03* 0.31±0.03* W, r=0.338 0.29±0.03*
Data of A presented as mean with standard deviation (M±SD); r, pair correlation coefficient with components of consumed wine; ICF, International Classification of Functioning, Disability and Health; MS, metabolic syndrome; * , statistically significant (p<0.05) difference of domain values before and after treatment, i.e., significant A of domain; $, &, § , statistically significant (p<0.05) difference between the means in two groups with the same notation (between $ and $, between & and &, between § and §). W, significant (p<0.05) pair correlation coefficient with wine course dose (drinks); E, significant (p<0.05) pair correlation coefficient r with ethanol course dose (ml); PC, significant (p<0.05) pair correlation coefficient with total polyphenol compound course dose (mg); A, significant (p<0.05) pair correlation coefficient with anthocyanin course dose (mg).
Results and Discussion
The mean values of domains had the similar level at initial state in all groups of patients. The data that are indicate influence of wine are presented in Table 1.
The medical rehabilitation in both core groups of patients with CHD is characterized by high efficiency, which is in agreement with the data obtained earlier on beneficial effect of the Cabernet-Sauvignon alcohol free concentrate [9]. We have shown that
patients without MS have the better rehabilitation prognosis for a complex of controlled ICF domains. Influence of wine on functional state in core group 1A (patients with MS) demonstrated the same beneficial trend than in control group 1B (3 beneficial effects versus 3 harmful). In core group 2A (patients without MS) we can see another picture - 11 beneficial effects of red wines versus 3 harmful effects.
2018. Volume 7. Issue 4. Article CID e0414 DOI: 10.15275/rusomj.2018.0414_
Preventive Medicine
The significant negative dynamics of b4303 "Clotting functions" in patients without MS (in the main group 2A) and the tendency to negative dynamics of this function in patients with MS (in the main group 1A) could be formally evaluated as undesirable effect of the wine. But the analysis showed that a decrease in the prothrombin index, which led to negative dynamics of b4303 "Clotting functions" in patients with CHD is more likely to be sought and can't be assessed as an undesirable result of the wine influence.
Under the influence of red wines, the cholesterol level in patients with MS significantly decreased from 5.89 (±0.36) to 4.50 (±0.33). In patients without MS, under the influence of red wines, a decrease in the level of cholesterol from 5,30 (±0.22) to 5.16 (±0.25) was also noted, but that dynamics is not statistically reliable. In patients with MS, the significant positive dynamics of b540 "General metabolic functions" and the b5408 "General metabolic functions, other specified - MS" were noted only when LW was used, whereas this effect was not observed with DW. Our data is in good accordance with clinical data on the normalization of the profile of blood lipids under the influence of red wine [1316].
In patients without MS a positive correlation of the dynamics of b540 "General metabolic functions" with the course doses of red wine (r=0.328) and ethanol (r=0.283) were found. Mild to moderate alcohol consumption (15-20 ml of ethanol daily), especially wine, is associated with a lower prevalence of MS, but the relative contribution of wine's alcohol and polyphenol components to beneficial effect is unclear [3].
Our data indicate rather a prophylactic than therapeutic effect of red wine in relation to MS. It is the prophylactic effect on the development of MS components that is in good agreement with meta-analysis data indicating the predominantly preventive effect of such an important component of wine on development of cardiovascular diseases [17].
The investigated effects of red wines in CHD patients with MS and of white wines in hypertensive patients with MS [5] are in good accordance to beneficial reputation of Mediterranean diet rich in wine.
Conclusion
The positive effects of polyphenols indicate that red wines consumption is more preferable than strong alcoholic beverages consumption. The moderate consumption of red wines can be recommended to patients with CHD, as a preventive measure to developing MS. The clinical significance of these findings needs further investigation.
Conflict of interest
The authors declare no conflict of interest. This study is designed as a range of joint research work of above mentioned author's affiliation institutions and in no way was supported by any sponsors.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Authors:
Vladimir I. Mizin - MD, DSc, Assistant Professor, Deputy Director of Science, Academic Scientific Research Institute of Physical Methods of Treatment, Medical Climatology and Rehabilitation n.a. I.M. Sechenov, Yalta, Russia. http://orcid.org/0000-0001-9121-8184.
Vladimir V. Iezhov - MD, DSc, Professor, Head of Physiotherapy Department, Academic Scientific Research Institute of Physical Methods of Treatment, Medical Climatology and Rehabilitation n.a. I.M. Sechenov, Yalta, Russia. http://orcid.org/0000-0002-1190-967X. Nikita A. Severin - MD, PhD, Assistant Professor, Department of Health and Rehabilitation, Crimean Federal University n.a. V.I. Vernadsky, Yalta, Russia. http://orcid.org/0000-0002-4255-4496.
Anatolij Ya. Yalaneckyy - GE, PhD, Head of Wine Technology department, Russian National Scientific Research Institute of Viticulture and Wine-Making "Magarach" of Russian Academy of Science, Yalta, Russia. http://orcid.org/0000-0003-2008-8436.
