Effect of Glycocalyx-targeted Therapy on Vascular Function in Older Adults: A Randomized Controlled Trial
Abstract
Advancing age increases cardiovascular disease risk, in part, because of impaired glycocalyx thickness and endothelial dysfunction. Glycocalyx-targeted therapies, such as Endocalyx Pro™, could improve both glycocalyx thickness and endothelial function in older adults, however, this has yet to be tested. We hypothesized that Endocalyx Pro™ supplementation would increase glycocalyx thickness and endothelial function in older adults. Twenty-three older adults aged 66±7 years (52% female) were enrolled in a randomized, double-blind, placebo-controlled, parallel-arms study to investigate the effect of 12-week Endocalyx Pro™ supplementation (3,712 mg/day) on glycocalyx thickness and endothelial function. Glycocalyx thickness was assessed using the GlycoCheck and endothelial function was determined via brachial artery flow-mediated dilation (FMD). Between-group comparisons revealed Endocalyx Pro™ did not increase glycocalyx thickness in microvessels 4-25µm (P=0.33), 4-7µm (P=0.07), or 10-25µm (P=0.47) in diameter when compared with placebo. Additionally, Endocalyx Pro™ did not significantly improve FMD [mean ratio (95% CI) for between-group comparisons, 1.16 (0.77-1.74); P=0.48]. However, Endocalyx Pro™ improved FMD normalized to shear rate area under the curve [mean ratio (95% CI) for between-group comparisons, 2.41 (1.14,4.13); P=0.001]. Moreover, Endocalyx Pro™ increased capillary glycocalyx thickness more than placebo in individuals not taking anti-hypertensive medication [mean difference (95% CI) for between-group comparison, -0.08 (-0.15,-0.01); P=0.02]. Our pilot study suggests that Endocalyx Pro™ supplementation is feasible in older adults but had no measurable effect on overall glycocalyx thickness and FMD. However, Endocalyx Pro™ may have select effects on capillary glycocalyx thickness and FMD normalized to shear rate among older adults, but further investigation is warranted.