Oral Azelaic Acid Ester Decreases Markers of Insulin Resistance in Overweight Human Male Subjects

In Vivo. 2020 May-Jun;34(3):1173-1186. doi: 10.21873/invivo.11890.

Abstract

Background/aim: Insulin resistance (IR) is linked to increased risk of cardiovascular disease and cancer. We examined safety and efficacy of the natural product diethyl azelate (DEA) in overweight males with a varying degree of IR.

Patients and methods: Seventeen subjects [age 18-42, hemoglobin A1c (A1c) of 5.2-6.2%] received orally 1 mg/kg DEA daily for 21 days. Blood plasma glucose, insulin and lipid levels were assessed before and after treatment.

Results: DEA was well tolerated without hypoglycemia or adverse effects except transient diarrhea (n=1). DEA significantly reduced fasting glucose by 6.06 mg/dl (n=8) and insulin by 37.8% (n=8) in subjects with IR and/or A1c ≥5.6%. Furthermore, it improved cholesterol/HDL, LDL/HDL, and non-cholesterol HDL/HDL by 5.4, 6.5, and 6.6%, respectively in all subjects, and by 8.0, 9.8, and 9.8%, respectively in 9 subjects with A1c ≥5.6%.

Conclusion: DEA efficacy correlates with the degree of IR. DEA holds promise as a novel treatment for the management of IR.

Keywords: Insulin resistance; azelaic acid ester; cancer; cardiovascular disease; dyslipidemia; lipids; metabolic syndrome; metaflammation; metformin; obesity; type 2 diabetes.

MeSH terms

  • Administration, Oral
  • Biomarkers*
  • Blood Glucose
  • Dicarboxylic Acids / administration & dosage*
  • Dicarboxylic Acids / chemistry
  • Esters
  • Gas Chromatography-Mass Spectrometry
  • Humans
  • Insulin / blood
  • Insulin Resistance*
  • Lipid Metabolism
  • Male
  • Overweight / blood
  • Overweight / drug therapy
  • Overweight / etiology
  • Overweight / metabolism*
  • Sex Factors

Substances

  • Biomarkers
  • Blood Glucose
  • Dicarboxylic Acids
  • Esters
  • Insulin
  • azelaic acid