The role of acetic acid on glucose uptake and blood flow rates in the skeletal muscle in humans with impaired glucose tolerance

Background/Objectives: Previous studies support the glucose-lowering effect of vinegar. However, the effect of vinegar on muscle glucose metabolism and endothelial function has not been studied in humans. This open, randomized, crossover, placebo-controlled study aims to investigate the effects of vinegar on muscle glucose metabolism, endothelial function and circulating lipid levels in subjects with impaired glucose tolerance (IGT) using the arteriovenous difference technique. Subjects/Methods: Eight subjects with IGT (4 males, age 46±10 years, body mass index 30±5) were randomised to consume 0.50 mmol vinegar (6% acetic acid) or placebo before a mixed meal. Plasma samples were taken for 300 min from the radial artery and the forearm vein for measurements of glucose, insulin, triglycerides, non-esterified fatty acids (NEFAs) and glycerol. Muscle blood flow was measured with strain gauge plethysmography. Glucose flux was calculated as the arteriovenous difference of glucose multiplied by the blood flow rates. Results: Vinegar compared with placebo: (1) decreased arterial plasma insulin ( P overall <0.001; P 75 min =0.014, β =−42), (2) increased forearm blood flow ( P overall <0.001; P 240 min =0.011, β =1.53; P 300 min =0.023, β =1.37), (3) increased muscle glucose uptake ( P overall <0.001; P 60 min =0.029, β =2.78) and (4) decreased arterial plasma triglycerides ( P overall =0.005; P 240 min <0.001, β =−344; P 300 min <0.001, β =−373), without changing NEFA and glycerol. Conclusions: In individuals with IGT, vinegar ingestion before a mixed meal results in an enhancement of muscle blood flow, an improvement of glucose uptake by the forearm muscle and a reduction of postprandial hyperinsulinaemia and hypertriglyceridaemia. From this point of view, vinegar may be considered beneficial for improving insulin resistance and metabolic abnormalities in the atherogenic prediabetic state.