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

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.