Acta Diabetologica

, Volume 55, Issue 2, pp 149–153 | Cite as

Association between different dietary polyphenol subclasses and the improvement in cardiometabolic risk factors: evidence from a randomized controlled clinical trial

  • Claudia Vetrani
  • Marilena Vitale
  • Lutgarda Bozzetto
  • Giuseppe Della Pepa
  • Sara Cocozza
  • Giuseppina Costabile
  • Anna Mangione
  • Paola Cipriano
  • Giovanni Annuzzi
  • Angela A. Rivellese
Original Article



Due to their different chemical structures and metabolism, polyphenol subclasses may have specific impact on cardiometabolic risk factors. Our aim was to evaluate whether the intake of different polyphenol subclasses is associated with clinical outcomes beneficially improved by polyphenols in a nutritional trial performed by our group (postprandial lipid response, glucose homeostasis, early insulin secretion and oxidative stress).


The present study is a secondary analysis of a nutritional intervention study with a diet naturally rich in polyphenols. The data are derived from 78 participants at high cardiovascular risk who completed the ETHERPATH trial. The associations between variations in polyphenol subclasses (phenolic acids, anthocyanidins, flavones, flavan-3-ols, flavonols and flavanones) and clinical outcomes beneficially influenced by polyphenols were firstly explored by Spearman’s correlation. Thereafter, adjustment for gender, age and body mass index (BMI) was run. Linear regression analysis was used to assess the class of polyphenols that best predicted the outcome.


Flavanone intake was inversely correlated with postprandial lipid response, whereas flavone intake was related to postchallenge glucose response. Anthocyanidins and flavan-3-ols associated positively with early insulin secretion. The decrease in urinary isoprostanes correlated with anthocyanidins, flavan-3-ols and flavonols. Correlations did not change after adjustment for gender, age, and BMI. Linear regression analysis showed an independent association between flavonols and urinary isoprostanes, whereas early insulin secretion was mainly associated with flavan-3-ols intake.


The results of this study show that a polyphenol-rich diet may have a pleiotropic effect on cardiometabolic risk factors thanks to the specific action of different polyphenol subclasses.


Flavonoids Phenolic acids Lipid response Glucose homeostasis Urinary isoprostanes 



The trial was supported by European Community’s Seventh Framework Programme FP7/2009-2012 under grant agreement FP7-KBBE-222639, Etherpaths Project and by “Ministero dell’Istruzione, dell’Università e della Ricerca,” Rome, Italy, PRIN 2010-2011—2010JCWWKM. We gratefully acknowledge Angela Giacco for skillful dietary assistance.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

This study was approved by the Ethics Committee for the Biomedical Activity of the Federico II University of Naples.

Human and Animal Rights disclosure

All human rights were observed in keeping with the Declaration of Helsinki 2008 (ICH GCP), and with the ethical standards of the responsible committee on human experimentation (Ethics Committee for the Biomedical Activity of the Federico II University of Naples). There are no animal rights issues as this is a clinical study.

Informed consent

Written informed consent was obtained from all participants being included in the study.

Supplementary material

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Supplementary material 1 (DOCX 22 kb)
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Supplementary material 2 (PNG 46 kb)
592_2017_1075_MOESM3_ESM.pdf (172 kb)
Supplementary material 3 (PDF 171 kb)


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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2017

Authors and Affiliations

  • Claudia Vetrani
    • 1
  • Marilena Vitale
    • 1
  • Lutgarda Bozzetto
    • 1
  • Giuseppe Della Pepa
    • 1
  • Sara Cocozza
    • 1
  • Giuseppina Costabile
    • 1
  • Anna Mangione
    • 1
  • Paola Cipriano
    • 1
  • Giovanni Annuzzi
    • 1
  • Angela A. Rivellese
    • 1
  1. 1.Department of Clinical Medicine and Surgery“Federico II” UniversityNaplesItaly

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