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Bahreini N, Saghafi-Asl M, Nikpayam O, Safaei E, Sadra V, Fakhr L, Beyrampour-Basmenj H, Asgharian P, Asghari-Jafarabadi M. Effects of dried okra extract on lipid profile, renal function and some RAGE-related inflammatory genes expression in patients with diabetic nephropathy: A randomized controlled trial. Complement Ther Med 2024; 81:103027. [PMID: 38336011 DOI: 10.1016/j.ctim.2024.103027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Diabetic nephropathy (DN) is a common complication of type 2 diabetes. Okra (Abelmoschus esculentus L) is reported to have anti-diabetic effects. The present study aimed to investigate the effects of dried okra extract (DOE) supplementation on lipid profile, renal function indices, and expression of inflammatory genes, as well as serum level of soluble Receptor for Advanced glycation end products (sRAGE) in patients with DN. METHODS In this triple-blind randomized placebo-controlled clinical trial, 64 eligible patients with DN received either 125 mg of DOE or placebo daily along with DN-related nutritional recommendations for 10 weeks. Changes in kidney indices including proteinuria and estimated glomerular filtration rate (eGFR), lipid profile, serum SRAGE, as well as the expression of RAGE, ICAM-1, and IL-1 genes were measured over 10 weeks. RESULTS After adjustment for the potential confounders, between-group analyses showed no significant differences in terms of lipid profile, kidney function indices, sRAGE, and RAGE-related inflammatory genes expression after 10 weeks. CONCLUSION Daily 125 mg DOE along with nutritional recommendations on top of usual care did not lead to significant changes in renal function indices, lipid profile, and inflammatory genes expression in patients with DN.
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Affiliation(s)
- Nazgol Bahreini
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Saghafi-Asl
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Science, Tabriz, Iran; Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Omid Nikpayam
- Department of Nutritional Sciences, School of Health, Golestan University of Medical Sciences, Iran
| | - Ehsan Safaei
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahideh Sadra
- Endocrine Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Laleh Fakhr
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hanieh Beyrampour-Basmenj
- Department of Medical Biotechnology, School of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parina Asgharian
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari-Jafarabadi
- Cabrini Research, Cabrini Health, VIC 3144, Australia; School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, VIC 3800, Australia; Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Nikpayam O, Saghafi-Asl M, Safaei E, Bahreyni N, Sadra V, Asgharian P. The effect of Abelmoschus esculentus L. (Okra) extract supplementation on glycaemic control, inflammation, kidney function and expression of PPAR- α, PPAR- γ, TGF- β and Nrf-2 genes in patients with diabetic nephropathy: a triple-blind, randomised, placebo-controlled trial. Br J Nutr 2024; 131:648-657. [PMID: 37840235 DOI: 10.1017/s0007114523002180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
The present study was carried out to evaluate the effects of okra extract supplementation on kidney function, glycaemic control, inflammation and gene expression in patients with diabetic nephropathy (DN). A total of sixty-four DN patients based on the inclusion and exclusion criteria were recruited in this triple-blind placebo-controlled randomised clinical trial. Participants were randomly allocated to receive a 125-mg capsule of dried okra extract (DOE) (n 32) or placebo (n 32) for 10 weeks. At the baseline and endpoint of the trial, kidney function, glycaemic indices, inflammation and gene expression were evaluated. Statistical analysis showed that fasting blood glucose, HbA1c and insulin resistance significantly reduced in the DOE group although between-group analysis did not show any significant difference. Also, no significant difference was observed in urine protein, urine creatinine and high-sensitivity C-reactive protein between the two groups. Furthermore, gene expression of PPAR-α, PPAR-γ, transforming growth factor-beta and Nrf-2 did not affect the end of the trial in comparison with the baseline. According to the present study, DOE did not have impressive effects on kidney function, inflammation, glycaemic management and gene expression in patients with DN.
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Affiliation(s)
- Omid Nikpayam
- Department of Nutrition, School of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Maryam Saghafi-Asl
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Science, Tabriz, Iran
| | - Ehsan Safaei
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nazgol Bahreyni
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahideh Sadra
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parina Asgharian
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Wang X, Hu K, Chen Y, Lai J, Zhang M, Li J, Li Q, Zhao N, Liu S. Effect of Lactiplantibacillus plantarum fermentation on the physicochemical, antioxidant activity and immunomodulatory ability of polysaccharides from Lvjian okra. Int J Biol Macromol 2024; 257:128649. [PMID: 38065452 DOI: 10.1016/j.ijbiomac.2023.128649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 11/28/2023] [Accepted: 12/05/2023] [Indexed: 01/26/2024]
Abstract
Okra polysaccharides exhibits a range of biological activities. To date, its processing using microbial fermentation has not been explored. This study investigated the fermentation of okra juice with various lactic acid bacteria, followed by the extraction and characterization of crude polysaccharides (termed OPS-F), in contrast to their non-fermented counterpart (OPS). Changes in physicochemical properties, antioxidant activity and immunomodulatory ability were noted. The results demonstrated that OPS-F had a 7.42-12.53 % increase in total polysaccharides content compared to OPS. However, high-performance size-exclusion chromatography indicated a reduction in the molecular weight of OPS-F (7.9-9.5 × 105 Da) relative to OPS (1.66 × 106 Da). Compared to OPS, OPS-F had reduced levels of mannose, glucose, glucuronic acid and arabinose, but increased rhamnose, galacturonic acid and galactose, exhibiting enhanced solubility and lower apparent viscosity. Fourier transform infrared spectroscopy and nuclear magnetic resonance analysis showed minimal changes in polysaccharide structure post-fermentation. Moreover, despite a decrease in antioxidant activity post-fermentation, OPS-F exhibited superior immunomodulatory potential. In conclusion, fermenting okra juice with lactic acid bacteria alters the physicochemical properties of crude polysaccharides and enhances their immunomodulatory activity, offering a promising approach for developing new functional food resources.
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Affiliation(s)
- Xingjie Wang
- College of Food Science, Sichuan Agricultural University, Ya'an 625014, China
| | - Kaidi Hu
- College of Food Science, Sichuan Agricultural University, Ya'an 625014, China
| | - Yuan Chen
- College of Food Science, Sichuan Agricultural University, Ya'an 625014, China
| | - Jinghui Lai
- College of Food Science, Sichuan Agricultural University, Ya'an 625014, China
| | - Mengmei Zhang
- College of Food Science, Sichuan Agricultural University, Ya'an 625014, China
| | - Jianlong Li
- College of Food Science, Sichuan Agricultural University, Ya'an 625014, China
| | - Qin Li
- College of Food Science, Sichuan Agricultural University, Ya'an 625014, China
| | - Ning Zhao
- College of Food Science, Sichuan Agricultural University, Ya'an 625014, China
| | - Shuliang Liu
- College of Food Science, Sichuan Agricultural University, Ya'an 625014, China.
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Tavakolizadeh M, Peyrovi S, Ghasemi-Moghaddam H, Bahadori A, Mohkami Z, Sotoudeh M, Ziaee M. Clinical efficacy and safety of okra (Abelmoschus esculentus (L.) Moench) in type 2 diabetic patients: a randomized, double-blind, placebo-controlled, clinical trial. Acta Diabetol 2023; 60:1685-1695. [PMID: 37507536 DOI: 10.1007/s00592-023-02149-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023]
Abstract
AIMS The recent trend toward the use of natural functional and medical supplements has motivated the focus on the search and revival of traditional medicinal plant applications for many years. As a valuable dietary crop, okra fruit (Abelmoschus esculentus (L.) Moench) has been used for thousands of years as a medicinal food. This clinical trial aimed to assess the efficacy and safety of the okra pod capsule as an adjuvant treatment in controlling type 2 diabetes mellitus and provide clinical trial-based evidence about its anti-inflammatory effects. METHODS A total of 100 type II diabetic patients, aged between 40 and 60 years, were randomly assigned into two groups of okra and placebo. The first group was administered 1000 mg of powdered okra fruit three times a day for 3 months, while the other group received a placebo capsule with the same dosage. Both groups continued the standard antidiabetic therapy (consisting of metformin and gliclazide, as well as a nutritional regimen). At the start and three months later, various factors were measured, including FBG, insulin, HbA1c, cholesterol, triglycerides, HDL, LDL, CRP, liver and renal function tests, blood pressure, and BMI changes. RESULTS According to the results, patients who received okra treatment exhibited a significant decrease in FBG, HbA1c, total cholesterol, and triglyceride levels when compared to both the baseline and the placebo group. Patients in the okra group have lower levels of hs-CRP compared with the placebo group after 3 months of treatment. No liver, kidney, and blood pressure or other side effects were observed in the groups associated with okra treatment. CONCLUSIONS The present study demonstrated that adjunctive consumption of okra, in type 2 diabetic patients with 1000 mg three times a day for three months, improves lipid profile, glycemic control, and chronic inflammation without any tangible adverse effects. CLINICAL TRIAL REGISTRY IRCT.Ir (IRCT20120112008712N2). https://www.irct.ir/trial/42042 .
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Affiliation(s)
- Mahdi Tavakolizadeh
- Department of Pharmacognosy, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Saeid Peyrovi
- Medicinal Plants Research Center, Maragheh University of Medical Sciences, Maragheh, Iran
| | | | - Ali Bahadori
- Department of Medical Microbiology, Sarab Faculty of Medical Sciences, Sarab, Iran
| | - Zeynab Mohkami
- Department of Agriculture and Plant Breeding, Agriculture Institute, Research Institute of Zabol, Zabol, Iran
| | - Mahtab Sotoudeh
- Department of Pharmacognosy, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mojtaba Ziaee
- Medicinal Plants Research Center, Maragheh University of Medical Sciences, Maragheh, Iran.
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Mokgalaboni K, Lebelo SL, Modjadji P, Ghaffary S. Okra ameliorates hyperglycaemia in pre-diabetic and type 2 diabetic patients: A systematic review and meta-analysis of the clinical evidence. Front Pharmacol 2023; 14:1132650. [PMID: 37077817 PMCID: PMC10107009 DOI: 10.3389/fphar.2023.1132650] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/22/2023] [Indexed: 04/05/2023] Open
Abstract
Background: Despite the use of available pharmaceutical drugs, high rates of metabolic diseases and cardiovascular disorders are alarming. This calls for alternative therapies that can attenuate these complications. Therefore, we investigated the beneficial effects of okra on glycaemic control in pre-diabetes and type 2 diabetes mellitus (T2D).Methods: MEDLINE and Scopus were searched for relevant studies. Collected data were analysed using RevMan and reported as mean difference and 95% confidence intervals (CI). Eight studies, including 331 patients with pre-diabetes or T2D, were eligible.Results: Our findings showed that okra treatment reduced the levels of fasting blood glucose: mean difference (MD) = −14.63 mg/dL; 95% CI (-25.25, −4.00, p = 0.007); I2 = 33%, p = 0.17 compared to placebo. Glycated haemoglobin, however, did not differ significantly between the groups: MD = 0.01%; 95%CI (-0.51, 0.54, p = 0.96); I2 = 23%, p = 0.28.Conclusion: this systematic review and meta-analysis found that okra treatment improves glycaemic control in patients with pre-diabetes or T2D. The findings suggest that okra may be used as a supplemental dietary nutrient, especially in pre-diabetic and T2D patients due to its potential to regulate hyperglycaemia.
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Affiliation(s)
- Kabelo Mokgalaboni
- Department of Life and Consumer Sciences, College of Agriculture and Environmental Sciences, Florida Campus, University of South Africa, Roodepoort, South Africa
- *Correspondence: Kabelo Mokgalaboni, ; Saba Ghaffary,
| | - Sogolo Lucky Lebelo
- Department of Life and Consumer Sciences, College of Agriculture and Environmental Sciences, Florida Campus, University of South Africa, Roodepoort, South Africa
| | - Perpetua Modjadji
- Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Public Health, School of Healthcare Sciences, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa
| | - Saba Ghaffary
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- *Correspondence: Kabelo Mokgalaboni, ; Saba Ghaffary,
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Liao Z, Li Y, Liao L, Shi Q, Kong Y, Hu J, Cai Y. Structural characterization and anti-lipotoxicity effects of a pectin from okra (Abelmoschus esculentus (L.) Moench). Int J Biol Macromol 2023; 238:124111. [PMID: 36948330 DOI: 10.1016/j.ijbiomac.2023.124111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 03/13/2023] [Accepted: 03/16/2023] [Indexed: 03/24/2023]
Abstract
Okra (Abelmoschus esculentus (L.) Moench) is rich in various bioactive ingredients and used as a medicinal plant in traditional medicine. In the present study, to find the polysaccharide with anti-lipotoxicity effects from okra and clarify its structure, a pectin OP-1 was purified from okra, which had a backbone containing →4)-α-GalpA-(1 → residues, and 1,5-Ara linked the main chain through the O-3 of the residue →3,4)-α-GalpA-(1→, and the C-6 of residue 1, 4-α-GalpA replaced by methyl ester. In vitro experiments showed that OP-1 pretreatment alleviated oleic acid (OA)-induced lipid accumulation, ROS generation, apoptosis, transaminase leakage, and inflammatory cytokine secretion in HepG2 cells, resulting in reduced lipotoxicity. Further molecular results revealed that OP-1 increased Adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK) phosphorylation and affected the expression of AMPK downstream targets, including inhibit SREBP1c and FAS, as well as activate CPT-1A. Impressively, AMPK inhibitor dorsomorphin (Compound C) blocked the effects of OP-1 against lipotoxicity. The effects of OP-1 on lipid metabolism were also diminished by dorsomorphin. Our results demonstrated that OP-1 possesses a potent function in preventing lipotoxicity via regulating AMPK-mediated lipid metabolism and provide a novel insight into the future utilization of okra polysaccharide.
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Affiliation(s)
- Zhengzheng Liao
- Department of Pharmacy, the First Affiliated Hospital of Nanchang University, 330006 Nanchang, Jiangxi, People's Republic of China
| | - Yuhua Li
- Department of Pharmacy, the First Affiliated Hospital of Nanchang University, 330006 Nanchang, Jiangxi, People's Republic of China
| | - Lihong Liao
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Nanchang University, 330006 Nanchang, Jiangxi, People's Republic of China
| | - Qing Shi
- Department of Endocrinology and Metabolism, the First Affiliated Hospital of Nanchang University, 330006 Nanchang, Jiangxi, People's Republic of China
| | - Ying Kong
- Department of Pharmacy, the First Affiliated Hospital of Nanchang University, 330006 Nanchang, Jiangxi, People's Republic of China
| | - Jinfang Hu
- Department of Pharmacy, the First Affiliated Hospital of Nanchang University, 330006 Nanchang, Jiangxi, People's Republic of China.
| | - Yaojun Cai
- Department of Endocrinology and Metabolism, the First Affiliated Hospital of Nanchang University, 330006 Nanchang, Jiangxi, People's Republic of China; Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Jiangxi, 330006 Nanchang, People's Republic of China; Jiangxi Branch of National Clinical Research Center for Metabolic Disease, Jiangxi, 330006 Nanchang, People's Republic of China.
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Nikpayam O, Safaei E, Bahreyni N, Sadra V, Saghafi-Asl M, Fakhr L. The effect of Abelmoschus esculentus L. (Okra) extract supplementation on dietary intake, appetite, anthropometric measures, and body composition in patients with diabetic nephropathy. Health Promot Perspect 2022; 12:169-177. [PMID: 36276416 PMCID: PMC9508394 DOI: 10.34172/hpp.2022.21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/13/2022] [Indexed: 11/09/2022] Open
Abstract
Background: Diabetes is a risk factor for chronic kidney disease because it induces nephropathy. Okra is a rich source of antioxidants, vitamins, minerals, and fibers, of which favorable effects in diabetes have been reported in many animal studies. The present trial aimed to investigate the effect of dried okra extract (DOE) supplementation on anthropometric measures, body composition, appetite, and dietary intake in diabetic nephropathy (DN) patients. Methods: In this triple-blind placebo-controlled randomized clinical trial, 64 DN patients were randomly allocated to receive a 125-mg capsule of DOE (n=32) or placebo (n=32) for 10 weeks. At baseline and endpoint of the trial, anthropometric variables, body composition indices, dietary intake, and appetite scores were evaluated. Results: The results showed that energy (P=0.047, CI: -425.87, -3.25, ES: 0.539) and carbohydrate (P=0.038, CI: -85.64, -2.53, ES: 0.555) intake as well as desire to eat salty food (P=0.023) were reduced in DOE group at the endpoint, compared to the baseline values. However, anthropometric measures, body composition, and appetite score were not significantly different between the two study groups. Conclusion: In conclusion, the present clinical trial showed that DOE could significantly decrease energy intake and carbohydrate consumption in the DN patients. Further clinical trials are needed to determine the effects of this supplement.
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Affiliation(s)
- Omid Nikpayam
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ehsan Safaei
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nazgol Bahreyni
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahideh Sadra
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Saghafi-Asl
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Science, Tabriz, Iran
| | - Laleh Fakhr
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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