The effects of purslane (Portulaca oleracea) on glycemic indices: A GRADE-assessed systematic review and meta-analysis of randomized controlled trials

The effects of purslane (Portulaca oleracea) on C-reactive protein, lipid profile, and glycemic control in patients with type 2 diabetes mellitus: A GRADE-assessed systematic review and meta-analysis of randomized controlled trials

Although numerous trials have demonstrated the benefits of purslane on patients with type 2 diabetes mellitus (T2DM), the results of some studies reject such effect. We elucidated the influence of purslane on c-reactive protein (CRP), lipid profile, and glycemic control in patients with T2DM. We conducted a systematic search on Web of Sciences, Scopus, the Cochrane Library, PubMed, and Embase, to identify studies published from their inception to February 10, 2024. The random effect model was used to calculate the combined effect, the weighted mean differences (WMDs) and its 95 % confidence interval (CI). Purslane supplementation significantly reduced fasting blood glucose (FBG) levels (WMD: -15.01; 95 % CI: -25.31, -4.71, p= 0.004), total cholesterol (TC) (WMD: -17.75; 95 % CI: -26.06, -9.45; p< 0.001), triglyceride (TG) (WMD: -21.30; 95 % CI: -32.59, -10.00; p< 0.001), low-density lipoprotein cholesterol (LDL-C) (WMD: -6.10; 95 % CI: -9.52, -2.68; p< 0.001), and CRP levels (WMD: -1.44; 95 % CI: -2.25, -0.63; p< 0.001), and increased high-density lipoprotein cholesterol (HDL-C) (WMD: 6.17; 95 % CI: 2.53, 9.80; p< 0.001). Also, purslane did not significant effect on serum levels of insulin, hemoglobin A1C (HbA1c), and homeostatic model Assessment for insulin resistance (HOMA-IR). The results of our study showed that purslane supplementation improved FBG, and lipid profile levels, but did not affect HOMA-IR, insulin, and HbA1c levels. However, high-quality trials are needed to approve our results.

Effects of saffron (Crocus sativus L.) supplementation on cardiometabolic Indices in diabetic and prediabetic overweight patients: a systematic review and meta-analysis of RCTs

BACKGROUND

The incidence of diabetes mellitus (DM) is increasing worldwide, and there is growing interest in the potential use of natural compounds as an alternative treatment for managing DM. Several research studies have investigated the impact of saffron consumption on managing and improving metabolic profiles in patients with DM, and they have shown promising results.

OBJECT

The study aims to systematically review and perform a meta-analysis to evaluate the potential effects of saffron and its extract on cardiometabolic indicators in diabetic and prediabetic overweight patients.

METHODS

We conducted a comprehensive systematic review and meta-analysis, searching PubMed, Scopus, Web of Science, Embase, and Google Scholar for all relevant studies published before April 20, 2024. We extracted weighted (WMD) or standardized (SMD) mean differences (before-after) and 95% confidence intervals (95%CI) of the outcomes and conducted meta-analyses using R. The study protocol was registered in PROSPERO (CRD42024538380).

RESULTS

Out of the studies screened, 15 RCTs were selected for inclusion in the systematic review and meta-analysis. These studies collectively involved 869 participants, 438 in the intervention group and 431 in the control group. Notably, our results showed that saffron supplementation led to significant changes in FBS (MD: - 8.75 mg/dL, 95% CI [- 14.75; - 2.76], P < 0.01), HbA1C (MD: - 0.34%, 95% CI [- 0.39; - 0.9], P < 0.01), TG (MD: - 13.28 mg/dL, 95% CI [- 22.82; - 3.75], P < 0.01), SBP (MD: - 5.33 mmHg, 95% CI [- 8.99-1.67], P = 0.04), DBP (MD: - 1.02 mmHg, 95% CI [- 3.91; 1.86], P = 0.03), AST (MD: - 1.32 IU/L, 95% CI [- 1.72, - 0.93], P < 0.01) levels in T2DM patients compared to placebo or no supplementation, indicating its potential as a therapeutic intervention. However, there was no significant effect on Insulin secretion (MD: - 0.15 µU/ml, 95% CI [- 2.1763; 1.8689], P = 0.88), HOMA (MD: - 0.35%, 95% CI [- 1.34;0.63], P = 0.48), TC (MD: - 4.86 mg/dL, 95% CI [- 9.81-0.09], P = 0.54), HDL (MD: 0.18 mg/dL, 95% CI [- 0.93; 1.29], P = 0.74), LDL (MD: - 1.77 mg/dL, 95% CI [- 5.99-2.45], P = 0.41), TNF-α (MD: - 0.34 pg/mL, 95% CI [- 0.99-0.30], P = 0.29), creatinine (MD: 2.83 mg/dL, 95% CI [2.29, 3.37], P = 0.31) and BUN (MD: - 0.44 mg/dL, 95% CI [- 1.43, 0.55], P = 0.38).

CONCLUSION

Saffron may improve specific CMI indices in overweight patients with diabetes or prediabetes, including significant reductions in FBS, HbA1C, TG, SBP, and AST. However, it did not significantly affect HDL, TC, LDL, insulin secretion, HOMA, DBP, TNF-α, ALT, Cr, or BUN. Further research with more trials and extended follow-up periods is needed to confirm and expand these findings.

The effect of different dietary restriction on weight management and metabolic parameters in people with type 2 diabetes mellitus: a network meta-analysis of randomized controlled trials

BACKGROUND

Type 2 diabetes mellitus (T2DM) is a globally prevalent chronic condition. Individuals with T2DM are at increased risk of developing complications associated with both macrovascular and microvascular pathologies. These comorbidities reduce patient quality of life and increase mortality. Dietary restriction is a principal therapeutic approach for managing T2DM. This study assessed the effects of various dietary regimens on body weight and metabolic profiles in T2DM patients, aiming to determine the most beneficial interventions for enhancing clinical outcomes and overall well-being.

METHODS

We conducted a literature search in PubMed, Embase, and Web of Science from 2003 to April 15, 2024. The risk of bias was assessed via the Revised Cochrane risk-of-bias tool for randomized trials (RoB2). The certainty of the evidence was appraised via the confidence in network meta-analysis (CINeMA) framework. Intermittent fasting (IF) was directly compared with continuous energy restriction (CER) via Review Manager 5.4. Network meta-analysis was statistically assessed via R Studio 4.3.3 and STATA 14.0.

RESULTS

Eighteen studies involving 1,658 participants were included. The network meta-analysis indicated that intermittent energy restriction, the twice-per-week fasting, time-restricted eating, fasting-mimicking diets (FMD), and CER interventions were more effective than conventional diets. Direct comparisons revealed that IF was as effective as CER for reducing glycated haemoglobin A1c, body weight, and body mass index. The results of the cumulative ranking analysis demonstrated that FMD had the greatest combined intervention effect, followed by TRE in terms of overall effectiveness.

CONCLUSIONS

Both IF and CER exert positive influences on weight control and metabolic profile enhancement in individuals with T2DM, with FMD as part of IF demonstrating the greatest impact. To substantiate these findings, more rigorous randomized controlled trials that directly compare the effects of the different IF regimens with one another and with the CER regimen are needed.

Effects of mind-body interventions on polycystic ovary syndrome: a comprehensive meta-analysis

BACKGROUND

Mind-body interventions (MBI) have emerged as a potential therapeutic approach, but their effectiveness in the treatment of Polycystic Ovary Syndrome (PCOS) remains inconclusive. This study systematically evaluates the effectiveness of MBI on quality of life, anthropometry, androgen secretion, glucose, and lipid metabolism in PCOS.

METHODS

A computer search was conducted across three databases: PubMed, the Cochrane Library, and EMBASE, to identify randomized controlled trials (RCTs) related to MBI for PCOS from their inception until July 2024. DerSimonian and Laird's random-effects model and Stata 17.0 software was employed for our meta-analysis.

RESULTS

Twelve RCTs were included. MBI significantly improved PCOSQ subscale scores, including emotional disturbances (MD: 7.75, 95% CI: 6.10 to 9.40), body hair (MD: 2.73, 95% CI: 0.54 to 4.91), menstrual problems (MD: 3.79, 95% CI: 2.89 to 4.69), and weight (MD: 1.48, 95% CI: 0.03 to 2.93). Furthermore, there was a reduction in depression levels (MD: -1.53, 95% CI: -2.93 to -0.13). Sensitivity analysis confirmed the robustness of PCOSQ-Emotional disturbances and PCOSQ-Menstrual problems, with a high GRADE level of evidence for these subscales. Secondary outcome measures, including waist-hip ratio, fasting blood glucose, and HOMA-IR exhibited statistically significant differences. Subgroup analysis revealed that obesity could influence treatment outcomes.

CONCLUSION

MBI can serve as an alternative therapy, modulating effect on the quality of life and depression in PCOS patients. Future well-designed, high-quality, and large-scale studies should be conducted to thoroughly assess the impact of different Mind-Body Interventions (MBI) on various PCOS phenotypes.

TRIAL REGISTRATION

PROSPERO (CRD42023472035).

Effect of zinc supplementation on glycemic biomarkers: an umbrella of interventional meta-analyses

BACKGROUND

Several studies have evaluated the effects of zinc supplementation on glycemic biomarkers in humans and have demonstrated varying results. We systematically evaluated the literature and performed an umbrella meta-analysis of the effects of zinc supplementation on type 2 diabetes biomarkers.

METHODS

A comprehensive literature search was conducted in the following databases; PubMed, Embase, Embase, Cochrane Library, Scopus, and Web of Science for studies published up to March 10, 2024.

RESULTS

Zinc supplementation was effective in reducing serum FBS (WMD: - 13.58, 95% CI: - 17.38, - 9.77; p < 0.001; SMD: - 0.52, 95% CI - 0.79, - 0.25; p =  < 0.001), insulin (SMD: - 0.67, 95% CI - 0.96, - 0.38; p < 0.001), HOMA-IR levels (WMD - 0.52, 95% CI - 0.66, - 0.38; p < 0.001; SMD: - 0.78, 95% CI - 1.02, - 0.42; p < 0.001), and HbA1c (WMD: - 0.35, 95% CI - 0.43, - 0.27; p < 0.001).

CONCLUSION

Zinc supplementation significantly reduced FBS, HOMA-IR, insulin and HbA1c. These findings suggest that zinc is potentially an effective complementary intervention to improve type 2 diabetes biomarkers.

Portulaca Oleracea L. (Purslane) Extract Protects Endothelial Function by Reducing Endoplasmic Reticulum Stress and Oxidative Stress through AMPK Activation in Diabetic Obese Mice

Portulaca oleracea L. (purslane) is a food and a traditional drug worldwide. It exhibits anti-inflammatory, anti-oxidative, anti-tumor, and anti-diabetic bioactivities; but its activity on diabetic-associated endothelial dysfunction is unknown. This study aimed to investigate the effect of purslane on endothelial function and the underlying mechanisms. Male C57BL/6 mice had 14-week ad libitum access to a high-fat rodent diet containing 60% kcal% fat to induce obesity and diabetes whereas purslane extract (200 mg/kg/day) was administered during the last 4 weeks via intragastric gavage. Primary rat aortic endothelial cells and isolated mouse aortas were cultured with a risk factor, high glucose or tunicamycin, together with purslane extract. By ESI-QTOF-MS/MS, flavonoids and their glycoside products were identified in the purslane extract. Exposure to high glucose or tunicamycin impaired acetylcholine-induced endothelium-dependent relaxations in aortas and induced endoplasmic reticulum (ER) stress and oxidative stress with the downregulation of 5' AMP-activated protein kinase (AMPK)/ endothelial nitric oxide synthase (eNOS) signaling. Co-incubation with purslane significantly ameliorated these impairments. The effects of purslane were abolished by Compound C (AMPK inhibitor). Four-week purslane treatment ameliorated aortic relaxations, ER stress, and oxidative stress in diabetic obese mice. This study supported that purslane protected endothelial function, and inhibited ER stress and oxidative stress in vasculature through AMPK/eNOS activation, revealing its therapeutic potential against vascular complications in diabetes.