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Giannoulaki P, Kotzakioulafi E, Nakas A, Kontoninas Z, Karlafti E, Evripidou P, Kantartzis K, Savopoulos C, Chourdakis M, Didangelos T. Effect of Crocus sativus Extract Supplementation in the Metabolic Control of People with Diabetes Mellitus Type 1: A Double-Blind Randomized Placebo-Controlled Trial. Nutrients 2024; 16:2089. [PMID: 38999837 PMCID: PMC11243156 DOI: 10.3390/nu16132089] [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: 05/31/2024] [Revised: 06/27/2024] [Accepted: 06/27/2024] [Indexed: 07/14/2024] Open
Abstract
Introduction-Background: Data from experimental trials show that Crocus sativus L. (saffron) is considered to improve glycemia, lipid profile, and blood pressure and reduce oxidative stress. So far, clinical trials have been conducted in individuals with metabolic syndrome and Diabetes Mellitus type 2 (DMT-2). The purpose of this study is to assess the effectiveness of saffron in individuals with Diabetes Mellitus type 1 (DMT-1). PATIENTS-METHODS 61 individuals with DMT-1, mean age 48 years old (48.3 ± 14.6), 26 females (42.6%) were randomized to receive a new oral supplement in sachets containing probiotics, prebiotics, magnesium, and Crocus sativus L. extract or placebo containing probiotics, prebiotics and magnesium daily for 6 months. Glycemic control was assessed with a continuous glucose monitoring system and laboratory measurement of HbA1c and lipid profile was also examined. Blood pressure at baseline and end of intervention was also measured. Individuals were either on a continuous subcutaneous insulin infusion with an insulin pump or in multiple daily injection regimens. Diabetes distress and satiety were assessed through a questionnaire and body composition was assessed with bioelectrical impedance. RESULTS At the end of the intervention, the two groups differed significantly only in serum triglycerides (p = 0.049). After 6 months of treatment, a significant reduction in the active group was observed in glycated hemoglobin (p = 0.046) and serum triglycerides (p = 0.021) compared to baseline. The other primary endpoints (glycemic control, lipid profile, blood pressure) did not differ within the groups from baseline to end of intervention, and there was no significant difference between the two groups. Diabetes distress score improved significantly only in the active group (p = 0.044), suggesting an overall improvement in diabetes disease burden in these individuals but that was not significant enough between the two groups. CONCLUSIONS A probiotic supplement with saffron extract improves serum triglycerides in well-controlled people with DMT-1 and may potentially be a valuable adjunct for enhancing glycemic control.
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Affiliation(s)
- Parthena Giannoulaki
- Department of Clinical Nutrition, University General Hospital of Thessaloniki AHEPA, 54636 Thessaloniki, Greece
- Diabetes Center, 1st Propaedeutic Department of Internal Medicine, School of Medicine, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Evangelia Kotzakioulafi
- Diabetes Center, 1st Propaedeutic Department of Internal Medicine, School of Medicine, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Alexandros Nakas
- Diabetes Center, 1st Propaedeutic Department of Internal Medicine, School of Medicine, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Zisis Kontoninas
- Diabetes Center, 1st Propaedeutic Department of Internal Medicine, School of Medicine, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Eleni Karlafti
- Diabetes Center, 1st Propaedeutic Department of Internal Medicine, School of Medicine, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Polykarpos Evripidou
- Diabetes Center, 1st Propaedeutic Department of Internal Medicine, School of Medicine, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Konstantinos Kantartzis
- Department of Internal Medicine IV, Division of Endocrinology, Diabetology and Nephrology, University of Tübingen, 72076 Tübingen, Germany
- Institute for Diabetes Research and Metabolic Diseases (IDM), Helmholtz Centre Munich, University of Tübingen, 72076 Tübingen, Germany
- German Center for Diabetes Research (DZD), 72076 Tübingen, Germany
| | - Christos Savopoulos
- Diabetes Center, 1st Propaedeutic Department of Internal Medicine, School of Medicine, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Triantafyllos Didangelos
- Diabetes Center, 1st Propaedeutic Department of Internal Medicine, School of Medicine, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
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Zamani M, Zarei M, Nikbaf-Shandiz M, Gholami F, Hosseini AM, Nadery M, Shiraseb F, Asbaghi O. The effects of saffron supplementation on cardiovascular risk factors in adults: A systematic review and dose-response meta-analysis. Front Nutr 2022; 9:1055517. [PMID: 36570145 PMCID: PMC9774508 DOI: 10.3389/fnut.2022.1055517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/15/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction Cardiovascular disease (CVD) is one of the leading causes of death and disability in the world and is estimated to involve more people in the next years. It is said that alternative remedies such as herbs can be used to manage the complications of this disease. For this reason, we aimed to conduct this meta-analysis to systematically assess and summarize the effects of saffron supplementation as an important herb on cardiovascular risk factors in adults. Methods A systematic search was done in PubMed, Scopus, and Web of Science to find eligible articles up to September 2022. Randomized controlled trials (RCTs) that evaluated the effects of saffron on lipid profiles, glycemic control, blood pressure, anthropometric measures, and inflammatory markers were included. In the meta-analysis, 32 studies were taken into account (n = 1674). Results Consumption of saffron significantly decreased triglyceride (TG) (WMD = -8.81 mg/dl, 95%CI: -14.33, -3.28; P = 0.002), total cholesterol (TC) (WMD = -6.87 mg/dl, 95%CI: -11.19, -2.56; P = 0.002), low density lipoprotein (LDL) (WMD = -6.71 mg/dl, 95%CI: -10.51, -2.91; P = 0.001), (P = 0.660), fasting blood glucose (FBG) level (WMD = -7.59 mg/dl, 95%CI: -11.88, -3.30; P = 0.001), HbA1c (WMD = -0.18%, 95%CI: -0.21, -0.07; P < 0.001), homeostasis model assessment-insulin resistance (HOMA-IR) (WMD = -0.49, 95%CI: -0.89, -0.09; P = 0.016), systolic blood pressure (SBP) (WMD = -3.42 mmHg, 95%CI: -5.80, -1.04; P = 0.005), tumor necrosis factor α (TNF-α) (WMD = -2.54 pg/ml, 95%CI: -4.43, -0.65; P = 0.008), waist circumference (WC) (WMD = -1.50 cm; 95%CI: -2.83, -0.18; P = 0.026), malondialdehyde (MDA) (WMD = -1.50 uM/L, 95%CI: -2.42, -0.57; P = 0.001), and alanine transferase (ALT) (WMD = -2.16 U/L, 95%CI: -4.10, -0.23; P = 0.028). Also, we observed that saffron had an increasing effect on total antioxidant capacity (TAC) (WMD = 0.07 mM/L, 95%CI: 0.01, 0.13; P = 0.032). There was linear regression between FBG and the duration of saffron intake. Additionally, the non-linear dose-response analysis has shown a significant association of saffron intervention with HDL (P = 0.049), HOMA-IR (P = 0.002), weight (P = 0.036), ALP (P = 0.016), FBG (P = 0.011), HbA1c (P = 0.002), and TNF-α (P = 0.042). A non-linear association between the length of the intervention and the level of HDL and DBP was also found. Discussion That seems saffron could effectively improve TG, TC, LDL, FBG, HbA1c, HOMA-IR, SBP, CRP, TNF-α, WC, MDA, TAC, and ALT.
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Affiliation(s)
- Mohammad Zamani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahtab Zarei
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | - Fatemeh Gholami
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Amir Mehdi Hosseini
- Faculty of Medical Sciences and Technologies, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Maryam Nadery
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran,*Correspondence: Farideh Shiraseb,
| | - Omid Asbaghi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Omid Asbaghi,
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Vajdi M, Musazadeh V, Karimi A, Heidari H, Tarrahi MJ, Askari G. Effects of Chromium Supplementation on Lipid Profile: an Umbrella of Systematic Review and Meta-analysis. Biol Trace Elem Res 2022:10.1007/s12011-022-03474-2. [PMID: 36376714 DOI: 10.1007/s12011-022-03474-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 11/04/2022] [Indexed: 11/16/2022]
Abstract
Dyslipidemia is one of the most well-established modifiable risk factors for cardiovascular disease (CVD) development. Several meta-analyses have revealed the improving effects of chromium on dyslipidemia, while some studies have reported controversial results. This study aimed to summarize meta-analyses of randomized controlled trials (RCTs) that examined the effects of chromium supplementation on lipid profiles in adults. The literature search was conducted using Embase, Scopus, Web of Science, Cochrane Central Library, and PubMed databases with appropriate keywords from the beginning to May 2022. Based on the pooled analysis results, a random-effects model was used to determine the effects of chromium on blood lipid levels. Heterogeneity, publication bias, and sensitivity analysis were also evaluated using standard methods. A total of eight meta-analyses were included in this study. The pooled analysis of eight meta-analyses did not find any significant effect of chromium supplementation on triglycerides (TG) (ES = - 0.20 mg/dl; 95% CI: - 0.50, 0.10, p = 0.185), total cholesterol (TC) (ES = - 0.14 mg/dl, 95% CI: - 0.43, 0.16; p = 0.369), low-density lipoprotein cholesterol (LDL-c) (ES = - 0.08 mg/dl; 95% CI: - 0.19, 0.03; p = 0.142), and high-density lipoprotein cholesterol (HDL-C) levels (ES: 0.05 mg/dl, 95% CI: - 0.05, 0.14, p = 0.312). However, subgroup analysis by the intervention dose suggested that chromium supplementation in doses higher than 500 µg/day could significantly decrease TG. The available evidence proposes no beneficial effects of chromium intervention on blood lipids. As a result, it cannot be used as a single therapy to treat adults with lipid abnormalities.
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Affiliation(s)
- Mahdi Vajdi
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Vali Musazadeh
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Arash Karimi
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hajar Heidari
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Javad Tarrahi
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Gholamreza Askari
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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Sani A, Tajik A, Seiiedi SS, Khadem R, Tootooni H, Taherynejad M, Sabet Eqlidi N, Alavi dana SMM, Deravi N. A review of the anti-diabetic potential of saffron. Nutr Metab Insights 2022; 15:11786388221095223. [PMID: 35911474 PMCID: PMC9335478 DOI: 10.1177/11786388221095223] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 03/30/2022] [Indexed: 11/15/2022] Open
Abstract
Diabetes mellitus is one of the most prevalent metabolic disorders that affect people of all genders, ages, and races. Medicinal herbs have gained attention from researchers and have been widely investigated for their antidiabetic potential. Saffron (Crocus sativus L.) and its main constituents, that is, crocin and crocetin, are natural carotenoid compounds, widely known to possess a wide spectrum of properties and induce pleiotropic anti-inflammatory, anti-oxidative, and neuro-protective effects. An increasing number of experimental, animal and human studies have investigated the effects and mechanism of action of these compounds and their potential therapeutic use in the treatment of diabetes. This narrative review presents the key findings of published clinical studies that examined the effects of saffron and/or its constituents in the context of diabetes mellitus. Moreover, an overview of the proposed underlying mechanisms mediating these effects, the medicinal applications of saffron, and the new findings regarding its effect on diabetes and various cellular and molecular mechanisms of action will be debated.
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Affiliation(s)
- Anis Sani
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Tajik
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seiied Sina Seiiedi
- Student Research Committee, Department of Medicine, Ardabil branch, Islamic Azad University, Ardabil, Iran
| | - Razieh Khadem
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Haniye Tootooni
- Student Research Committee, Varastegan Institute for Medical Sciences, Mashhad, Iran
| | | | - Nasim Sabet Eqlidi
- Student Research Committee, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | | | - Niloofar Deravi
- Student Research committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Niloofar Deravi, Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Arabi Ave, Daneshjoo Blvd, Velenjak, Tehran 19839-63113, Iran.
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Butnariu M, Quispe C, Herrera-Bravo J, Sharifi-Rad J, Singh L, Aborehab NM, Bouyahya A, Venditti A, Sen S, Acharya K, Bashiry M, Ezzat SM, Setzer WN, Martorell M, Mileski KS, Bagiu IC, Docea AO, Calina D, Cho WC. The Pharmacological Activities of Crocus sativus L.: A Review Based on the Mechanisms and Therapeutic Opportunities of its Phytoconstituents. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:8214821. [PMID: 35198096 PMCID: PMC8860555 DOI: 10.1155/2022/8214821] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 01/22/2022] [Accepted: 01/28/2022] [Indexed: 12/14/2022]
Abstract
Crocus species are mainly distributed in North Africa, Southern and Central Europe, and Western Asia, used in gardens and parks as ornamental plants, while Crocus sativus L. (saffron) is the only species that is cultivated for edible purpose. The use of saffron is very ancient; besides the use as a spice, saffron has long been known also for its medical and coloring qualities. Due to its distinctive flavor and color, it is used as a spice, which imparts food preservative activity owing to its antimicrobial and antioxidant activity. This updated review discusses the biological properties of Crocus sativus L. and its phytoconstituents, their pharmacological activities, signaling pathways, and molecular targets, therefore highlighting it as a potential herbal medicine. Clinical studies regarding its pharmacologic potential in clinical therapeutics and toxicity studies were also reviewed. For this updated review, a search was performed in the PubMed, Science, and Google Scholar databases using keywords related to Crocus sativus L. and the biological properties of its phytoconstituents. From this search, only the relevant works were selected. The phytochemistry of the most important bioactive compounds in Crocus sativus L. such as crocin, crocetin, picrocrocin, and safranal and also dozens of other compounds was studied and identified by various physicochemical methods. Isolated compounds and various extracts have proven their pharmacological efficacy at the molecular level and signaling pathways both in vitro and in vivo. In addition, toxicity studies and clinical trials were analyzed. The research results highlighted the various pharmacological potentials such as antimicrobial, antioxidant, cytotoxic, cardioprotective, neuroprotective, antidepressant, hypolipidemic, and antihyperglycemic properties and protector of retinal lesions. Due to its antioxidant and antimicrobial properties, saffron has proven effective as a natural food preservative. Starting from the traditional uses for the treatment of several diseases, the bioactive compounds of Crocus sativus L. have proven their effectiveness in modern pharmacological research. However, pharmacological studies are needed in the future to identify new mechanisms of action, pharmacokinetic studies, new pharmaceutical formulations for target transport, and possible interaction with allopathic drugs.
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Affiliation(s)
- Monica Butnariu
- 1Banat's University of Agricultural Sciences and Veterinary Medicine “King Michael I of Romania” from Timisoara, Timișoara, Romania
| | - Cristina Quispe
- 2Facultad de Ciencias de la Salud, Universidad Arturo Prat, Avda Arturo Prat 2120, Iquique 1110939, Chile
| | - Jesús Herrera-Bravo
- 3Departamento de Ciencias Básicas, Facultad de Ciencias, Universidad Santo Tomas, Chile
- 4Center of Molecular Biology and Pharmacogenetics, Scientific and Technological Bioresource Nucleus, Universidad de La Frontera, Temuco 4811230, Chile
| | | | - Laxman Singh
- 6G.B. Pant National Institute of Himalayan Environment & Sustainable Development Kosi-Katarmal, Almora, Uttarakhand, India
| | - Nora M. Aborehab
- 7Biochemistry Department, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA), 6th of October 12566, Egypt
| | - Abdelhakim Bouyahya
- 8Laboratory of Human Pathologies Biology, Department of Biology, Faculty of Sciences and Genomic Center of Human Pathologies, Faculty of Medicine and Pharmacy, Mohammed V University of Rabat, Morocco
| | - Alessandro Venditti
- 9Dipartimento di Chimica, “Sapienza” Università di Roma, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Surjit Sen
- 10Molecular and Applied Mycology and Plant Pathology Laboratory, Department of Botany, University of Calcutta, Kolkata 700019, India
- 11Department of Botany, Fakir Chand College, Diamond Harbour, West Bengal 743331, India
| | - Krishnendu Acharya
- 10Molecular and Applied Mycology and Plant Pathology Laboratory, Department of Botany, University of Calcutta, Kolkata 700019, India
| | - Moein Bashiry
- 12Department of Food Science and Technology, Nutrition and Food Sciences Faculty, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahira M. Ezzat
- 13Pharmacognosy Department, Faculty of Pharmacy, Cairo University, Kasr El-Ainy Street, Cairo 11562, Egypt
- 14Pharmacognosy Department, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA), 6th of October 12566, Egypt
| | - William N. Setzer
- 15Department of Chemistry, University of Alabama in Huntsville, Huntsville, AL 35899, USA
| | - Miquel Martorell
- 16Department of Nutrition and Dietetics, Faculty of Pharmacy, University of Concepcion, Concepcion, Chile
| | - Ksenija S. Mileski
- 17Department of Morphology and Systematic of Plants, Faculty of Biology, University of Belgrade, Studentski Trg 16, 11000 Belgrade, Serbia
| | - Iulia-Cristina Bagiu
- 18Victor Babes University of Medicine and Pharmacy of Timisoara Discipline of Microbiology, Timișoara, Romania
- 19Multidisciplinary Research Center on Antimicrobial Resistance, Timișoara, Romania
| | - Anca Oana Docea
- 20Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Daniela Calina
- 21Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - William C. Cho
- 22Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong
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