1
|
de Moura SL, Gomes BGR, Guilarducci MJ, Coelho OGL, Guimarães NS, Gomes JMG. Effects of cinnamon supplementation on metabolic biomarkers in individuals with type 2 diabetes: a systematic review and meta-analysis. Nutr Rev 2024:nuae058. [PMID: 38917435 DOI: 10.1093/nutrit/nuae058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024] Open
Abstract
CONTEXT The global prevalence of type 2 diabetes mellitus (DM2) has been rising significantly over the years. Recent studies have shown beneficial effects of cinnamon on metabolic biomarkers. OBJECTIVE The objective of this review was to assess the effect of cinnamon supplementation on metabolic biomarkers in patients with DM2. DATA SOURCES The Pubmed/MEDLINE, Cochrane CENTRAL, and Embase databases were searched up to November 10, 2022. DATA EXTRACTION A systematic search was performed for randomized controlled trials (RCTs) evaluating the effect of cinnamon supplementation on metabolic biomarkers, in adults and the elderly with DM2, and comparing the data for a cinnamon intervention group with that for a placebo group or a control group. The main exclusion criteria were studies (1) with other types of diabetes (ie, gestational diabetes or type 1 diabetes), (2) without cinnamon consumption, (3) that did not evaluate metabolic biomarkers, or (4) in vitro and animal studies. Two researchers independently screened 924 records, evaluated full-text studies, extracted data, and appraised their quality. A third researcher was consulted to resolve any discrepancies. The data were pooled using random-effects models and expressed as the weighted mean difference (WMD) with 95% CI. Heterogeneity was assessed using Cochran's Q test and quantified using I2 statistics. Risk of bias was assessed using the Joanna Briggs Institute (JBI) instrument. Sensitivity analysis and the GRADE system were used to assess the robustness and certainty of the findings. DATA ANALYSIS In total, 28 RCTs with a duration ranging from 30 to 120 days and a total enrollment of 3054 patients with DM2 were included. Participants consuming cinnamon showed a significant reduction in fasting blood glucose (FBG) (WMD: -15.26 mg/dL; 95% CI: -22.23 to -8.30; I2 = 88%), postprandial glucose (WMD: -39.22 mg/dL; 95% CI: -63.90 to -14.55; I2 = 100%), HbA1c (WMD: -0.56 mg/dL; 95% CI: -0.99 to -0.13; I2 = 94%), and HOMA-IR (WMD = -0.76, 95% CI: -1.13 to -0.39; I2 = 22%) compared with the control group. An intervention of cinnamon in capsule form reduced FBG (WMD:-18.43 mg/dL, 95% CI: -26.32 to -10.53; I2 = 89%), postprandial glucose (WMD: -44.83 mg/dL, 95% CI: -70.67 to -18.99; I2 = 100%), HbA1c (WMD: -0.56 mg/dL, 95% CI: -1.02 to -0.09; I2 = 94%), total cholesterol (WMD: -13.39 mg/dL; 95% CI: -24.71 to -2.07; I2 = 96%), LDL-C (WMD: -6.49 mg/dL, 95% CI: -12.69 to -0.29; I2 = 92%), and triglycerides (WND: -19.75 mg/dL; 95% CI, -33.71 to -5.80; I2 = 88%). Both doses (≤2 g/day and >2 g/day) reduced FBG and postprandial glucose. Only cinnamon doses of ≤2 g/day reduced HbA1c (WMD: -0.68 mg/dL, 95% CI: -1.16 to -0.1; I2 = 92%), HOMA-IR (WMD: -0.94 mg/dL; 95% CI: -1.21 to -0.67; I2 = 0%), and BMI (WMD: -1.18 kg/m2; 95% CI: -1.97 to -0.39; I2 = 0%). CONCLUSION The data suggest that cinnamon improves the glycemic and lipid profile and reduces the BMI, particularly in DM2 patients who receive cinnamon supplementation in capsule form and at a dose of ≤2 g/day. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022370332.
Collapse
Affiliation(s)
- Suzana Laís de Moura
- Federal Institute of Education, Science and Technology of the Southeast of Minas Gerais-Campus Barbacena-IF Sudeste MG, Barbacena, MG, 36.205-018, Brazil
| | - Bruna Gabrielle Rocha Gomes
- Federal Institute of Education, Science and Technology of the Southeast of Minas Gerais-Campus Barbacena-IF Sudeste MG, Barbacena, MG, 36.205-018, Brazil
| | | | | | - Nathalia Sernizon Guimarães
- Department of Nutrition, Federal University of Minas Gerais School of Nursing, Belo Horizonte, MG, 30.130-100, Brazil
| | - Júnia Maria Geraldo Gomes
- Federal Institute of Education, Science and Technology of the Southeast of Minas Gerais-Campus Barbacena-IF Sudeste MG, Barbacena, MG, 36.205-018, Brazil
| |
Collapse
|
2
|
Al Dhaheri AS, Alkhatib DH, Feehan J, Cheikh Ismail L, Apostolopoulos V, Stojanovska L. The Effect of Therapeutic Doses of Culinary Spices in Metabolic Syndrome: A Randomized Controlled Trial. Nutrients 2024; 16:1685. [PMID: 38892617 PMCID: PMC11175078 DOI: 10.3390/nu16111685] [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: 04/04/2024] [Revised: 05/15/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
Non-communicable diseases (NCDs) place a significant burden on global health and the healthcare systems which support it. Metabolic syndrome is a major risk factor for a large number of NCDs; however, treatments remain limited. Previous research has shown the protective benefits of edible dietary spices on key components of metabolic syndrome. Therefore we performed a 12-week double-blind, placebo-controlled, randomized, clinical trial to evaluate the effect of ginger (Zingiber officinale), cinnamon (Cinnamomum), and black seed (Nigella sativa) consumption on blood glucose, lipid profiles, and body composition in 120 participants with, or at risk of, metabolic syndrome. Each participant consumed 3 g/day of powder (spice or placebo). Data related to different parameters were collected from participants at the baseline, midpoint, and endpoint of the intervention. Over the 12-week interventions, there was an improvement in a number of biochemical indices of metabolic syndrome, including fasting blood glucose, HbA1c, LCL, and total cholesterol associated with supplementation with the spices when compared to a placebo. This study provides evidence to support the adjunct use of supplementation for those at risk of metabolic syndrome and its sequelae.
Collapse
Affiliation(s)
- Ayesha S. Al Dhaheri
- Department of Nutrition & Health Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (D.H.A.); (L.S.)
| | - Dana Hasan Alkhatib
- Department of Nutrition & Health Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (D.H.A.); (L.S.)
| | - Jack Feehan
- Institute for Health and Sport, Victoria University, Melbourne, VIC 8001, Australia; (J.F.); (V.A.)
| | - Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates;
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford OX1 2JD, UK
| | - Vasso Apostolopoulos
- Institute for Health and Sport, Victoria University, Melbourne, VIC 8001, Australia; (J.F.); (V.A.)
- Immunology Program, Australian Institute of Musculoskeletal Science (AIMSS), Melbourne, VIC 3021, Australia
| | - Lily Stojanovska
- Department of Nutrition & Health Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; (D.H.A.); (L.S.)
- Institute for Health and Sport, Victoria University, Melbourne, VIC 8001, Australia; (J.F.); (V.A.)
| |
Collapse
|
3
|
Bakhach H, Nuffer M, Tall Bull S, Nuffer W. A Systematic Review Evaluating Cinnamon's Effects on Glucose Utilizing a Ranking System to Assess Bias and Study Quality. J Med Food 2024. [PMID: 38466959 DOI: 10.1089/jmf.2023.0277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
In the context of diabetes, the use of cinnamon continues to be among the most popular supplements taken by patients for glucose control. To strategically evaluate the available literature comparing various cinnamon species and statistically significant glucose effects after ranking studies based on two tools to assess bias and overall study quality, to clarify cinnamon's role in glucose control. The authors performed a systematic search based upon PRISMA guidelines. The search was conducted utilizing PubMed, AMED, CINAHL, EMBASE, Cochrane, and Medline databases, with the final search performed in September 2022 with restrictions to human subjects and English language. Electronic searches were conducted utilizing the keywords "diabetes mellitus" combined with Cinnamomum zeylanicum/Cinnamomum cassia/Cinnamomum verum combined with blood glucose (BG). A second search utilized "cinnamomum zeylanicum/cinnamomum cassia/cinnamomum verum" combined with "blood glucose," and a final search utilized "diabetes mellitus" combined with "cinnamon." Data extraction and ranking of included studies utilizing the risk of bias 2 tool and modified Heyland Methodological Quality Scoring tool were performed independently by two review authors. These authors compared their results and reconciled any differences in scoring to generate a final ranking of studies. A third author was available for any discrepancies that could not be resolved but was not needed. Forty-five studies were included in the review and were scored for bias and quality. Overall 62% demonstrated statistical significance for positive effects in at least one parameter around BG control. Applying the ranking systems reduced the percentage closer to 50%. Safety was extremely well documented across studies with few adverse effects. Results are limited by heterogeneity of glucose parameters, leading to studies being ranked individually and not synthesized. Cinnamon supplementation likely has a modest positive effect on BG. Based upon the strong safety profile, utilization of this spice as an adjunct to pharmacologic therapy is reasonable.
Collapse
Affiliation(s)
- Hebat Bakhach
- Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA
| | - Monika Nuffer
- Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA
| | - Shasta Tall Bull
- Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA
| | - Wesley Nuffer
- Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA
| |
Collapse
|
4
|
Zelicha H, Yang J, Henning SM, Huang J, Lee RP, Thames G, Livingston EH, Heber D, Li Z. Effect of cinnamon spice on continuously monitored glycemic response in adults with prediabetes: a 4-week randomized controlled crossover trial. Am J Clin Nutr 2024; 119:649-657. [PMID: 38290699 DOI: 10.1016/j.ajcnut.2024.01.008] [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: 07/03/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Previous clinical studies showing that cinnamon spice lowers blood glucose concentrations had inconsistent results. OBJECTIVES To determine the effect of daily cinnamon spice supplementation in an amount commonly used for seasoning on glucose concentrations in adults with obesity and prediabetes. METHODS Following a 2-wk run-in period of maintaining a low polyphenol/fiber diet, 18 participants with obesity and prediabetes underwent a 10-wk randomized, controlled, double-blind, crossover trial (mean age 51.1 y; mean fasting plasma glucose 102.9 mg/dL). The participants were randomly assigned to take cinnamon (4 g/d) or placebo for 4-wk, followed by a 2-wk washout period, and then crossed over to the other intervention for an additional 4-wk. Glucose changes were measured with continuous glucose monitoring. Oral glucose tolerance testing immediately following ingestion of cinnamon or placebo was performed at 4-time points to assess their acute effects both at the baseline and end of each intervention phase. Digestive symptom logs were obtained daily. RESULTS There were 694 follow-up days with 66,624 glucose observations. When compared with placebo, 24-h glucose concentrations were significantly lower when cinnamon was administered [mixed-models; effect size (ES) = 0.96; 95 % confidence interval (CI): -2.9, -1.5; P < 0.001]. Similarly, the mean net-area-under-the-curve (netAUC) for glucose was significantly lower than for placebo when cinnamon was given (over 24 h; ES = -0.66; 95 % CI: 2501.7, 5412.1, P = 0.01). Cinnamon supplementation resulted in lower glucose peaks compared with placebo (Δpeak 9.56 ± 9.1 mg/dL compared with 11.73 ± 8.0 mg/dL; ES = -0.57; 95 % CI: 0.8, 3.7, P = 0.027). Glucose-dependent-insulinotropic-polypeptide concentrations increased during oral glucose tolerance testing + cinnamon testing (mixed-models; ES = 0.51; 95 % CI: 1.56, 100.1, P = 0.04), whereas triglyceride concentrations decreased (mixed-models; ES = 0.55; 95 % CI: -16.0, -1.6, P = 0.02). Treatment adherence was excellent in both groups (cinnamon: 97.6 ± 3.4 % compared with placebo: 97.9 ± 3.7 %; ES = -0.15; 95 % CI: -1.8, 0.2, P = 0.5). No differences were found in digestive symptoms (abdominal pain, borborygmi, bloating, excess flatus, and stools/day) between cinnamon and placebo groups. CONCLUSIONS Cinnamon, a widely available and low-cost supplement, may contribute to better glucose control when added to the diet in people who have obesity-related prediabetes. This trial was registered at clinicaltrials.gov as NCT04342624.
Collapse
Affiliation(s)
- Hila Zelicha
- Department of Surgery, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jieping Yang
- Department of Medicine, Center for Human Nutrition, David Geffen School of Medicine, Los Angeles, United States
| | - Susanne M Henning
- Department of Medicine, Center for Human Nutrition, David Geffen School of Medicine, Los Angeles, United States
| | - Jianjun Huang
- Department of Medicine, Center for Human Nutrition, David Geffen School of Medicine, Los Angeles, United States
| | - Ru-Po Lee
- Department of Medicine, Center for Human Nutrition, David Geffen School of Medicine, Los Angeles, United States
| | - Gail Thames
- Department of Medicine, Center for Human Nutrition, David Geffen School of Medicine, Los Angeles, United States
| | - Edward H Livingston
- Department of Surgery, University of California, Los Angeles, Los Angeles, CA, United States
| | - David Heber
- Department of Medicine, Center for Human Nutrition, David Geffen School of Medicine, Los Angeles, United States
| | - Zhaoping Li
- Department of Medicine, Center for Human Nutrition, David Geffen School of Medicine, Los Angeles, United States.
| |
Collapse
|
5
|
Moridpour AH, Kavyani Z, Khosravi S, Farmani E, Daneshvar M, Musazadeh V, Faghfouri AH. The effect of cinnamon supplementation on glycemic control in patients with type 2 diabetes mellitus: An updated systematic review and dose-response meta-analysis of randomized controlled trials. Phytother Res 2024; 38:117-130. [PMID: 37818728 DOI: 10.1002/ptr.8026] [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: 02/12/2023] [Revised: 08/20/2023] [Accepted: 09/18/2023] [Indexed: 10/13/2023]
Abstract
Although many randomized controlled trials (RCTs) have revealed the benefits of cinnamon on type 2 diabetes mellitus (T2DM), the effects of cinnamon supplementation on glycemic control in patients with T2DM are inconclusive. Therefore, the aim of this meta-analysis of RCTs was to assess the effects of cinnamon supplementation in managing glycemic control in patients with T2DM. Scientific international databases including Scopus, Web of Sciences, PubMed, Embase, and the Cochrane Library were searched till December 2022. For net changes in glycemic control, standard mean differences (SMDs) were calculated using random-effects models. Findings from 24 RCTs revealed that cinnamon supplementation had a statistically significant reduction in fasting blood sugar (SMD: -1.32; 95% CI: -1.77, -0.87, p < 0.001), Homeostatic Model Assessment for Insulin Resistance (SMD: -1.32; 95% CI: -1.77, -0.87, p < 0.001), and hemoglobin A1C (SMD: -0.67; 95% CI: -1.18, -0.15, p = 0.011) compared with the control group in patients with T2DM. Additionally, cinnamon did not change the serum levels of insulin (SMD: -0.17; 95% CI: -0.34, 0.01, p = 0.058) significantly. Our analysis indicated that glycemic control indicators are significantly decreased by cinnamon supplementation. Together, these findings support the notion that cinnamon supplementation might have clinical potential as an adjunct therapy for managing T2DM.
Collapse
Affiliation(s)
| | - Zeynab Kavyani
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Somaye Khosravi
- Department of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Vali Musazadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Hossein Faghfouri
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
| |
Collapse
|
6
|
Sarmadi B, Musazadeh V, Dehghan P, Karimi E. The effect of cinnamon consumption on lipid profile, oxidative stress, and inflammation biomarkers in adults: An umbrella meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis 2023; 33:1821-1835. [PMID: 37500345 DOI: 10.1016/j.numecd.2023.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 03/11/2023] [Accepted: 03/13/2023] [Indexed: 07/29/2023]
Abstract
AIMS Cinnamon is a polyphenol-rich spice that has beneficial effects on markers of cardio metabolic health such as lipid profile, oxidative stress, and inflammation. Despite the accumulating evidence from meta-analyses on the effects of cinnamon on these markers, their findings are controversial. Thus, this umbrella meta-analysis was performed to evaluate the present evidence and provide a conclusive clarification. DATA SYNTHESIS We searched the following international databases from inception to January 2022: PubMed, Scopus, Web of Science and Embase, and Google Scholar. Our findings of eleven meta-analyses showed that cinnamon consumption can significantly improve total cholesterol (TC) (WMD = -1.01 mg/dL; 95% CI: -2.02, -0.00, p = 0.049), low-density lipoprotein-cholesterol (LDL-C) (WMD = -0.82 mg/dL; 95% CI: -1.57, -0.07, p = 0.032), and high-density lipoprotein-cholesterol (HDL-C) (WMD = 0.47 mg/dL; 95% CI: 0.17, 0.77, p = 0.002) levels but not triglyceride (TG) levels (WMD = -0.13 mg/dL; 95% CI: -0.58, 0.32, p = 0.570). Our results did not show any significant effect of cinnamon on malondialdehyde (MDA) levels (WMD = -0.47; 95% CI: -0.99, 0.05, p = 0.078) and C-reactive protein (CRP) levels (WMD = -1.33; 95% CI: -2.66, 0.00, p = 0.051) but there was enhanced total antioxidant capacity (TAC) in patients with type 2 diabetes (T2DM) and polycystic ovary syndrome (PCOS) (WMD = 0.34; 95% CI: 0.04, 0.64, p = 0.026) and increased levels of interleukin-6 (WMD = -1.48; 95% CI: -2.96, -0.01, p = 0.049). CONCLUSIONS Our results support the usefulness of cinnamon intake in modulating an imbalanced lipid profile in some metabolic disorders, particularly PCOS, as well as in improving TAC and interleukin-6. The review protocol was registered on PROSPERO as CRD42022358827.
Collapse
Affiliation(s)
- Bahareh Sarmadi
- Department of Nutrition Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Vali Musazadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Parvin Dehghan
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Elham Karimi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
7
|
Kumar S, Sharma SK, Mudgal SK, Gaur R, Agarwal R, Singh H, Kalra S. Comparative effectiveness of six herbs in the management of glycemic status of type 2 diabetes mellitus patients: A systematic review and network meta-analysis of randomized controlled trials. Diabetes Metab Syndr 2023; 17:102826. [PMID: 37451111 DOI: 10.1016/j.dsx.2023.102826] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND AND AIMS There are several herbal formulations for type 2 diabetes (T2D), but many of them have never been directly compared to establish the most effective methods. Therefore, the present systematic review and network meta-analysis aimed to compare and rank the effects of herbal formulations by combining direct and indirect evidence on the management of type 2 diabetes. METHODS From five electronic databases, relevant studies on the effectiveness of herbal formulations for glycemic status for people with type 2 diabetes were retrieved. Only randomized controlled trials that were published in English and looked at how herbal formulations affected adults' (>18-year-old) glycemic levels were included. A systematic review and network meta-analysis design with the random-effects model was used. RESULTS A total of 44 trials included 3130 participants on six herbs were included in the final analysis. Apple cider vinegar (ACV) (standardized mean difference (SMD) = -28.99), cinnamon (-9.73), curcumin (-13.15), and fenugreek (-19.64) significantly reduced fasting blood glucose (FBG) compared with placebo (all p < 0.05). Notably, only ACV (SMD = -2.10) and fenugreek seeds (0.84) were found significantly effective in reducing HbA1C. ACV was most effective herb to reduce FBG comparison with other herbs. CONCLUSIONS Several herbs could be considered as a valuable adjuvant therapy regarding glycemic control of type 2 diabetes patients. Health professionals should be encouraged to incorporate these herbs for the management of type 2 diabetes as part of their standard care.
Collapse
Affiliation(s)
- Subodh Kumar
- Department of Pharmacology, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.
| | - Suresh K Sharma
- College of Nursing, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
| | - Shiv Kumar Mudgal
- College of Nursing, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.
| | - Rakhi Gaur
- College of Nursing, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.
| | - Rajat Agarwal
- Department of Cardiothoracic Surgery, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.
| | - Harminder Singh
- Department of Pharmacology, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital and BRIDE, Karnal, Haryana, India.
| |
Collapse
|
8
|
Yu T, Lu K, Cao X, Xia H, Wang S, Sun G, Chen L, Liao W. The Effect of Cinnamon on Glycolipid Metabolism: A Dose-Response Meta-Analysis of Randomized Controlled Trials. Nutrients 2023; 15:2983. [PMID: 37447309 DOI: 10.3390/nu15132983] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
(1) Background: The effect of cinnamon on the regulation of glycolipid levels in type 2 diabetic patients is still controversial, and there is a lack of research on the dose-response relationship between cinnamon and glycolipid indicators in type 2 diabetic patients. (2) Methods: This dose-response meta-analysis was performed to explore the effect of the cinnamon intervention on glycolipid metabolism. We conducted a comprehensive database search for literature published before November 2022. Nonlinear models were used for dose-response relationship analysis. (3) Results: We identified that a cinnamon intervention was effective in controlling triglyceride (TG) levels (mean difference = -7.31; 95%CI: -12.37, -2.25, p = 0.005) and low-density lipoprotein cholesterol (LDL-C) levels (mean difference = -6.78; 95%CI: -11.35, -2.22, p = 0.004) in type 2 diabetic patients; however, it also was able to increase high-density lipoprotein cholesterol (HDL-C) levels in patients with type 2 diabetes (mean difference = 1.53; 95%CI: 1.01, 2.05, p < 0.001). However, the cinnamon intervention had no significant effect on the level of fasting blood glucose, glycated hemoglobin (HbA1c), or total cholesterol (TC) levels. We found a significant effect of the cinnamon intervention dose on the TG level (p-nonlinearity = 0.016) and LDL-C (p-nonlinearity = 0.019) in the nonlinear dose-response analysis. In the subgroup analysis, we found a hypoglycemic effect with the cinnamon dose ≤1200 mg (mean difference = -11.1, 95%CI: -14.64, -7.58, p < 0.001). (4) Conclusion: Cinnamon intervention may be beneficial in lowering TG and LDL-C levels while enhancing HDL-C levels, and the dosage of the intervention was an important factor in influencing the TG and LDL-C levels.
Collapse
Affiliation(s)
- Tingqing Yu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China
| | - Kun Lu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China
| | - Xinyi Cao
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China
| | - Hui Xia
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China
| | - Shaokang Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China
| | - Guiju Sun
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China
| | - Liang Chen
- Public Service Platform of South China Sea for R&D Marine Biomedicine Resources, The Marine Biomedical Research Institute, Guangdong Medical University, Zhanjiang 524023, China
| | - Wang Liao
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China
| |
Collapse
|
9
|
Delgadillo-Centeno JS, Grover-Páez F, Hernández-González SO, Ramos-Zavala MG, Cardona-Müller D, López-Castro A, Pascoe-González S. Cinnamomum cassia on Arterial Stiffness and Endothelial Dysfunction in Type 2 Diabetes Mellitus: Outcomes of a Randomized, Double-Blind, Placebo-Controlled Clinical Trial. J Med Food 2023. [PMID: 37262194 DOI: 10.1089/jmf.2022.0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
Cinnamomum cassia is a medicinal plant whose use has demonstrated benefits on body weight, blood pressure, glucose, and lipids. This study aimed to evaluate the effect of C. cassia on arterial stiffness and endothelial dysfunction (ED) in patients with type 2 diabetes mellitus (T2DM). A randomized, double-blind, placebo-controlled clinical trial was carried out in 18 subjects aged 40-65 years, with a diagnosis of T2DM of one year or less since diagnosis and treated with Metformin 850 mg daily. Patients were randomly assigned to receive either C. cassia or a placebo in 1000 mg capsules, thrice a day, before each meal for 12 weeks. At baseline and after 12 weeks of intervention, brachial-ankle pulse wave velocity and Flow Mediated Dilation were measured, as well as body weight, body mass index (BMI), blood pressure (BP), fasting glucose (FG), glycated hemoglobin A1c (HbA1c), total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, and very low density lipoprotein cholesterol, respectively, triglycerides, creatinine, and transaminases. The Mann-Whitney U test for differences between groups and the Wilcoxon signed-rank test for intragroup differences were used, and a P ≤ .05 was considered statistically significant. After C. cassia administration, statistically significant reductions in body weight (81.4 ± 10.4 kg vs. 79.9 ± 9.0 kg, P = .037), BMI (30.6 ± 4.2 kg/m2 vs. 30.1 ± 4.2 kg/m2, P = .018), and HbA1c (53 ± 5.4 mmol/mol vs. 45 ± 2.1 mmol/mol, P = .036) were observed. No changes statistically significant on arterial stiffness, ED, FG, BP, and lipids were observed. C. cassia administration decreases body weight, BMI, and HbA1c without statistically significant changes on arterial stiffness, ED, FG, BP, and lipids. CTR Number: NCT04259606.
Collapse
Affiliation(s)
- Jesús S Delgadillo-Centeno
- Instituto de Terapéutica Experimental y Clínica (INTEC), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara, Jalisco, México
| | - Fernando Grover-Páez
- Instituto de Terapéutica Experimental y Clínica (INTEC), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara, Jalisco, México
| | - Sandra O Hernández-González
- Unidad de Investigación Biomédica 02. Instituto Mexicano del Seguro Social (IMSS), Centro Médico Nacional de Occidente, Unidad Médica de Alta Especialidad (UMAE), Hospital de Especialidades, Guadalajara, Jalisco, México
| | - María G Ramos-Zavala
- Instituto de Terapéutica Experimental y Clínica (INTEC), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara, Jalisco, México
| | - David Cardona-Müller
- Instituto de Terapéutica Experimental y Clínica (INTEC), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara, Jalisco, México
| | - Alicia López-Castro
- Unidad de Investigación Biomédica 02. Instituto Mexicano del Seguro Social (IMSS), Centro Médico Nacional de Occidente, Unidad Médica de Alta Especialidad (UMAE), Hospital de Especialidades, Guadalajara, Jalisco, México
| | - Sara Pascoe-González
- Instituto de Terapéutica Experimental y Clínica (INTEC), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara, Jalisco, México
| |
Collapse
|
10
|
Li W, Qiao J, Lin K, Sun P, Wang Y, Peng Q, Ye X, Liu W, Sun B. Ethyl-acetate fraction from a cinnamon-cortex extract protects pancreatic β-cells from oxidative stress damage. Front Pharmacol 2023; 14:1111860. [PMID: 36950010 PMCID: PMC10025376 DOI: 10.3389/fphar.2023.1111860] [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: 11/30/2022] [Accepted: 02/24/2023] [Indexed: 03/08/2023] Open
Abstract
Background: The pathogenesis of diabetes mellitus is mediated mainly by oxidative stress produced by damaged pancreatic β-cells. We identified that an ethyl-acetate fraction (EA) from a cinnamon-cortex extract (CCE) is rich in flavonoid, and showed no toxicity to β cells. Objective: In this study, we evaluated the pharmacologic activities of EA on pancreatic β cells using a model of oxidative stress induced by H2O2 or alloxan. Results: The results showed that EA could significantly reduce reactive oxygen (ROS) accumulation to improve the survival of cells. Western blot showed that EA treatment upregulated expression of nuclear factor erythroid 2 related factor 2, heme oxygenase-1, and gamma glutamylcysteine synthetase. The same model study found that EA also can protect β cells against the apoptosis induced by oxidative stress. Furthermore, EA can enhance insulin secretion in rat and mouse β cell lines treated or not with alloxan or H2O2. The expression of the insulin transcription factor PDX-1 increased in an EA concentration-dependent manner. At last, the major functional compounds of EA analysis showed that three compounds, cinnamyl alcohol, coumarin, and cinnamic acid, had similar effects as EA. Conclusions: In sum, our data suggested that EA fraction from CCE can protect β cells from oxidative stress, and increase insulin secretion to improve the function of β cells. This function might be due to these three compounds found in EA. Our findings provide a theoretical basis and functional molecules for the use of CCE against diabetes mellitus.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Wei Liu
- *Correspondence: Binlian Sun, ; Wei Liu,
| | | |
Collapse
|
11
|
Nuffer W, Tall Bull S, Bakhach H, Nuffer M. Sweetly Improving Sugars? Reviewing Cinnamon's Effects on Blood Glucose. J Med Food 2023; 26:68-73. [PMID: 36206028 DOI: 10.1089/jmf.2022.0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Cinnamon is a spice that has been used in various cultures for centuries for its potential health benefits. While there are health claims for a variety of health conditions, it has continuously been explored for its ability to improve glucose handling in diabetes. Cinnamon is a very popular supplement used by patients with diabetes to help normalize blood glucose levels. A systematic review of the literature was conducted to assess the available evidence evaluating effects on diabetes and glucose handling with the use of various species of cinnamon. The intention was to summarize the existing evidence for cinnamon's effects on blood glucose, both for safety and efficacy, to help guide providers and consumers alike. Reviewing the available literature for the different types of cinnamon and their effects on the diabetes disease process, there are multiple proposed mechanisms for how cinnamon could improve diabetes, including increasing insulin sensitivity by multiple receptor signaling pathways, reducing inflammation, enhancing glucose uptake by effects on glucose transporter proteins, and effects on gastric emptying, and blocking glucose absorption. There appears to be conflicting evidence on whether cinnamon produces any significant effect on glucose parameters, and the extent of these effects. There are several variables that could explain these conflicting data, such as patient sample size, doses and formulations of cinnamon used, baseline patient characteristics, and study duration. A more in-depth evaluation and rating of the available evidence could help clarify this, but data suggest that in some circumstances, cinnamon may have modest effects on improving glucose handling in adults. The safety profile also has been demonstrated to be extremely favorable, with very few adverse events reported in the active treatment groups across all studies. Based upon these data, clinicians should consider cinnamon to be a potential adjunctive therapy to traditional diabetes treatments, and should be open to discussing this with patients expressing interest in the supplement.
Collapse
Affiliation(s)
- Wesley Nuffer
- Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA
| | - Shasta Tall Bull
- Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA
| | - Hebat Bakhach
- Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA
| | - Monika Nuffer
- Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA
| |
Collapse
|
12
|
Wijewardhana U, Jayasinghe M, Wijesekara I, Ranaweera KKDS. Zingiber officinale, Phyllanthus emblica, Cinnamomum verum, and Curcuma longa to Prevent Type 2 Diabetes: An Integrative Review. Curr Diabetes Rev 2023; 19:e241122211183. [PMID: 36424773 DOI: 10.2174/1573399819666221124104401] [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: 06/28/2022] [Revised: 10/11/2022] [Accepted: 10/21/2022] [Indexed: 11/27/2022]
Abstract
Diabetes mellitus has become a global pandemic progressively rising and affecting almost every household in all world regions. Diet is a significant root cause of type II diabetes; thus, the significance of dietary interventions in preventing and managing the disease cannot be neglected. Lowering the glycemic impact of diet is an alternative way of managing type II diabetes while improving insulin sensitivity. Medicinal plants are rich in therapeutic phytochemicals which possess hypoglycemic properties. Therefore, it could be speculated that the glycemic impact of diet can be reduced by adding hypoglycemic plant ingredients without altering the sensory properties of food. The main aim of this review is to discuss dietary interventions to manage diabetes and summarize available information on the hypoglycemic properties of four prime herbs of Asian origin. This article collected, tabulated, and summarized groundbreaking reveals from promising studies. This integrative review provides information on the hypoglycemic properties of ginger, Indian gooseberry, cinnamon, and turmeric and discusses the possibility of those herbs reducing the glycemic impact of a diet once incorporated. Further research should be done regarding the incorporation of these herbs successfully into a regular diet.
Collapse
Affiliation(s)
- Uththara Wijewardhana
- Department of Food Science and Technology, Faculty of Applied Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Madhura Jayasinghe
- Department of Food Science and Technology, Faculty of Applied Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Isuru Wijesekara
- Department of Food Science and Technology, Faculty of Applied Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - K K D S Ranaweera
- Department of Food Science and Technology, Faculty of Applied Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| |
Collapse
|
13
|
Nishikai-Shen T, Hosono-Fukao T, Ariga T, Hosono T, Seki T. Cinnamon extract improves abnormalities in glucose tolerance by decreasing Acyl-CoA synthetase long-chain family 1 expression in adipocytes. Sci Rep 2022; 12:12574. [PMID: 35869105 PMCID: PMC9307619 DOI: 10.1038/s41598-022-13421-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 05/24/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractWe previously demonstrated that cinnamon extract (CE) alleviates streptozotocin-induced type 1 diabetes in rats. The present study aimed to elucidate the detailed molecular target of cinnamon in cultured adipocytes and epididymal adipose tissue of type 2 diabetes model mice. Two-dimensional gel electrophoresis was employed to determine the molecular target of cinnamon in adipocytes. The function of Acyl-CoA synthetase long-chain family-1 (ACSL1), a molecular target of cinnamon that was identified in this study, was further investigated in 3T3-L1 adipocytes using specific inhibitors. Type 2 diabetes model mice (KK-Ay/TaJcl) were used to investigate the effect of CE on glucose tolerance, ACSL1 expression, and related signal molecules in vivo. CE decreased ACSL1 mRNA and protein expression in 3T3-L1 adipocytes but increased glucose uptake and AMPK signaling activation; moreover, a similar effect was observed with an ACSL1 inhibitor. CE improved glucose tolerance and downregulated ACSL1 in mice adipose tissue in vivo. ACSL1 was demonstrated as a molecular target of CE in type 2 diabetes both in a cell culture system and diabetic mouse model.
Collapse
|
14
|
Zhou Q, Lei X, Fu S, Li Z, Chen Y, Long C, Li S, Chen Q. Efficacy of cinnamon supplementation on glycolipid metabolism in T2DM diabetes: A meta-analysis and systematic review. Front Physiol 2022; 13:960580. [PMID: 36505061 PMCID: PMC9731104 DOI: 10.3389/fphys.2022.960580] [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: 06/22/2022] [Accepted: 10/28/2022] [Indexed: 11/27/2022] Open
Abstract
Background: Cinnamon is a spice used in cooking and in large quantities as a medical complement with hypoglycemic and lipid-lowering properties. The potential pharmacological mechanisms underlying cinnamon's anti-diabetic properties and its active ingredients have not been adequately determined. The current meta-analysis aims to systematically review the potential pharmacological mechanisms underlying the hypoglycemic and hypolipidemic efficacy of cinnamon administration and summarize clinical recommendations of cinnamon and its active ingredients. Method: Relevant randomized clinical trials (RCTs) were identified through a literature search that spanned the years January 2005 to April 2022. Retrieve electronic databases including Web of Science, PubMed, Embase, Medline, and the Cochrane Library. To obtain standardized mean differences (SMDs), continuous outcomes were pooled and 95 percent confidence intervals (CIs) were provided. Categorical outcomes were aggregated to calculate relative risks (RRs) and were accompanied by 95% CIs. Heterogeneity was measured using the Cochrane Q-test and I2 statistics, with a p < 0.05 considered as substantial heterogeneity. If I2 was less than 50%, a fixed effect model was employed; otherwise, a random effect model was used. Subgroup analyses and sensitivity analyses were performed to identify the origins of heterogeneity. Publication bias was retrieved by means of a funnel-plot analysis and Egger's test. The data were analyzed using revman (V.5.3) and stata (V.15) software packages. Results: These 16 RCTs included a total of 1,020 patients who were followed for a duration ranging from 40 days to 4 months. According to the current meta-analysis results, glycolipid levels in diabetic individuals who received cinnamon were significantly improved as compared to those who got placebo (All p < 0.05). An adverse effect was only detected in one patient. Conclusion: These findings imply that cinnamon has a significant influence on lipid and glucose metabolism regulation. An even more pronounced effect was observed in patients with HbA1c of 8%. The results of this study suggested that cinnamon may be utilized as hypoglycemic and lipid-lowering supplement in clinical settings with a guaranteed safety profile.Systematic Review Registration: [PROSPERO], identifier [CRD42022322735].
Collapse
|
15
|
Abedelmalek S, Aloui K, Boussetta N, Alahmadi B, Zouch M, Chtourou H, Souissi N. Does Opuntia ficus-indica Juice Supplementation Improve Biochemical and Cardiovascular Response to a 6-Minute Walk Test in Type 2 Diabetic Patients? MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1561. [PMID: 36363518 PMCID: PMC9696711 DOI: 10.3390/medicina58111561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 10/03/2022] [Accepted: 10/06/2022] [Indexed: 11/11/2022]
Abstract
Background and objectives: The purpose of this study was to evaluate the effect of Opuntia ficus-indica juice (OFIJ) on performance and biochemical and physiological responses to a 6 min walking test (6MWT) in diabetic patients. Materials and Methods: Twenty diabetic patients performed a 6MWT at 07:00 h. During each test session, they were asked to drink 70 mL/day of natural OFIJ or placebo (PLA) for 4 days. Results: the results showed that cardiovascular parameters increased significantly after the 6MWT under both conditions. While, cortisol, HbA1c, cholesterol total (CT), triglycerides (TG), as well as low-density lipoprotein (LDL) were not modified between without and with supplementation. Likewise, no significant variation in performance was observed for PLA and OFIJ (p > 0.05). The cardiovascular parameters (heart rate max (HRmax), diastolic blood pressure (DBP), and systolic blood pressure (SBP)), lipid profile (CT, TG, LDL, and high-density lipoprotein HDL), hormonal parameters (insulin and glucagon), HbA1c and lactate ([La]) did not present any significant modification either between PLA or OFIJ (p > 0.05). Muscle-damage markers (creatine kinase (CK) and lactate dehydrogenase (LDH)], cortisol, and liver parameters (i.e., oxidative stress marker, γGT, and total bilirubin) as well as glucose (GLC) were affected by supplementation (p < 0.05) before and after the 6MWT, but this change was significant only for OFIJ (p < 0.05). Conclusion: OFIJ had an antioxidant capacity, improved performance of the 6MWT, and reduced muscle-damage markers and glucose level in type 2 diabetic patients.
Collapse
Affiliation(s)
- Salma Abedelmalek
- Laboratory of Physiology and Functional Exploration, Faculty of Medicine, Sousse 4002, Tunisia
- Department of Sport Science and Physical Activity, College of Education, University of Ha’il, Hail 55255, Saudi Arabia
| | - Khouloud Aloui
- Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis 1003, Tunisia
| | - Nesrine Boussetta
- Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis 1003, Tunisia
| | - Bayan Alahmadi
- Department of Sport Science and Physical Activity, College of Education, University of Ha’il, Hail 55255, Saudi Arabia
| | - Mohamed Zouch
- Laboratory of Physiology and Functional Exploration, Faculty of Medicine, Sousse 4002, Tunisia
- Department of Sport Science and Physical Activity, College of Education, University of Ha’il, Hail 55255, Saudi Arabia
| | - Hamdi Chtourou
- Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis 1003, Tunisia
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia
| | - Nizar Souissi
- Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis 1003, Tunisia
| |
Collapse
|
16
|
A Phase II, Randomized, Double-Blind, Double-Dummy, Active-Controlled Clinical Trial to Investigate the Efficacy and Safety of NW Low-Glu® in Patients Newly Diagnosed with Type 2 Diabetes Mellitus. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:9176026. [PMID: 36204125 PMCID: PMC9532066 DOI: 10.1155/2022/9176026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/05/2022] [Indexed: 11/29/2022]
Abstract
Background Medicinal plants have long been used for the treatment of type 2 diabetes mellitus (T2DM). This study aimed to investigate the hypoglycemic efficacy and safety of NW Low-Glu® (contents of one capsule are 300 mg Mas Cotek + 100 mg Cinnamomum cassia L. + 250 mg Nigella sativa L. powdered extracts) in treatment-naïve, newly diagnosed T2DM patients. Methods This was a 12-week, double-blind, double-dummy, randomized, phase 2 clinical trial. A total of 232 male and female patients aged ≥18 and ≤65 years who were newly diagnosed with T2DM and have not received any antidiabetic drugs before and were equally randomized to receive metformin (2000 mg per day), low-dose NW Low-Glu® (content of four capsules per day), or high-dose NW Low-Glu® (content of five capsules per day). Our primary objective was to measure the mean change in HbA1c between each of the experimental arms and the metformin arm. Results There was a significant reduction in mean HbA1c at 12 weeks compared to baseline in the low-dose (0.6 (1.4)%; p=0.002) and high-dose arms (0.8 (1.7)%; p=0.004). There was also a significant reduction in 2 hr PPG at 12 weeks in the low-dose (35.4 (74.9) mg/dL, p=0.001) and high-dose arms (24.7 (100.8) mg/dL, p=0.04). Weight reduction was significantly higher with both high-dose (1.1 (−1.7) Kg; p=0.005) and low-dose arms (0.9 (−1.5) Kg; p=0.023) compared to metformin (0.8 (−1.8) Kg). No serious AEs or deaths were reported. Conclusions After 3 months of treatment, NW Low-Glu® was noninferior to metformin in reducing HbA1c and 2 hr PPG, while leading to significantly higher weight reduction in newly diagnosed T2DM patients. It was also safe and well tolerated.
Collapse
|
17
|
A Critical Review on Role of Available Synthetic Drugs and Phytochemicals in Insulin Resistance Treatment by Targeting PTP1B. Appl Biochem Biotechnol 2022; 194:4683-4701. [PMID: 35819691 DOI: 10.1007/s12010-022-04028-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2022] [Indexed: 11/02/2022]
Abstract
Insulin resistance (IR) is a condition of impaired response of cells towards insulin. It is marked by excessive blood glucose, dysregulated insulin signalling, altered pathways, damaged pancreatic β-cells, metabolic disorders, etc. Chronic hyperglycemic conditions leads to type 2 diabetes mellitus (T2DM) which causes excess generation of highly reactive free radicals, causing oxidative stress, further leading to development and progression of complications like vascular dysfunction, damaged cellular proteins, and DNA. One of the causes for IR is dysregulation of protein tyrosine phosphatase 1B (PTP1B). Advancements in drug therapeutics have helped people manage IR by regulating PTP1B, however have been reported to cause side effects. Therefore, there is a growing interest on usage of phytochemical constituents having IR therapeutic properties and aiding to minimize these complications. Medicinal plants have not been utilized to their full potential as a therapeutic drug due to lack of knowledge of their active and effective chemical constituents, mode of action, regulation of IR parameters, and dosage of administration. This review highlights phytochemical constituents present in medicinal plants or spices, their potential effectiveness on proteins (PTP1B) regulating IR, and reported possible mechanism of action studied on in vitro models. The study gives current knowledge and future recommendations on the above aspects and is expected to be beneficial in developing herbal drug using these phytochemical constituents, either alone or in combination, for medication of IR and diabetes.
Collapse
|
18
|
Silva ML, Bernardo MA, Singh J, de Mesquita MF. Cinnamon as a Complementary Therapeutic Approach for Dysglycemia and Dyslipidemia Control in Type 2 Diabetes Mellitus and Its Molecular Mechanism of Action: A Review. Nutrients 2022; 14:nu14132773. [PMID: 35807953 PMCID: PMC9269353 DOI: 10.3390/nu14132773] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/01/2022] [Accepted: 07/02/2022] [Indexed: 12/10/2022] Open
Abstract
The scientific evidence that cinnamon may exert beneficial effects on type 2 diabetes mellitus due to the biological activity of its bioactive compounds has been increasing in recent years. This review provides an overview of the effects of cinnamon on clinical parameters of diabetes and summarizes the molecular mechanisms of action of cinnamon on glucose and lipid metabolism. Search criteria include an electronic search using PubMed, Medline, and Cochrane Library databases. English literature references from 2000 up to 2022 were included. Following title and abstract review, full articles that met the inclusion criteria were included. The results from the available evidence revealed that cinnamon improved glycemic and lipidemic indicators. Clinical trials clarified that cinnamon also possesses an anti-inflammatory effect, which may act beneficially in diabetes. Based on in vitro and in vivo studies, cinnamon seems to elicit the regulation of glucose metabolism in tissues by insulin-mimetic effect and enzyme activity improvement. Furthermore, cinnamon seems to decrease cholesterol and fatty acid absorption in the gut. The current literature search showed a considerable number of studies on diabetic subjects. Some limitations in comparing published data should be highlighted, including variability in doses, extracts and species of cinnamon, administration forms, and antidiabetic therapy.
Collapse
Affiliation(s)
- Maria Leonor Silva
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511 Caparica, Portugal; (M.L.S.); (M.A.B.)
| | - Maria Alexandra Bernardo
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511 Caparica, Portugal; (M.L.S.); (M.A.B.)
| | - Jaipaul Singh
- School of Natural Sciences, University of Central Lancashire, Preston PR1 2HE, UK;
| | - Maria Fernanda de Mesquita
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz, Campus Universitário, Quinta da Granja, Monte de Caparica, 2829-511 Caparica, Portugal; (M.L.S.); (M.A.B.)
- Correspondence:
| |
Collapse
|
19
|
Wu T, Huang W, He M, Yue R. Effects of cinnamon supplementation on lipid profiles among patients with metabolic syndrome and related disorders: A systematic review and meta-analysis. Complement Ther Clin Pract 2022; 49:101625. [PMID: 35803022 DOI: 10.1016/j.ctcp.2022.101625] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/22/2022] [Accepted: 06/25/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND AND PURPOSE Studies in animals and humans have reported numerous beneficial effects of cinnamon. However, its hypolipidemic efficacy in patients with metabolic syndrome (MetS) and related disorders is still controversial. This meta-analysis aimed to evaluate the lipid-regulating effects and safety of cinnamon in a population with MetS and related disorders. METHODS Studies that met the inclusion criteria were retrieved from PubMed, Embase, Cochrane Library, and Web of Science. Randomized placebo-controlled trials of cinnamon or its extracts in the treatment of MetS and related metabolic diseases were the main eligibility criteria. The Cochrane Handbook was used to guide the study selection, quality assessment, and data analysis. All statistical analyses were performed using Stata 15.0. RESULTS Twelve studies involving 773 subjects were included in the meta-analysis. The overall results showed that cinnamon could significantly reduce total cholesterol (weighted mean difference [WMD]: -0.19 mmol/L [-7.34 mg/dL]; 95% confidence interval [CI]: -0.24, -0.14 [-9.27, -5.41]), triglyceride (WMD: -0.10 mmol/L [-8.85 mg/dL]; 95% CI: -0.16, -0.04 [-14.16, -3.54]), and low-density lipoprotein cholesterol (WMD: -0.16 mmol/L [-6.18 mg/dL]; 95% CI: -0.20, -0.11 [-7.72, -4.25]). In the subgroup analysis, cinnamon did not exhibit a significant effect on lipid profiles in European and American patients. Larger doses of cinnamon tended to exhibit better regulation of lipid profiles and high-dose cinnamon (≥1.5 g/d) significantly increased high-density lipoprotein cholesterol (WMD: 0.07 mmol/L [2.70 mg/dL]; 95% CI: 0.03, 0.11 [1.16, 4.25]). CONCLUSION The current evidence shows that cinnamon can regulate lipid profiles in patients with metabolic disorders.
Collapse
Affiliation(s)
- Tingchao Wu
- Chengdu Second People's Hospital, Chengdu, China.
| | - Wenhui Huang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| | - Mingmin He
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| | - Rensong Yue
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| |
Collapse
|
20
|
Chattopadhyay K, Wang H, Kaur J, Nalbant G, Almaqhawi A, Kundakci B, Panniyammakal J, Heinrich M, Lewis SA, Greenfield SM, Tandon N, Biswas TK, Kinra S, Leonardi-Bee J. Effectiveness and Safety of Ayurvedic Medicines in Type 2 Diabetes Mellitus Management: A Systematic Review and Meta-Analysis. Front Pharmacol 2022; 13:821810. [PMID: 35754481 PMCID: PMC9213670 DOI: 10.3389/fphar.2022.821810] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 04/07/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction: Many Ayurvedic medicines have the potential for managing type 2 diabetes mellitus (T2DM), with previous systematic reviews demonstrating effectiveness and safety for specific Ayurvedic medicines. However, many of the reviews need updating and none provide a comprehensive summary of all the Ayurvedic medicines evaluated for managing T2DM. Objective: The objective of this systematic review was to evaluate and synthesize evidence on the effectiveness and safety of Ayurvedic medicines for managing T2DM. Inclusion criteria: Published and unpublished RCTs assessing the effectiveness and safety of Ayurvedic medicines for managing T2DM in adults. Methods: The JBI systematic review methodology was followed. A comprehensive search of sources (including 18 electronic databases) from inception to 16 January 2021 was made. No language restrictions were applied. Data synthesis was conducted using narrative synthesis and random effects meta-analyses, where appropriate. Pooled results are reported as mean differences (MD) with 95% confidence intervals (CI). Results: Out of 32,519 records identified from the searches, 219 articles were included in the systematic review representing 199 RCTs (21,191 participants) of 98 Ayurvedic medicines. Overall, in the studies reviewed the methodology was not adequately reported, resulting in poorer methodological quality scoring. Glycated hemoglobin (HbA1c) was reduced using Aegle marmelos (L.) Corrêa (MD -1.6%; 95% CI −3 to −0.3), Boswellia serrata Roxb. (−0.5; −0.7 to −0.4), Gynostemma pentaphyllum (Thunb.) Makino (−1; −1.5 to −0.6), Momordica charantia L. (−0.3; −0.4 to −0.1), Nigella sativa L. (−0.4; −0.6 to −0.1), Plantago ovata Forssk. (−0.9; −1.4 to −0.3), Tinospora cordifolia (Willd.) Hook.f. and Thomson (−0.5; −0.6 to −0.5), Trigonella foenum-graecum L. (−0.6; −0.9 to −0.4), and Urtica dioica L. (−1.3; −2.4 to −0.2) compared to control. Similarly, fasting blood glucose (FBG) was reduced by 4–56 mg/dl for a range of Ayurvedic medicines. Very few studies assessed health-related quality of life (HRQoL). Adverse events were not reported in many studies, and if reported, these were mostly none to mild and predominately related to the gastrointestinal tract. Conclusion: The current evidence suggests the benefit of a range of Ayurvedic medicines in improving glycemic control in T2DM patients. Given the limitations of the available evidence and to strengthen the evidence base, high-quality RCTs should be conducted and reported.
Collapse
Affiliation(s)
- Kaushik Chattopadhyay
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,The Nottingham Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, Nottingham, United Kingdom
| | - Haiquan Wang
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Jaspreet Kaur
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Gamze Nalbant
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Abdullah Almaqhawi
- Department of Family and Community Medicine, College of Medicine, King Faisal University, Alahsa, Saudi Arabia
| | - Burak Kundakci
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Jeemon Panniyammakal
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Michael Heinrich
- Centre for Pharmacognosy and Phytotherapy, School of Pharmacy, University College London, London, United Kingdom
| | - Sarah Anne Lewis
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | | | - Nikhil Tandon
- Department of Endocrinology, Metabolism and Diabetes, All India Institute of Medical Sciences, New Delhi, India
| | - Tuhin Kanti Biswas
- Department of Kayachikitsa, J B Roy State Ayurvedic Medical College and Hospital, Kolkata, India
| | - Sanjay Kinra
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jo Leonardi-Bee
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,The Nottingham Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, Nottingham, United Kingdom
| |
Collapse
|
21
|
Farazandeh M, Mahmoudabady M, Asghari AA, Niazmand S. Diabetic cardiomyopathy was attenuated by cinnamon treatment through the inhibition of fibro-inflammatory response and ventricular hypertrophy in diabetic rats. J Food Biochem 2022; 46:e14206. [PMID: 35474577 DOI: 10.1111/jfbc.14206] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 03/13/2022] [Accepted: 04/13/2022] [Indexed: 12/14/2022]
Abstract
Diabetic cardiomyopathy (DCM) is a chronic complication of diabetes that emphasizes the urgency of developing new drug therapies. With an illustrious history in traditional medicine to improve diabetes, cinnamon has been shown to possess blood lipids lowering effects and antioxidative and anti-inflammatory properties. However, the extent to which it protects the diabetic heart has yet to be determined. Forty-eight rats were administered in the study and grouped as: control; diabetic; diabetic rats given 100, 200, or 400 mg/kg cinnamon extract, metformin (300 mg/kg), valsartan (30 mg/kg), or met/val (combination of both drugs), via gavage for six weeks. Fasting blood sugar (FBS) and markers of cardiac injury including creatine kinase-muscle/brain (CK-MB), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) were evaluated in blood samples. Malondialdehyde (MDA) levels, the total contents of thiol, superoxide dismutase (SOD), and catalase (CAT) activities were measured. Histopathology study and gene expression measurement of angiotensin II type 1 receptor (AT1), atrial natriuretic peptide (ANP), beta-myosin heavy chain (β-MHC), and brain natriuretic peptide (BNP) were done on cardiac tissue. FBS and cardiac enzyme indicators were reduced in all treated groups. A reduction in MDA level and enhancement in thiol content alongside with increase of SOD and CAT activities were observed in extract groups. The decrease of inflammation and fibrosis was obvious in treated groups, notably in the high-dose extract group. Furthermore, all treated diabetic groups showed a lowering trend in AT1, ANP, β-MHC, and BNP gene expression. Cinnamon extract, in addition to its hypoglycemic and antioxidant properties, can prevent diabetic heart damage by alleviating cardiac inflammation and fibrosis. PRACTICAL APPLICATIONS: This study found that cinnamon extract might protect diabetic heart damage by reducing inflammation and fibrosis in cardiac tissue, in addition to lowering blood glucose levels and increasing antioxidant activity. Our data imply that including cinnamon in diabetic participants' diets may help to reduce risk factors of cardiovascular diseases.
Collapse
Affiliation(s)
- Maryam Farazandeh
- Department of Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Mahmoudabady
- Department of Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Akbar Asghari
- Department of Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeed Niazmand
- Department of Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
22
|
Effect of Aqueous Cinnamon Extract on the Postprandial Glycemia Levels in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial. Nutrients 2022; 14:nu14081576. [PMID: 35458138 PMCID: PMC9024929 DOI: 10.3390/nu14081576] [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: 02/02/2022] [Revised: 04/04/2022] [Accepted: 04/08/2022] [Indexed: 02/04/2023] Open
Abstract
Cinnamon is a spice used in traditional cuisine that has been investigated due to hypoglycemic properties. The objective of this study was to investigate the effect of aqueous cinnamon extract on postprandial glycemia levels in type 2 diabetes mellitus (DM2) adults. This clinical trial enrolled 36 adults with DM2, randomly allocated in two groups: the control group (n = 18) took only an oral glucose tolerance test (OGTT) and the intervention group (n = 18) took OGTT immediately followed by aqueous cinnamon extract (6 g/100 mL) ingestion. Blood glucose levels were measured on fasting and after 30, 60, 90 and 120 min in both groups. The chemical analysis of the aqueous cinnamon extract included total phenols content determination and antioxidant activity assessment through FRAP and DPPH methods. The data reveal that aqueous cinnamon extract ingestion did not show a significant difference in the incremental area under the curve (p = 0.834), maximum glucose concentration (p = 0.527) and glucose concentration variation (p = 0.873) compared with the control group. Cinnamon extract possess a total phenol content of 1554.9 mg/L gallic acid equivalent and a strong antioxidant capacity, revealed by the DPPH (5125.0 µmol Trolox/L) and FRAP (3658.8 µmol Trolox/L) tests. Aqueous cinnamon extract did not significantly influence postprandial glucose response in diabetic patients during an OGTT.
Collapse
|
23
|
Effects of Diet, Lifestyle, Chrononutrition and Alternative Dietary Interventions on Postprandial Glycemia and Insulin Resistance. Nutrients 2022; 14:nu14040823. [PMID: 35215472 PMCID: PMC8878449 DOI: 10.3390/nu14040823] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/18/2022] [Accepted: 01/18/2022] [Indexed: 02/08/2023] Open
Abstract
As years progress, we are found more often in a postprandial than a postabsorptive state. Chrononutrition is an integral part of metabolism, pancreatic function, and hormone secretion. Eating most calories and carbohydrates at lunch time and early afternoon, avoiding late evening dinner, and keeping consistent number of daily meals and relative times of eating occasions seem to play a pivotal role for postprandial glycemia and insulin sensitivity. Sequence of meals and nutrients also play a significant role, as foods of low density such as vegetables, salads, or soups consumed first, followed by protein and then by starchy foods lead to ameliorated glycemic and insulin responses. There are several dietary schemes available, such as intermittent fasting regimes, which may improve glycemic and insulin responses. Weight loss is important for the treatment of insulin resistance, and it can be achieved by many approaches, such as low-fat, low-carbohydrate, Mediterranean-style diets, etc. Lifestyle interventions with small weight loss (7–10%), 150 min of weekly moderate intensity exercise and behavioral therapy approach can be highly effective in preventing and treating type 2 diabetes. Similarly, decreasing carbohydrates in meals also improves significantly glycemic and insulin responses, but the extent of this reduction should be individualized, patient-centered, and monitored. Alternative foods or ingredients, such as vinegar, yogurt, whey protein, peanuts and tree nuts should also be considered in ameliorating postprandial hyperglycemia and insulin resistance. This review aims to describe the available evidence about the effects of diet, chrononutrition, alternative dietary interventions and exercise on postprandial glycemia and insulin resistance.
Collapse
|
24
|
Gu DT, Tung TH, Jiesisibieke ZL, Chien CW, Liu WY. Safety of Cinnamon: An Umbrella Review of Meta-Analyses and Systematic Reviews of Randomized Clinical Trials. Front Pharmacol 2022; 12:790901. [PMID: 35115937 PMCID: PMC8804376 DOI: 10.3389/fphar.2021.790901] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/16/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose: Many evidence-based studies have indicated that cinnamon has therapeutic effects. However, it may not be entirely safe and its adverse effects may be ignored. The present umbrella review was conducted to elucidate the safety of cinnamon. Methods: Pertinent meta-analyses and systematic reviews of randomized controlled trials on cinnamon use in humans were identified by searching PubMed, EMBASE, and the Cochrane Library from their inception to September 15, 2021. All meta-analyses and systematic reviews on the safety or adverse effects of cinnamon were considered. PRISMA 2020 was used as the standard of reporting (PRISMA registration ID: 286746). Results: We identified three meta-analyses and one systematic review that described the safety of cinnamon. The quality of the meta-analysis and systematic reviews was evaluated using “Assessing the Methodological Quality of Systematic Reviews.” Their quality was rated as low in two (50%) instances and moderate in two (50%). There were no significant toxic- or side effects between cinnamon group and placebo group regardless of dose and duration. Conclusion: There is evidence to support that the use of cinnamon has no adverse reactions. It can improve the health status of patients as an adjuvant treatment. Future studies exploring better profile risks and protective factors for cinnamon use-related adverse effect are needed, in order that preventive approaches can be developed.
Collapse
Affiliation(s)
- Dan-Tong Gu
- Institute of Otolaryngology, Clinical Research Center, Fudan University Affiliated Eye and ENT Hospital, Shanghai, China
| | - Tao-Hsin Tung
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated with Wenzhou Medical University, Linhai, China
| | | | - Ching-Wen Chien
- Institute for Hospital Management, Tsing Hua University, Shenzhen, China
| | - Wen-Yi Liu
- Institute for Hospital Management, Tsing Hua University, Shenzhen, China
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
- Shanghai Bluecross Medical Science Institute, Shanghai, China
- *Correspondence: Wen-Yi Liu,
| |
Collapse
|
25
|
Krittanawong C, Isath A, Scott CZ, Wang Z, Kaplin S, Jneid H, Lavie CJ, Virani SS. Association Between Cinnamon Consumption and Risk of Cardiovascular Health: A Systematic Review and Meta-Analysis. Am J Med 2022; 135:110-117. [PMID: 34411521 DOI: 10.1016/j.amjmed.2021.07.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/07/2021] [Accepted: 07/13/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cinnamon has been used as a traditional herbal medication for decades. Several studies have investigated cinnamon consumption and cardiovascular risk. So far, the evidence remains inconclusive. Thus, we aim to systematically review the currently available literature and quantify the evidence, if possible. METHODS We systematically searched Ovid MEDLINE, Ovid Embase, Ovid Cochrane Database of Systematic Reviews, Scopus, and Web of Science from database inception in 1966 through December 2020. The exposure of interest was cinnamon consumption, the outcome was cardiovascular risk defined as hemoglobin A1C, low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c). Two investigators independently reviewed the data. Conflicts were resolved through consensus. Random-effects meta-analyses were used. RESULTS Of 23 studies (1070 subjects), the included studies were heterogeneous, generally of very poor quality. We found no difference in LDL-c levels in patients who consumed cinnamon vs those who did not, with a weighted mean difference (WMD) of 0.38 (confidence interval [CI], -6.07-6.83). We also found no difference in HDL-c between the 2 groups with WMD 0.40 (CI, -1.14-1.94). In addition, we found no statistical differences in hemoglobin A1C between the 2 groups with WMD of 0.0 (CI, -0.44-0.45). CONCLUSIONS Our meta-analysis suggests that there is no association between cinnamon consumption and differences in LDL-c, HDL-c, and hemoglobin A1C levels. Further randomized control trials studies using a robust design with long-term cinnamon consumption are needed to further investigate any potential effect.
Collapse
Affiliation(s)
- Chayakrit Krittanawong
- The Michael E. DeBakey VA Medical Center, Houston, Texas; Section of Cardiology, Baylor College of Medicine, Houston, Texas.
| | - Ameesh Isath
- Department of Medicine, Mount Sinai Morningside and Mount Sinai West, Mount Sinai Heart, New York, NY
| | - Claire Ziemba Scott
- The Michael E. DeBakey VA Medical Center, Houston, Texas; Section of Cardiology, Baylor College of Medicine, Houston, Texas
| | - Zhen Wang
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery; Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, Minn
| | - Scott Kaplin
- Department of Cardiovascular Medicine, NYU Langone - Long Island, Mineola, NY
| | - Hani Jneid
- The Michael E. DeBakey VA Medical Center, Houston, Texas; Section of Cardiology, Baylor College of Medicine, Houston, Texas
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, La
| | - Salim S Virani
- The Michael E. DeBakey VA Medical Center, Houston, Texas; Section of Cardiology, Baylor College of Medicine, Houston, Texas
| |
Collapse
|
26
|
The Role of Bioactive Compounds from Dietary Spices in the Management of Metabolic Syndrome: An Overview. Nutrients 2021; 14:nu14010175. [PMID: 35011050 PMCID: PMC8747161 DOI: 10.3390/nu14010175] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/23/2021] [Accepted: 12/23/2021] [Indexed: 12/11/2022] Open
Abstract
Metabolic syndrome (MetS) is a combination of physiologically dysregulated parameters that can include elevated fasting blood glucose, high blood pressure, central obesity, increased triglyceride levels, insulin resistance, diabetes, elevated low density lipoprotein levels, and reduced high density lipoprotein levels in the blood. Effective clinical management of MetS is critical as it is strongly associated with long lasting and fatal complications in patients. Alongside standard care of lifestyle changes and medication, dietary supplements derived from herbal resources could be an alternative therapeutic strategy that is safe, efficient, culturally acceptable, and has few side effects. Of the dietary supplements, spicy foods have always been considered a great source of functional bioactive compounds. Herbal therapy is broadly used in many countries as a treatment or as a preventive measure in the management of MetS risk factors, including blood glucose, blood pressure, and blood lipid levels. Herein, an attempt is made to evaluate the recent studies in the management of MetS with herbal alternatives, and to explore the possibility of their use as therapeutic treatments or supplements.
Collapse
|
27
|
Majeed M, Majeed A, Nagabhusahnam K, Mundkur L, Paulose S. A randomized, double-blind clinical trial of a herbal formulation (GlycaCare-II) for the management of type 2 diabetes in comparison with metformin. Diabetol Metab Syndr 2021; 13:132. [PMID: 34789340 PMCID: PMC8596953 DOI: 10.1186/s13098-021-00746-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 10/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a major public health concern with growing prevalence with multiple debilitating complications. GlycaCare-II is a proprietary herbal formulation supplement for T2DM containing extracts of Cinnamomum cassia, Momordica charantia, Pterocarpus marsupium, Gymnema sylvestre, Salacia reticulata, Eugenia jambolana, and a bioavailability enhancer piperine from Piper nigrum. OBJECTIVE The antihyperglycemic potential of GlycaCare-II was compared against metformin in a double-blind study. DESIGN It was a randomized, two-arm design on prediabetic (N = 29; 12 in metformin and 17 in GlycaCare-II arm, respectively) and newly diagnosed diabetic (N = 40; 16 in metformin and 24 in GlycaCare-II) patients for 120 days. OUTCOME MEASURES Changes in diabetic panel glycosylated hemoglobin (HbA1c), fasting blood sugar (FBS), and postprandial blood sugar (PBS) were the primary endpoints. Lipid profile, liver profile, thyroid-stimulating hormone, bilirubin and creatinine were the secondary endpoints. RESULT Twice a day treatment for 120 days with GlycaCare-II led to a statistically significant change in HbA1c (p < 0.001), FBS (p < 0.001), PBS (p < 0.001) on both prediabetic and newly diagnosed diabetic patients. GlycaCare-II showed a similar potential as metformin in the treatment of T2DM. In the prediabetic group, both GlycaCare-II and metformin were comparable for all the hyperglycemic index parameters. In the case of newly diagnosed diabetic patients, GlycaCare-II showed a significantly better reduction for PBS (p = 0.026) as compared to metformin, while all other parameters in the diabetic panel were comparable. No adverse events were reported throughout the trial period. CONCLUSION These results suggest that GlycaCare-II is effective in managing T2DM in both newly diagnosed diabetic and prediabetic patients.
Collapse
Affiliation(s)
- Muhammed Majeed
- Sami-Sabinsa Group Limited, 19/1 & 19/2, I Main, II Phase, Peenya Industrial Area, Bangalore, 560 058, Karnataka, India
- Sabinsa Corporation, 20 Lake Drive, East Windsor, NJ, 08520, USA
| | - Anju Majeed
- Sami-Sabinsa Group Limited, 19/1 & 19/2, I Main, II Phase, Peenya Industrial Area, Bangalore, 560 058, Karnataka, India
| | | | - Lakshmi Mundkur
- Sami-Sabinsa Group Limited, 19/1 & 19/2, I Main, II Phase, Peenya Industrial Area, Bangalore, 560 058, Karnataka, India
| | - Shaji Paulose
- Sami-Sabinsa Group Limited, 19/1 & 19/2, I Main, II Phase, Peenya Industrial Area, Bangalore, 560 058, Karnataka, India.
| |
Collapse
|
28
|
Shang C, Lin H, Fang X, Wang Y, Jiang Z, Qu Y, Xiang M, Shen Z, Xin L, Lu Y, Gao J, Cui X. Beneficial effects of cinnamon and its extracts in the management of cardiovascular diseases and diabetes. Food Funct 2021; 12:12194-12220. [PMID: 34752593 DOI: 10.1039/d1fo01935j] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Cardiovascular diseases (CVDs) and diabetes are the leading causes of death worldwide, which underlines the urgent necessity to develop new pharmacotherapies. Cinnamon has been an eminent component of spice and traditional Chinese medicine for thousands of years. Numerous lines of findings have elucidated that cinnamon has beneficial effects against CVDs in various ways, including endothelium protection, regulation of immune response, lowering blood lipids, antioxidative properties, anti-inflammatory properties, suppression of vascular smooth muscle cell (VSMC) growth and mobilization, repression of platelet activity and thrombosis and inhibition of angiogenesis. Furthermore, emerging evidence has established that cinnamon improves diabetes, a crucial risk factor for CVDs, by enhancing insulin sensitivity and insulin secretion; regulating the enzyme activity involved in glucose; regulating glucose metabolism in the liver, adipose tissue and muscle; ameliorating oxidative stress and inflammation to protect islet cells; and improving diabetes complications. In this review, we summarized the mechanisms by which cinnamon regulates CVDs and diabetes in order to provide a theoretical basis for the further clinical application of cinnamon.
Collapse
Affiliation(s)
- Chang Shang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China. .,Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Hongchen Lin
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China. .,Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Xuqin Fang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China. .,Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Yuling Wang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China. .,Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Zhilin Jiang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
| | - Yi Qu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China. .,Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Mi Xiang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
| | - Zihuan Shen
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China. .,Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Laiyun Xin
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China. .,First Clinical Medical School, Shandong University of Chinese Medicine, Shandong, 250355, China
| | - Yingdong Lu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
| | - Jialiang Gao
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
| | - Xiangning Cui
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
| |
Collapse
|
29
|
Mandal A, Sharma S, Rani R, Ranjan S, Kant R, Mirza A. Impact of Cassia Bark Consumption on Glucose and Lipid Control in Type 2 Diabetes: An Updated Systematic Review and Meta-Analysis. Cureus 2021; 13:e16376. [PMID: 34408931 PMCID: PMC8361532 DOI: 10.7759/cureus.16376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2021] [Indexed: 11/30/2022] Open
Abstract
Control of diabetes is a constant challenge and natural remedies are being searched along with modern medicine. The effectiveness of cinnamon in managing it lacks consensus. Besides this, earlier trials had a variant in the type of product they used, quantity, duration, the form of molecules, etc. So, we aimed to measure the impact of cassia ground bark powder consumption, 1-2 gm/day for 90 days, in lowering plasma glucose and lipids among those with type 2 diabetes. The authors searched the PubMed, Medline, Embase, CINAHL, Clinical Key, Ovid, and Scopus databases and the Cochrane Central Register (last search December 30, 2020) with the MeSH terms and keywords of cinnamon, cassia cinnamon, Chinese cinnamon, and type 2 diabetes mellitus to conclude the effects of cassia cinnamon on diabetes based on the evidence of human clinical trials that reported at least one of the following: glycosylated hemoglobin (HbA1C), fasting blood glucose, total cholesterol, triglycerides, low-density lipoprotein (LDL), and high-density lipoprotein (HDL). Weighted mean differences were calculated by using the random-effect model of RevMan software (The Cochrane Collaboration, London, UK), and the pooled analysis found an insignificant reduction of the outcome variable (p>0.05).
Collapse
Affiliation(s)
- Anindita Mandal
- Nursing, All India Institute of Medical Sciences, Rishikesh, IND
| | - Suresh Sharma
- Nursing, All India Institute of Medical Sciences, Jodhpur, IND
| | - Ritu Rani
- Nursing, All India Institute of Medical Sciences, Rishikesh, IND
| | - Shashi Ranjan
- Biochemistry, All India Institute of Medical Sciences, Rishikesh, IND
| | - Ravi Kant
- General Medicine, All India Institute of Medical Sciences, Rishikesh, IND
| | - Anissa Mirza
- Biochemistry, All India Institute of Medical Sciences, Rishikesh, IND
| |
Collapse
|
30
|
The Use of Natural Compounds as a Strategy to Counteract Oxidative Stress in Animal Models of Diabetes Mellitus. Int J Mol Sci 2021; 22:ijms22137009. [PMID: 34209800 PMCID: PMC8268811 DOI: 10.3390/ijms22137009] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 12/14/2022] Open
Abstract
Diabetes mellitus (DM) is a chronic metabolic disease characterised by insulin deficiency, resulting in hyperglycaemia, a characteristic symptom of type 2 diabetes mellitus (DM2). DM substantially affects numerous metabolic pathways, resulting in β-cell dysfunction, insulin resistance, abnormal blood glucose levels, impaired lipid metabolism, inflammatory processes, and excessive oxidative stress. Oxidative stress can affect the body’s normal physiological function and cause numerous cellular and molecular changes, such as mitochondrial dysfunction. Animal models are useful for exploring the cellular and molecular mechanisms of DM and improving novel therapeutics for their safe use in human beings. Due to their health benefits, there is significant interest in a wide range of natural compounds that can act as naturally occurring anti-diabetic compounds. Due to rodent models’ relatively similar physiology to humans and ease of handling and housing, they are widely used as pre-clinical models for studying several metabolic disorders. In this review, we analyse the currently available rodent animal models of DM and their advantages and disadvantages and highlight the potential anti-oxidative effects of natural compounds and their mechanisms of action.
Collapse
|
31
|
Sharifi-Rad J, Dey A, Koirala N, Shaheen S, El Omari N, Salehi B, Goloshvili T, Cirone Silva NC, Bouyahya A, Vitalini S, Varoni EM, Martorell M, Abdolshahi A, Docea AO, Iriti M, Calina D, Les F, López V, Caruntu C. Cinnamomum Species: Bridging Phytochemistry Knowledge, Pharmacological Properties and Toxicological Safety for Health Benefits. Front Pharmacol 2021; 12:600139. [PMID: 34045956 PMCID: PMC8144503 DOI: 10.3389/fphar.2021.600139] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 04/06/2021] [Indexed: 12/22/2022] Open
Abstract
The genus Cinnamomum includes a number of plant species largely used as food, food additives and spices for a long time. Different traditional healing systems have used these plants as herbal remedies to cure diverse ailments. The aim of this comprehensive and updated review is to summarize the biodiversity of the genus Cinnamomum, its bioactive compounds, the mechanisms that underlie the pharmacological activities and molecular targets and toxicological safety. All the data in this review have been collected from databases and recent scientific literature including Web of Science, PubMed, ScienceDirect etc. The results showed that the bioactive compounds of Cinnamomum species possess antimicrobial, antidiabetic, antioxidant, anti-inflammatory, anticancer and neuroprotective effects. The preclinical (in vitro/in vivo) studies provided the possible molecular mechanisms of these action. As a novelty, recent clinical studies and toxicological data described in this paper support and confirm the pharmacological importance of the genus Cinnamomum. In conclusion, the obtained results from preclinical studies and clinical trials, as well as reduced side effects provide insights into future research of new drugs based on extracts and bioactive compounds from Cinnamomum plants.
Collapse
Affiliation(s)
- Javad Sharifi-Rad
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Facultad de Medicina, Universidad del Azuay, Cuenca, Ecuador
| | - Abhijit Dey
- Department of Life Sciences, Presidency University, Kolkata, India
| | - Niranjan Koirala
- Department of Natural Products Drugs Discovery, Dr. Koirala Research Institute for Biotechnology and Biodiversity, Kathmandu, Nepal
| | - Shabnum Shaheen
- Department of Botany, Lahore College for Women University, Lahore, Pakistan
| | - Nasreddine El Omari
- Laboratory of Histology, Embryology and Cytogenetic, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Bahare Salehi
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tamar Goloshvili
- Institute of Botany, Plant Physiology and Genetic Resources, Ilia State University, Tbilisi, Georgia
| | | | - Abdelhakim Bouyahya
- Laboratory of Human Pathology Biology, Faculty of Sciences, Genomic Center of Human Pathology, Faculty of Medicine and Pharmacy, Mohammed V University of Rabat, Rabat, Morocco
| | - Sara Vitalini
- Department of Agricultural and Environmental Sciences, Milan State University, Milan, Italy
| | - Elena M Varoni
- Department of Biomedical, Surgical and Dental Sciences, Milan State University, Milan, Italy
| | - Miquel Martorell
- Department of Nutrition and Dietetics, Faculty of Pharmacy, University of Concepcion, Concepcion, Chile.,Universidad de Concepción, Unidad de Desarrollo Tecnológico, UDT, Concepcion, Chile
| | - Anna Abdolshahi
- Food Safety Research Center (salt), Semnan University of Medical Sciences, Semnan, Iran
| | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Marcello Iriti
- Department of Agricultural and Environmental Sciences, Milan State University, Milan, Italy
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Francisco Les
- Department of Pharmacy, Faculty of Health Sciences, Universidad San Jorge, Zaragoza, Spain.,Instituto Agroalimentario de Aragón-IA2 (CITA-Universidad de Zaragoza), Zaragoza, Spain
| | - Víctor López
- Department of Pharmacy, Faculty of Health Sciences, Universidad San Jorge, Zaragoza, Spain.,Instituto Agroalimentario de Aragón-IA2 (CITA-Universidad de Zaragoza), Zaragoza, Spain
| | - Constantin Caruntu
- Department of Physiology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,Department of Dermatology, "Prof. N.C. Paulescu" National Institute of Diabetes, Nutrition and Metabolic Diseases, Bucharest, Romania
| |
Collapse
|
32
|
Momeni H, Salehi A, Absalan A, Akbari M. Hydro-alcoholic extract of Morus nigra reduces fasting blood glucose and HbA1c% in diabetic patients, probably via competitive and allosteric interaction with alpha-glucosidase enzyme; a clinical trial and in silico analysis. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 19:763-769. [PMID: 33946137 DOI: 10.1515/jcim-2021-0005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 02/07/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES 1-Deoxynojirimycin (1-DNJ), the main active component found in Morus nigra (black mulberry) is reported to be effective in controlling diabetes. We have evaluated the effect of hydro-alcoholic extract of M. nigra leaves on the fasting blood glucose (FBS) and hemoglobin A1c% (HbA1c%) in diabetic patients. Furthermore, we compared the interaction of 1-DNJ and glucose molecules with the alpha-glucosidase enzyme, which has a critical role in the lysis of glucose-based polymers in human cells. METHODS 4% hydro-alcoholic extract was prepared from black mulberry leaves. Patients in treatment (n=50) and control (n=50) groups received 3 mL extract or placebo in water, respectively, and three times a day. Fasting blood glucose and HbA1c% were evaluated before and after three months of evaluation. Potential binding sites of 1-DNJ or glucose on the enzyme glucosidase found by docking study. Docking scores were obtained using an energy minimization method by Molegro Virtual Docker software. The Mean ± SD of each variable was compared between groups at the 95% significant level. RESULTS Age mean ± SD was equal to 54.79 ± 9.203 (38-69) years. There was no significant difference between intervention and placebo groups considering FBS (p=0.633) but was for HbA1c% (p=0.0011), before treatment. After three months, both FBS and HbA1c% were significantly reduced in patients under mulberry leaves extract-treatment. FBS changed was from 182.23 ± 38.65 to 161.23 ± 22.14 mg/dL in treatment group (p<0.001) and from 178.45 ± 39.46 to 166.23 ± 29.64 mg/dL in control group (p<0.001). HbA1c was changed from 7.23 ± 0.25 to 6.13 ± 0.61% in treatment group (p<0.001) and from 7.65 ± 0.85 to 7.12 ± 0.33% in control group (p=0.854). Docking results showed that 1-DNJ binds more efficiently, and with a significant score than glucose, to human alpha-glucosidase. CONCLUSIONS This clinical trial and virtual analysis showed that a hydro-alcoholic extract of black mulberry (M. nigra) leaf may be efficient in reducing the blood glucose and HbA1c% in diabetic patients. Furthermore, docking studies propose a competitive and allosteric regulation for herbal ingredients. Drug-development could be based on the presented idea in this report.
Collapse
Affiliation(s)
- Hamid Momeni
- Department of Nursing, Khomein University of Medical Sciences, Khomein, Iran
| | - Ashraf Salehi
- Department of Nursing, Khomein University of Medical Sciences, Khomein, Iran
| | - Abdorrahim Absalan
- Department of Medical Laboratory Sciences, Khomein University of Medical Sciences, Khomein, Iran
| | - Mehran Akbari
- Department of Nursing, Khomein University of Medical Sciences, Khomein, Iran
| |
Collapse
|
33
|
Ahmad R, AlLehaibi LH, AlSuwaidan HN, Alghiryafi AF, Almubarak LS, AlKhalifah KN, AlMubarak HJ, Alkhathami MA. Evaluation of clinical trials for natural products used in diabetes: An evidence-based systemic literature review. Medicine (Baltimore) 2021; 100:e25641. [PMID: 33879744 PMCID: PMC8078398 DOI: 10.1097/md.0000000000025641] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 03/22/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND RELEVANCE A plethora of literature is available regarding the clinical trials for natural products however; no information is available for critical assessments of the quality of these clinical trials. AIM OF STUDY This is a first time report to critically evaluate the efficacy, safety and large scale applications of up-to-date clinical trials for diabetes, based on the three scales of Jadad, Delphi, and Cochrane. METHODOLOGY An in-depth and extensive literature review was performed using various databases, journals, and books. The keywords searched included, "clinical trials," "clinical trial in diabetes," "diabetes," "natural products in diabetes," "ethnopharmacological relevance of natural products in diabetes," etc. RESULTS Based on eligibility criteria, 16 plants with 74 clinical trials were found and evaluated. Major drawbacks observed were; "non-randomization and blindness of the studies," "non-blindness of patients/healthcare/outcome assessors," "lack of patient compliance and co-intervention reports," "missing information regarding drop-out/withdrawal procedures," and "inappropriate baseline characteristics." Principal component analysis and Pearson correlation revealed four components with %variability; PC1: 23.12, PC2: 15.83, PC3: 13.11, and PC4: 11.38 (P ≤ .000). According to descriptive statistics, "non-blinding of outcome assessors" was the major drawback (82%) whereas, "not mentioning the timing of outcome assessment" was observed lowest (6.8%). An in-house quality grading (scale 0-24) classified these clinical trials as; poor (67.6%), acceptable (19.9%), and good quality trials (13.5%). CONCLUSION Proper measures in terms of more strict regulations with pharmacovigilance of plants are utmost needed in order to achieve quality compliance of clinical trials.
Collapse
Affiliation(s)
- Rizwan Ahmad
- Natural Products and Alternative Medicines, College of Clinical Pharmacy, Imam Abdul Rahman Bin Faisal University, Kingdom of Saudi Arabia
| | | | - Hind Nasser AlSuwaidan
- College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Ali Fuad Alghiryafi
- College of Clinical Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Lyla Shafiq Almubarak
- College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Khawlah Nezar AlKhalifah
- College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Hawra Jassim AlMubarak
- College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Majed Ali Alkhathami
- First Health Cluster in Eastern Province, Dammam Medical Complex, Dammam, Saudi Arabia
| |
Collapse
|
34
|
Mihanfar A, Nouri M, Roshangar L, Khadem-Ansari MH. Polyphenols: Natural compounds with promising potential in treating polycystic ovary syndrome. Reprod Biol 2021; 21:100500. [PMID: 33878526 DOI: 10.1016/j.repbio.2021.100500] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/30/2021] [Accepted: 03/11/2021] [Indexed: 12/12/2022]
Abstract
Polyphenols are natural compounds used by plants as a defense system against various stresses. In recent years, the importance of these polyhydroxyphenols has extensively increased due to their potent cardioprotection, anti-carcinogenic, anti-oxidant, anti-apoptotic, and anti-inflammatory properties. Therefore, various studies have reported promising results from the studies investigating their efficacy as a therapeutic strategy in various disorders such as human malignancies, cardiovascular diseases, nervous system impairments, diabetes, metabolic syndrome, aging, and inflammation-associated disorders, as well as a polycystic ovarian syndrome (PCOS). Since oxidative stress, hormonal, metabolic, and endocrine disturbances have been shown to play a crucial role in the initiation/progression of PCOS, polyphenols are suggested to be an effective treatment for this disorder. Therefore, this study aimed to discuss the therapeutic potential of multiple polyphenols in PCOS.
Collapse
Affiliation(s)
- Aynaz Mihanfar
- Department of Clinical Biochemistry, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Mohammad Nouri
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences Tabriz, Iran; Stem Cell and Regenerative Medicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Roshangar
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | |
Collapse
|
35
|
Sivaranjani R, Zachariah TJ, Leela NK. Phytotherapeutic potential of bi-herbal extract of cinnamon and turmeric: in vivo antidiabetic studies. CLINICAL PHYTOSCIENCE 2021. [DOI: 10.1186/s40816-021-00275-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The spices, cinnamon and turmeric have both culinary and pharmaceutical applications. Earlier studies proved their effect on reducing the symptoms associated with type 2 diabetes, a major lifestyle disease affecting millions world over. In our work, we prepared a bi-herbal extract of cinnamon and turmeric and studied its effect to alleviate the symptoms of type 2 diabetes in rat model.
Method
The phenolic rich bi-herbal extract was given to diabetes induced male wistar rats for 28 days at two different concentrations (50 and 150 mg/Kg bwt.). The changes in blood glucose level were monitored at weekly interval. At the end of the experiment, blood serum was collected and used for the estimation of lipid profile, Glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), Total Protein (TP), Albumin, Urea and Creatinine levels.
Result
The serum analysis revealed that administration of the bi-herbal extract at 150 mg/Kg bwt. significantly reduced the blood glucose level (152.60 ± 40.2 mg/dL; p < 0.05) of diabetic animals as compared to diabetic control (335.40 ± 67.3 mg/dL; p < 0.05) at the end of 4 weeks. The treatment also resulted in the reduction of total cholesterol and LDL-cholestrol levels as compared to diabetic control animals. The histopathological examination of tissues showed the improvement in pancreatic architecture and restoration of tissue integrity in liver and kidney.
Conclusion
The study concludes that methanol extract of combination of cinnamon and turmeric has good hypoglycemic, hypolipidemic and organ protective potential in diabetic rats which could be developed into functional food supplementation for the prevention of type 2 diabetes.
Collapse
|
36
|
Kutbi EH, Sohouli MH, Fatahi S, Lari A, Shidfar F, Aljhdali MM, Alhoshan FM, Elahi SS, Almusa HA, Abu-Zaid A. The beneficial effects of cinnamon among patients with metabolic diseases: A systematic review and dose-response meta-analysis of randomized-controlled trials. Crit Rev Food Sci Nutr 2021; 62:6113-6131. [PMID: 33739219 DOI: 10.1080/10408398.2021.1896473] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This systematic review and meta-analysis aims to summarize and conclude the clinical evidence regarding the use of cinnamon among patients with metabolic diseases. A comprehensive literature search without any limitation on language was conducted using the following bibliographical databases: ISI Web of Science, Embase, Scopus, PubMed, and Google Scholar. Search was conducted up to 23 January 2020. A total of 35 clinical trials were included for final analysis. Pooling of results showed a significant reducing effect of cinnamon on total cholesterol (TC) (weighted mean difference (WMD) = -11.67 mg/dL; P = 0.010), triglyceride (TG) (WMD = -16.27 mg/dL; P < 0.001), low density lipoprotein-cholesterol (LDL-C) (WMD = -6.36 mg/dL; P < 0.001), serum glucose (WMD = -11.39 mg/dL; P < 0.001), serum insulin (WMD = -1.27 μIU/mL; P = 0.028), and waist circumstance (WC) (WMD = -1.68 cm; P = 0.016). These lowering effects on TG, TC, LDL-C, and serum glucose levels were robust in studies that used cinnamon supplementation dose ≤1.5 g. Also, our findings of the present meta-analysis showed that cinnamon supplementation could have favorable effects on high density lipoprotein-cholesterol (HDL-C, WMD = 1.35; P = 0.038) as well as systolic (WMD = -3.95 mmHg; P = 0.018) and diastolic (WMD = -3.36; P = 0.001) blood pressure among patients with metabolic diseases. The present meta-analysis suggests that cinnamon might exert beneficial effects on various cardiometabolic risk factors among patients with metabolic diseases.
Collapse
Affiliation(s)
- Emad H Kutbi
- Biomedical Research Administration, Biorepository Department, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohammad Hassan Sohouli
- Student Research Committee, Faculty of Public Health Branch, Iran University of Medical Sciences, Tehran, Iran.,Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Somaye Fatahi
- Student Research Committee, Faculty of Public Health Branch, Iran University of Medical Sciences, Tehran, Iran.,Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Abolfazl Lari
- Student Research Committee, Faculty of Public Health Branch, Iran University of Medical Sciences, Tehran, Iran
| | - Farzad Shidfar
- Student Research Committee, Faculty of Public Health Branch, Iran University of Medical Sciences, Tehran, Iran
| | - Maha Mari Aljhdali
- Department of Internal Medicine, King Fahad General Hospital, Jeddah, Saudi Arabia
| | - Faisal Musaad Alhoshan
- College of Medicine, Ibn Sina National College for Medical Studies, Jeddah, Saudi Arabia
| | - Saad Saif Elahi
- College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hashem Ameen Almusa
- Department of Respiratory Care, Dr. Sulaiman Al Habib Hospital, Riyadh, Saudi Arabia
| | - Ahmed Abu-Zaid
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.,College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| |
Collapse
|
37
|
Petriv N, Neubert L, Vatashchuk M, Timrott K, Suo H, Hochnadel I, Huber R, Petzold C, Hrushchenko A, Yatsenko AS, Shcherbata HR, Wedemeyer H, Lichtinghagen R, Falfushynska H, Lushchak V, Manns MP, Bantel H, Semchyshyn H, Yevsa T. Increase of α-dicarbonyls in liver and receptor for advanced glycation end products on immune cells are linked to nonalcoholic fatty liver disease and liver cancer. Oncoimmunology 2021; 10:1874159. [PMID: 33628620 PMCID: PMC7889131 DOI: 10.1080/2162402x.2021.1874159] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver with a very poor prognosis and constantly growing incidence. Among other primary risks of HCC, metabolic disorders and obesity have been extensively investigated over recent decades. The latter can promote nonalcoholic fatty liver disease (NAFLD) leading to the inflammatory form of nonalcoholic steatohepatitis (NASH), that, in turn, promotes HCC. Molecular determinants of this pathogenic progression, however, remain largely undefined. In this study, we have focussed on the investigation of α-dicarbonyl compounds (α-dC), highly reactive and tightly associated with overweight-induced metabolic disorders, and studied their potential role in NAFLD and progression toward HCC using murine models. NAFLD was induced using high-fat diet (HFD). Autochthonous HCC was induced using transposon-based stable intrahepatic overexpression of oncogenic NRASG12V in mice lacking p19Arf tumor suppressor. Our study demonstrates that the HFD regimen and HCC resulted in strong upregulation of α-dC in the liver, heart, and muscles. In addition, an increase in α-dC was confirmed in sera of NAFLD and NASH patients. Furthermore, higher expression of the receptor for advanced glycation products (RAGE) was detected exclusively on immune cells and not on stroma cells in livers of mice with liver cancer progression. Our work confirms astable interplay of liver inflammation, carbonyl stress mediated by α-dC, and upregulated RAGE expression on CD8+ Tand natural killer (NK) cells in situ in NAFLD and HCC, as key factors/determinants in liver disease progression. The obtained findings underline the role of α-dC and RAGE+CD8+ Tand RAGE+ NK cells as biomarkers and candidates for a local therapeutic intervention in NAFLD and malignant liver disease.
Collapse
Affiliation(s)
- Nataliia Petriv
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Lavinia Neubert
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Myroslava Vatashchuk
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine
| | - Kai Timrott
- Department of General-, Visceral and Transplantation Surgery, Hannover Medical School, Hannover, Germany
| | - Huizhen Suo
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Inga Hochnadel
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - René Huber
- Department of Clinical Chemistry, Hannover Medical School, Hannover, Germany
| | | | - Anastasiia Hrushchenko
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine
| | - Andriy S Yatsenko
- Gene Expression and Signaling Group, Institute of Cell Biochemistry, Hannover Medical School, Germany
| | - Halyna R Shcherbata
- Gene Expression and Signaling Group, Institute of Cell Biochemistry, Hannover Medical School, Germany
| | - Heiner Wedemeyer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Ralf Lichtinghagen
- Department of Clinical Chemistry, Hannover Medical School, Hannover, Germany
| | - Halina Falfushynska
- Department of Biochemistry, Ternopil Volodymyr Hnatiuk National Pedagogical University, Ternopil, Ukraine
| | - Volodymyr Lushchak
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine
| | - Michael P Manns
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Heike Bantel
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Halyna Semchyshyn
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine
| | - Tetyana Yevsa
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| |
Collapse
|
38
|
Hashim KN, Chin KY, Ahmad F. The Mechanism of Honey in Reversing Metabolic Syndrome. Molecules 2021; 26:molecules26040808. [PMID: 33557218 PMCID: PMC7913905 DOI: 10.3390/molecules26040808] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 01/30/2021] [Accepted: 02/02/2021] [Indexed: 12/22/2022] Open
Abstract
Metabolic syndrome is a constellation of five risk factors comprising central obesity, hyperglycaemia, dyslipidaemia, and hypertension, which predispose a person to cardiometabolic diseases. Many studies reported the beneficial effects of honey in reversing metabolic syndrome through its antiobesity, hypoglycaemic, hypolipidaemic, and hypotensive actions. This review aims to provide an overview of the mechanism of honey in reversing metabolic syndrome. The therapeutic effects of honey largely depend on the antioxidant and anti-inflammatory properties of its polyphenol and flavonoid contents. Polyphenols, such as caffeic acid, p-coumaric acid, and gallic acid, are some of the phenolic acids known to have antiobesity and antihyperlipidaemic properties. They could inhibit the gene expression of sterol regulatory element-binding transcription factor 1 and its target lipogenic enzyme, fatty acid synthase (FAS). Meanwhile, caffeic acid and quercetin in honey are also known to reduce body weight and fat mass. In addition, fructooligosaccharides in honey are also known to alter lipid metabolism by reducing FAS activity. The fructose and phenolic acids might contribute to the hypoglycaemic properties of honey through the phosphatidylinositol 3-kinase/protein kinase B insulin signalling pathway. Honey can increase the expression of Akt and decrease the expression of nuclear factor-kappa B. Quercetin, a component of honey, can improve vasodilation by enhancing nitric oxide production via endothelial nitric oxide synthase and stimulate calcium-activated potassium channels. In conclusion, honey can be used as a functional food or adjuvant therapy to prevent and manage metabolic syndrome.
Collapse
Affiliation(s)
- Khairun-Nisa Hashim
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia;
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia;
| | - Fairus Ahmad
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia;
- Correspondence: ; Tel.: +60-391-458-632
| |
Collapse
|
39
|
Cock IE, Ndlovu N, Van Vuuren SF. The use of South African botanical species for the control of blood sugar. JOURNAL OF ETHNOPHARMACOLOGY 2021; 264:113234. [PMID: 32768640 DOI: 10.1016/j.jep.2020.113234] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/07/2020] [Accepted: 07/29/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Diabetes mellitus (DM) is one of the most prevalent diseases globally and is of considerable concern to global health. Approximately 425 million people are estimated to have DM globally and this is predicted to increase to >642 million by 2040. Whilst the prevalence of DM in South Africa is slightly lower than the global average, it is expected to rise rapidly in future years as more South Africans adopt a high calorie "westernised" diet. Traditional medicines offer an alternative for the development of new medicines to treat DM and the usage of South African plants is relatively well documented. AIM OF THE STUDY To critically review the literature on the anti-diabetic properties of South African plants and to document plant species used for the treatment of DM. Thereafter, a thorough examination of the related research will highlight where research is lacking in the field. MATERIALS AND METHODS A review of published ethnobotanical books, reviews and primary scientific studies was undertaken to identify plants used to treat DM in traditional South African healing systems and to identify gaps in the published research. The study was non-biased, without taxonomic preference and included both native and introduced species. To be included, species must be recorded in the pharmacopeia of at least one South African ethnic group for the treatment of DM. RESULTS One hundred and thirty-seven species are recorded as therapies for DM, with leaves and roots most commonly used. The activity of only 43 of these species have been verified by rigorous testing, and relatively few studies have examined the mechanism of action. CONCLUSION Despite relatively extensive ethnobotanical records and a diverse flora, the anti-diabetic properties of South African medicinal plants is relatively poorly explored. The efficacy of most plants used traditionally to treat DM are yet to be verified and few mechanistic studies are available. Further research is required in this field.
Collapse
Affiliation(s)
- I E Cock
- School of Environment and Science, Nathan Campus, Griffith University, 170 Kessels Rd, Nathan, Queensland, 4111, Australia; Environmental Futures Research Institute, Nathan Campus, Griffith University, 170 Kessels Rd, Nathan, Queensland, 4111, Australia
| | - N Ndlovu
- Department of Pharmacy and Pharmacology, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Gauteng, 2193, South Africa
| | - S F Van Vuuren
- Department of Pharmacy and Pharmacology, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Gauteng, 2193, South Africa.
| |
Collapse
|
40
|
Protective Effects of Polyphenol Enriched Complex Plants Extract on Metabolic Dysfunctions Associated with Obesity and Related Nonalcoholic Fatty Liver Diseases in High Fat Diet-Induced C57BL/6 Mice. Molecules 2021; 26:molecules26020302. [PMID: 33435558 PMCID: PMC7827276 DOI: 10.3390/molecules26020302] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 12/31/2020] [Accepted: 01/06/2021] [Indexed: 12/21/2022] Open
Abstract
Background: Currently, obesity is a global health challenge due to its increasing prevalence and associated health risk. It is associated with various metabolic diseases, including diabetes, hypertension, cardiovascular disease, stroke, certain forms of cancer, and non-alcoholic liver diseases (NAFLD). Objective: The aim of this study to evaluate the effects of polyphenol enriched herbal complex (Rubus crataegifolius/ellagic acid, Crataegus pinnatifida Bunge/vitexin, chlorogenic acid, Cinnamomum cassiaa/cinnamic acid) on obesity and obesity induced NAFLD in the high-fat diet (HFD)-induced obese mouse model. Methods: Obesity was induced in male C57BL/6 mice using HFD. After 8 weeks, the mice were treated with HFD+ plants extract for 8 weeks. Body weight, food intake weekly, and blood sugar level were measured. After sacrifice, changes in the treated group’s liver weight, fat weight, serum biochemical parameters, hormone levels, and enzyme levels were measured. For histological analysis, tissues were stained with hematoxylin-eosin (H&E) and Oil Red-O. Results: Our results showed that the herbal complex ameliorated body weight and liver weight gain, and decreased total body fat in HFD-fed animals. Post prandial blood glucose (PBG) and fasting blood glucose (FBG) were lower in the herbal complex-treated group than in the HFD control group. Additionally, herbal formulation treatment significantly increased HDL levels in serum and decreased TC, TG, AST, ALT, deposition of fat droplets in the liver, and intima media thickness (IMT) in the aorta. Herbal complex increased serum adiponectin and decreased serum leptin. Herbal complex also increased carnitine palmityl transferase (CPT) activity and significantly decreased enzyme activity of beta-hydroxy beta methyl glutamyl-CoA (HMG-CoA) reductase, and fatty acid synthase (FAS). Conclusions: The results of this study demonstrated that the herbal complex is an effective herbal formulation in the attenuation of obesity and obesity-induced metabolic dysfunction including NAFLD in HFD-induced mouse model.
Collapse
|
41
|
Tan HY, Nabil WNN, Xu HX. Clinical Research on Cinnamomi Cortex: A Scoping Review. CHINESE MEDICINE AND CULTURE 2021. [DOI: 10.4103/cmac.cmac_42_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
42
|
Lucas K, Fröhlich-Nowoisky J, Oppitz N, Ackermann M. Cinnamon and Hop Extracts as Potential Immunomodulators for Severe COVID-19 Cases. FRONTIERS IN PLANT SCIENCE 2021; 12:589783. [PMID: 33719281 PMCID: PMC7952639 DOI: 10.3389/fpls.2021.589783] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 02/02/2021] [Indexed: 05/08/2023]
Affiliation(s)
- Kurt Lucas
- Multiphase Chemistry Department, Max Planck Institute for Chemistry, Mainz, Germany
- *Correspondence: Kurt Lucas
| | | | - Nicole Oppitz
- Multiphase Chemistry Department, Max Planck Institute for Chemistry, Mainz, Germany
| | - Maximilian Ackermann
- Institute of Pathology and Molecular Pathology, Helios University Clinic Wuppertal, University of Witten/Herdecke, Wuppertal, Germany
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| |
Collapse
|
43
|
Yaribeygi H, Sathyapalan T, Jamialahmadi T, Sahebkar A. Natural Insulin Sensitizers for the Management of Diabetes Mellitus: A Review of Possible Molecular Mechanisms. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1328:401-410. [PMID: 34981492 DOI: 10.1007/978-3-030-73234-9_26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Diabetes mellitus is a growing health challenge globally which is increasing in epidemic proportion. Naturally occurring pharmacological agents are more likely to provide beneficial therapeutic effects without undesirable side effects compared to the synthetic agents. There is a growing evidence that some naturally occurring pharmacological agents derived from plants have potential antihyperglycemic effects. In this study, we have reviewed the molecular mechanism behind potential hypoglycemic properties of four well-known herbal-based agents, namely, ginger, curcumin, garlic, and cinnamon. Also, we present the related clinical data confirming experimental results aiming to develop novel therapeutic strategies based on these herbal agents potentially for the management of patients with diabetes.
Collapse
Affiliation(s)
- Habib Yaribeygi
- Research Center of Physiology, Semnan University of Medical Sciences, Semnan, Iran
| | - Thozhukat Sathyapalan
- Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, UK
| | - Tannaz Jamialahmadi
- Department of Food Science and Technology, Quchan Branch, Islamic Azad University, Quchan, Iran
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
- School of Medicine The University of Western Australia, Perth, Australia.
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
| |
Collapse
|
44
|
The effect of cinnamon supplementation on lipid profiles in patients with type 2 diabetes: A systematic review and meta-analysis of clinical trials. Complement Ther Med 2020; 55:102571. [DOI: 10.1016/j.ctim.2020.102571] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 09/01/2020] [Accepted: 09/08/2020] [Indexed: 12/13/2022] Open
|
45
|
Zhou LP, Wang J, Xie RH, Pakhale S, Krewski D, Cameron DW, Wen SW. The Effects of Traditional Chinese Medicine as an Auxiliary Treatment for COVID-19: A Systematic Review and Meta-Analysis. J Altern Complement Med 2020; 27:225-237. [PMID: 33252246 DOI: 10.1089/acm.2020.0310] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: Coronavirus disease 2019 (COVID-19) has become a pandemic with no specific and widely accepted effective drug or vaccine. However, studies have shown that Traditional Chinese Medicine (TCM) may play a significant role as an auxiliary treatment for COVID-19. Objective: This study aimed to assess the effects of TCM as an auxiliary treatment for COVID-19 through a systematic review of randomized-controlled trials (RCTs). Methods: Four English and three Chinese language databases were searched from December 1, 2019, to June 30, 2020. RCTs comparing TCM in combination with Western medicine (WM) with the same WM therapies alone for confirmed COVID-19 patients were included. The outcome measures were cure rate, lowering of body temperature, cough relief, improvement in chest computed tomography (CT) images, deterioration of condition, and adverse effects. Methodological quality was assessed using the Cochrane risk-of-bias tool. A series of meta-analyses were conducted for selected outcomes using RevMan 5.3 software. The quality of evidence was appraised using the grading of recommendation, assessment, development, and evaluation (GRADE) recommendations. Results: Ten RCTs with a total of 1,285 patients were included. Compared with WM alone in treating COVID-19, WM with auxiliary treatment by TCM appears to have increased the cure rate (risk ratio [RR] 1.15 [95% confidence interval (CI) 1.04-1.26]), relieved cough (RR 1.32 [95% CI 1.15-1.52]), improved chest CT images (RR 1.23 [95% CI 1.11-1.37]), and reduced the number of cases transitioning from a moderate to severe condition (RR 0.58 [95% CI 0.43-0.77]). The authors are uncertain whether TCM combined WM has effects on fever normalization (RR 1.10 [95% CI 0.94-1.29]) or adverse effects (RR 0.81 (95% CI 0.42-1.57]). Although they evaluated the certainty of evidence for lowering body temperature and adverse effects as very low, and low for cure rate, certainty was evaluated as moderate for improvement in chest CT images, cough relief, and deterioration of condition. Conclusion: TCM may be an effective auxiliary treatment for COVID-19 patients, which is likely to help improve the main symptoms and reduce disease progression. However, due to the limited number of studies and apparent heterogeneity among them, a more definitive conclusion on the effect of TCM on lowering body temperature and adverse effects cannot be drawn at this time.
Collapse
Affiliation(s)
- Le-Peng Zhou
- Department of Nursing, Nanhai Hospital of Southern Medical University, Foshan, Guangdong, China.,General Practice Center, Nanhai Hospital of Southern Medical University, Foshan, Guangdong, China
| | - Jie Wang
- Department of Nursing, Nanhai Hospital of Southern Medical University, Foshan, Guangdong, China.,General Practice Center, Nanhai Hospital of Southern Medical University, Foshan, Guangdong, China
| | - Ri-Hua Xie
- Department of Nursing, Nanhai Hospital of Southern Medical University, Foshan, Guangdong, China.,General Practice Center, Nanhai Hospital of Southern Medical University, Foshan, Guangdong, China
| | - Smita Pakhale
- Division of Respirology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Daniel Krewski
- School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada.,McLaughlin Centre for Population Health Risk Assessment, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada.,Risk Science International, Ottawa, Ontario, Canada
| | - D William Cameron
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada.,Division of Infectious Diseases, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Shi Wu Wen
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada.,Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| |
Collapse
|
46
|
Mohammadi H, Manouchehri H, Changizi R, Bootorabi F, Khorramizadeh MR. Concurrent metformin and silibinin therapy in diabetes: assessments in zebrafish ( Danio rerio) animal model. J Diabetes Metab Disord 2020; 19:1233-1244. [PMID: 33553026 DOI: 10.1007/s40200-020-00637-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/14/2020] [Indexed: 01/11/2023]
Abstract
Objective In this study, zebrafish was used as a biological model to induce type 2 diabetes mellitus through glucose. Then, the effect of metformin and silibinin combination was examined on elevated blood glucose, intestinal tissues, liver enzymes, and TNF-α, IFN-γ, INL1β genes as inflammation marker genes. Methods The liver enzymes (AST, ALT, and ALP) derived from fish viscera homogenate supernatants were assayed in an auto-analyzer. The expression of target genes was quantified on RNA extracted from the tails by an in-house RT-PCR method, with fine intestine tissue staining performed by hematoxylin and eosin protocol (H&E). Result In the glucose-free treatments, metformin and silymarin decreased the levels of AST, ALT, and ALP enzymes in the blood. The combination of these two drugs had also a significant role in reducing glucose levels. The body weight increased significantly in the control group which was affected by glucose concentration, with the lowest body weight gain observed in the metformin group. The expression of INL-1β gene was significantly enhanced in the control group and the highest IFN-γ expression was observed in both control groups with glucose (G + CTRL) and without glucose (G-CTRL) (p < 0.05). The lowest level of TNF-α gene expression was observed in the control + glucose group (G + CTRL) (p < 0.05). Diabetic state causes weak absorption whereby the fish body demands to increase absorption level by enhancing the amount of acidic goblet cells thereby acidifying the environment in the gastric tracts. Conclusion Collectively, this study indicated that treatment with metformin and Silibinin could improve metabolic-mediated performances by reducing the expression of inflammatory genes and blood glucose, modulating liver enzymes, and ameliorating the intestinal inflammation in type 2 diabetic zebrafish model.
Collapse
Affiliation(s)
- Hassan Mohammadi
- Department of Aquaculture Science, Babol Branch, Islamic Azad University, Babol, Iran
| | - Hamed Manouchehri
- Department of Aquaculture Science, Babol Branch, Islamic Azad University, Babol, Iran
| | - Reza Changizi
- Department of Aquaculture Science, Babol Branch, Islamic Azad University, Babol, Iran
| | - Fatemeh Bootorabi
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Mohammad Reza Khorramizadeh
- Biosensor Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, and Zebra fish core Facility (ZFIN ID : ZDB-LAB-190117-2), Endocrinology and Metabolism research Institute, Tehran university of Medical Sciences, Tehran, Iran
| |
Collapse
|
47
|
Naserizadeh SK, Taherifard MH, Shekari M, Mesrkanlou HA, Asbaghi O, Nazarian B, Khosroshahi MZ, Heydarpour F. The effect of crocin supplementation on lipid concentrations and fasting blood glucose: A systematic review and meta-analysis and meta-regression of randomized controlled trials. Complement Ther Med 2020; 52:102500. [PMID: 32951748 DOI: 10.1016/j.ctim.2020.102500] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/30/2020] [Accepted: 06/30/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE This meta-analysis aimed to assess the effects of crocin supplementation on fasting blood glucose (FBG) and lipid profile levels in clinical trial studies. DESIGN A systematic literature search was performed in PubMed, Scopus, Embase, Web of Science, and the Cochrane Library databases for clinical trials published from the beginning up to November 2019. Of the 547 papers identified from all searched databases, eight eligible studies with nine effect sizes have all needed criteria for inclusion in this meta-analysis. RESULTS Results of the pooled random-effect size analysis showed just a significant decreasing effect of crocin supplementation on FBG (WMD: -6.52 mg/l, 95 % CI, -11.96, -1.08; p = 0.019) and TC (WMD: -4.64 mg/l, 95 % CI, -8.19, -1.09; p = 0.010). Crocin supplements did not have any significant effect on serum TG (p = 0.144) levels, LDL-C (p = 0.161), and HDL-C (p = 0.872) levels. Results showed that crocin supplementation could beneficially have effect on TG level only when trial duration less than 12 weeks and LDL-C levels in trials that used high dose intervention and trials that conducted on subjects with metabolic disorders. However, crocin supplementation did not significantly change FBG in trials that used low dose intervention. Meta-regression analysis indicated a linear relationship between the duration of intervention and significant change in FBG (p = 0.019). CONCLUSION Results of this systematic review and meta-analysis study have shown that crocin supplementation can decrease significantly FBS and TC without any beneficial effects on TG, LDL-C, and HDL-C levels.
Collapse
Affiliation(s)
| | | | - Mahdi Shekari
- Department of Nutrition, Faculty of Health, Qazvin University of Medical Sciences Qazvin, Iran.
| | | | - Omid Asbaghi
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran.
| | - Behzad Nazarian
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran.
| | | | - Fatemeh Heydarpour
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| |
Collapse
|
48
|
Medicinal plants in the adjunctive treatment of patients with type-1 diabetes: a systematic review of randomized clinical trials. J Diabetes Metab Disord 2020; 19:1917-1929. [PMID: 33520869 DOI: 10.1007/s40200-020-00633-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 09/08/2020] [Indexed: 12/22/2022]
Abstract
Propose This study aims to systematically review the randomized controlled trials that address the effectiveness and safety of herbal medicine in patients with type 1 diabetes. Methods The Cochrane Library (latest issue); MEDLINE (until recent); EMBASE (until recent); AMED (Allied and Complementary Medicine Database) (until recent); and CINHAL (until recent) were searched electronically for the identification of trials until October 2019. Articles were initially screened based on title and abstract and then by full text by two independent authors. References of retrieved studies were hand-searched for further studies. Risk of bias was assessed according to the Cochrane handbook of systematic reviews of interventions. The results were summarized into GRADE (grading of recommendations, assessment, development and evaluation) tables. No meta-analysis was applicable as only one study was found for each intervention. Results Four RCTs were finally included in the systematic review with an overall moderate quality of conduct and low quality of reporting. The sample sizes were very small. The results of these RCTs show that cinnamon pills and Berberine/Silymarine compound capsules may decrease blood glucose indices from baseline, while fenugreek seeds and fig leaf decoction do not show any statistically significant effect. Conclusions The evidence is scarce and no recommendations can be made based on current evidence. Further trials with more rigorous methodology and stronger quality of reporting are needed to make conclusions.
Collapse
|
49
|
E Ul Haq M, Akash MSH, Rehman K, Mahmood MH. Essential Oils Downregulate Pro-Inflammatory Cytokines and Nitric Oxide-Mediated Oxidative Stress in Alloxan-Induced Diabetogenic Rats. Endocr Metab Immune Disord Drug Targets 2020; 21:756-767. [PMID: 32727343 DOI: 10.2174/1871530320666200729113954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/02/2020] [Accepted: 06/17/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Hyperglycemia is associated with an elevated level of reactive nitrogen species (RNS) that leads to nitrosative stress and exacerbates the progression of diabetic complications. METHODS Present study was aimed to evaluate the therapeutic effects of essential oils (EOs) on increased serum levels of nitric oxide (NO) in diabetogenic rats. Diabetogenic rats were treated with EOs separately and/or in combination at the dose of 100 mg/kg, orally for one month. Blood sampling was done at the 1st, 15th and 30th day of the treatment period to investigate the effect of treatment on biomarkers of diabetic complications. RESULTS In diabetogenic rats, serum levels of NO, malondialdehyde (MDA) and pro-inflammatory cytokines were significantly increased when compared with that of the control group. Whereas, diabetogenic rats treated with EOs decreased serum levels of NO, MDA and pro-inflammatory cytokines up to a significant extent when compared with that diabetogenic rats treated with the standard antidiabetic drug. Moreover, EOs also increased insulin sensitivity in peripheral tissues and insulin secretion from β-cells of pancreatic islets more efficiently when compared with that of diabetogenic rats. Additionally, it was also found that EOs improved lipid profile and normal functions of kidney and liver as compared to that of diabetogenic rats. CONCLUSION Findings of this study indicate that EOs may reduce pro-inflammatory cytokine levels by modulating the expression of NO. EOs may also ameliorate the nitrosative stress and maintain glucose homeostasis that are major culprits of diabetic complications.
Collapse
Affiliation(s)
- Muhammad E Ul Haq
- Department of Pharmaceutical Chemistry, Government College University, Faisalabad, Pakistan
| | - Muhammad S H Akash
- Department of Pharmaceutical Chemistry, Government College University, Faisalabad, Pakistan
| | - Kanwal Rehman
- Department of Pharmacy, University of Agriculture, Faisalabad, Pakistan
| | - Malik H Mahmood
- Department of Pharmacology, Government College University, Faisalabad, Pakistan
| |
Collapse
|
50
|
The Herbal Combination CPA4-1 Inhibits Changes in Retinal Capillaries and Reduction of Retinal Occludin in db/db Mice. Antioxidants (Basel) 2020; 9:antiox9070627. [PMID: 32708791 PMCID: PMC7402168 DOI: 10.3390/antiox9070627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 12/11/2022] Open
Abstract
Increased formation of advanced glycation end products (AGEs) plays an important role in the development of diabetic retinopathy (DR) via blood-retinal barrier (BRB) dysfunction, and reduction of AGEs has been suggested as a therapeutic target for DR. In this study, we examined whether CPA4-1, a herbal combination of Cinnamomi Ramulus and Paeoniae Radix, inhibits AGE formation. CPA4-1 and fenofibrate were tested to ameliorate changes in retinal capillaries and retinal occludin expression in db/db mice, a mouse model of obesity-induced type 2 diabetes. CPA4-1 (100 mg/kg) or fenofibrate (100 mg/kg) were orally administered once a day for 12 weeks. CPA4-1 (the half maximal inhibitory concentration, IC50 = 6.84 ± 0.08 μg/mL) showed approximately 11.44-fold higher inhibitory effect on AGE formation than that of aminoguanidine (AG, the inhibitor of AGEs, IC50 = 78.28 ± 4.24 μg/mL), as well as breaking effect on AGE-bovine serum albumin crosslinking with collagen (IC50 = 1.30 ± 0.37 μg/mL). CPA4-1 treatment ameliorated BRB leakage and tended to increase retinal occludin expression in db/db mice. CPA4-1 or fenofibrate treatment significantly reduced retinal acellular capillary formation in db/db mice. These findings suggested the potential of CPA4-1 as a therapeutic supplement for protection against retinal vascular permeability diseases.
Collapse
|