The effects of green cardamom supplementation on blood glucose, lipids profile, oxidative stress, sirtuin-1 and irisin in type 2 diabetic patients: a study protocol for a randomized placebo-controlled clinical trial

Antioxidant Activity in Extracts from Zingiberaceae Family: Cardamom, Turmeric, and Ginger

An increase in life expectancy leads to a greater impact of chronic non-communicable diseases. This is even more remarkable in elder populations, to whom these become main determinants of health status, affecting mental and physical health, quality of life, and autonomy. Disease appearance is closely related to the levels of cellular oxidation, pointing out the importance of including foods in one's diet that can prevent oxidative stress. Previous studies and clinical data suggest that some plant-based products can slow and reduce the cellular degradation associated with aging and age-related diseases. Many plants from one family present several applications that range from the food to the pharmaceutical industry due to their characteristic flavor and scents. The Zingiberaceae family, which includes cardamom, turmeric, and ginger, has bioactive compounds with antioxidant activities. They also have anti-inflammatory, antimicrobial, anticancer, and antiemetic activities and properties that help prevent cardiovascular and neurodegenerative diseases. These products are abundant sources of chemical substances, such as alkaloids, carbohydrates, proteins, phenolic acids, flavonoids, and diarylheptanoids. The main bioactive compounds found in this family (cardamom, turmeric, and ginger) are 1,8-cineole, α-terpinyl acetate, β-turmerone, and α-zingiberene. The present review gathers evidence surrounding the effects of dietary intake of extracts of the Zingiberaceae family and their underlying mechanisms of action. These extracts could be an adjuvant treatment for oxidative-stress-related pathologies. However, the bioavailability of these compounds needs to be optimized, and further research is needed to determine appropriate concentrations and their antioxidant effects in the body.

The effect of green cardamom on blood pressure and inflammatory markers among patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized clinical trials

Research shows that herbal spices, including seeds of Elettaria cardamomum, may exert beneficial effects on unhealthy metabolic status. This study is a systematic review of the effect of green cardamom in patients with metabolic syndrome and its related disorders. PubMed/Medline, Scopus, EMBASE, Web of Science, and Cochrane Library were searched to identify the relevant randomized clinical trials. The data were pooled using the random-effects model, and weighted mean difference (WMD) was considered as summary effect size. Of 625 clinical trials, eight reports with 595 patients (299 in intervention group and 296 in control group) were included. The findings indicated that green cardamom significantly decreased diastolic blood pressure (WMD: -0.91 mmHg, 95%CI; -1.19, -0.62), high-sensitivity C-reactive protein (WMD: -1.21 mg/L, 95%CI; -2.18, -0.24), interleukin 6 levels (WMD: -2.41 ng/L, 95%CI; -4.35, -0.47). However, cardamom supplementation did not significantly affect systolic blood pressure. This meta-analysis demonstrated that green cardamom could improve blood pressure control and exert antiinflammatory effects which could help patients with unhealthy metabolic profile better manage their health. Importantly, there were few eligible randomized trials with quite a low number of participants. Further prospective studies on larger sample sizes and longer duration of supplementation are warranted for its widespread use.

Effect of green cardamom on the expression of genes implicated in obesity and diabetes among obese women with polycystic ovary syndrome: a double blind randomized controlled trial

BACKGROUND

Polycystic ovary syndrome (PCOS) is an endocrine disease in which related to obesity, metabolic disorders and is considered as one of the main causes of infertility in women. This trial was investigated the effects of green cardamom on the expression of genes implicated in obesity and diabetes among obese women with PCOS.

METHODS

One hundred ninety-four PCOS women were randomly divided two groups: intervention (n = 99; 3 g/day green cardamom) and control groups (n = 95). All of them were given low calorie diet. Anthropometric, glycemic and androgen hormones were assessed before and after 16-week intervention. The reverse transcription-polymerase chain reaction (RT-PCR) method was used to measure fat mass and obesity-associated (FTO), peroxisome proliferative activating receptor- (PPAR-), carnitine palmitoyltransferase 1A (CPT1A), acetyl-CoA carboxylase beta (ACAB), leptin receptor (LEPR), ghrelin, and lamin A/C (LAMIN) genes expression in each group.

RESULTS

Anthropometric indices were significantly decreased after intervention in both two studied groups. Glycemic indices and androgen hormones were significantly improved in the intervention group compared to the control group. The expression levels of FTO, CPT1A, LEPR, and LAMIN were significantly downregulated compared to control group (P < 0.001), as well as, PPAR-y was significantly upregulated in the intervention group after intervention with green cardamom compared to control group (P < 0.001).

CONCLUSION

This current study showed that the administration of green cardamom is a beneficial approach for improving anthropometric, glycemic, and androgen hormones, as well as obesity and diabetes genes expression in PCOS women under the low-calorie diet.

TRIAL REGISTRATION

This trial was registered with the Iranian Clinical Trials Registry (registration number: IRCT20200608047697N1). 1 August, 2020; https://www.irct.ir/trial/48748.

Irisin enhances longevity by boosting SIRT1, AMPK, autophagy and telomerase

Ageing is characterised by the accumulation of molecular and cellular damage through time, leading to a decline in physical and mental abilities. Currently, society has experienced a rapid increase in life expectancy, which has led to an increase in age-associated diseases. Therefore, it is crucial to study the process of ageing to guarantee the best conditions in the final stages of life. In recent years, interest has increased in a myokine known as irisin, which is secreted during physical exercise. This polypeptide hormone is produced by various organs, mainly muscle, and once it is released into the blood, it performs a wide variety of functions that are involved in metabolic control and may be relevant during some of the diseases associated with ageing. The aim of this review is to highlight the recent studies of irisin, such as its mechanism of expression, blood release, distribution, tissue target and participation in various cellular metabolic reactions and the relationship with key anti-ageing pathways such as adenosine monophosphate-activated protein kinase, silent information regulator T 1, autophagy and telomerase. In conclusion, irisin is a key player during the ageing process and it could be a novel target molecule for the therapeutic approach to boost longevity pathways. However, more research will be necessary to use this promising hormone for this gain.

Green cardamom plus low-calorie diet can decrease the expression of inflammatory genes among obese women with polycystic ovary syndrome: a double-blind randomized clinical trial

PURPOSE

Polycystic ovary syndrome (PCOS) is an endocrine disorder and a common cause of infertility among women that is associated with low-grade inflammation. Therefore, the current randomized, double-blind, placebo-controlled clinical trial was conducted to assess the effects of green cardamom supplementation on the serum level of inflammatory markers and their gene expression among obese women with PCOS.

METHODS

We included 194 obese women with PCOS and administered low-calorie diet to all of them. These subjects were randomly divided into two groups including the intervention group with 3 g/day green cardamom (n = 99) and the placebo group (n = 95). Anthropometric indices, androgen hormones, and inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6), and C-reactive protein (CRP)] were assessed before and after the 4-month intervention. TNF-α, IL-6, and CRP gene expression levels were measured using reverse transcription-polymerase chain reaction (RT-PCR) method.

RESULTS

Anthropometric indices were improved in both studied groups (P < 0.001). Among androgen hormones, luteinizing hormone, androstenedione, and dehydroepiandrosterone were significantly decreased (P < 0.001), and follicle-stimulating hormone was significantly increased (P < 0.001) in the green cardamom group. Our findings showed that TNF-α, IL-6, and CRP serum levels were significantly decreased after the intervention with green cardamom plus low-calorie diet (P < 0.001). In addition, the expression levels of TNF-α and CRP genes were significantly decreased in the intervention group (P < 0.001).

CONCLUSIONS

The present study supports the beneficial anti-inflammatory effect of green cardamom on the inflammatory state in PCOS women.

LEVEL OF EVIDENCE

Level I: randomized clinical trial. Trial registration This trial was registered with the Iranian Clinical Trials Registry (registration number: IRCT20200608047697N1). 1 August, 2020; https://www.irct.ir/trial/48748 .

Nutrition in the management of type 2 diabetes mellitus: review

Type 2 diabetes mellitus (T2DM) is the most prevalent disease and becoming a serious public health threat worldwide. In recent years, numerous effective T2DM intervention regimens have been developed, with promising results. However, these regimens are not usually economically available, and they are not well tolerated due to treatment-related toxicities. The focus nowadays is to identify new effective therapeutic agents, with relatively low cost and low toxicity, which can be used regularly to control a progression of T2DM in the prediabetic population. Accordingly, there has been growing attention in herbal remedies that can be presented into the general population with the tiniest side effects and the maximal preventive outcome. This article reviews recent publications in experimental models of T2DM not revised before, and supporting the potential use of nutraceuticals and phytochemicals through different mechanisms with promising results in the context of T2DM.

Effect of omega-3 and vitamin D co-supplementation on psychological distress in reproductive-aged women with pre-diabetes and hypovitaminosis D: A randomized controlled trial

PURPOSE

Psychological distresses and pre-diabetes are among the risk factors of developing type-II diabetes. The present study was conducted to determine the effectiveness of omega-3 and vitamin D co-supplementation on psychological distresses in women of reproductive age with pre-diabetes and hypovitaminosis D.

METHODS

The present factorial clinical trial was conducted on 168 women of reproductive age with pre-diabetes and hypovitaminosis D. These participants were selected by stratified random sampling and were assigned to four groups for 8 weeks: group 1 (placebo group), group 2 (omega-3 group), group 3 (vitamin D group), and group 4 (co-supplement group). The medication and placebo doses being two 1000-mg tablets each day for omega-3 and 50,000-IU pearls every 2 weeks for vitamin D. Fasting blood glucose and vitamin D were measured at the beginning of the study. The Depression Anxiety Stress Scale-21 and the Pittsburgh Sleep Quality Index were completed by the participants at the start and end of the intervention.

RESULTS

A significant difference was observed in terms of reduction in anxiety and improvement in sleep quality in the co-supplementation compared to the other three groups (p < .05). There was also a significant difference between the group receiving both supplements and the group receiving only placebos in terms of reduction in depression and stress (p < .05).

CONCLUSION

Vitamin D and omega-3 co-supplementation improved depression, anxiety, and sleep quality in women of reproductive age with pre-diabetes and hypovitaminosis D. Therefore, these two supplements can be recommended for improving the mental health of this group of women.

CLINICAL TRIAL REGISTRY

Iranian Registry of Clinical Trials Code: IRCT20100130003226N17. Registered on February 9, 2019.

Chemical Profile, In Vitro Antioxidant, Pancreatic Lipase, and Alpha-Amylase Inhibition Assays of the Aqueous Extract of Elettaria cardamomum L. Fruits

Phytochemical and pharmacological investigations of Elettaria cardamomum L. were mostly focused on its essential oil and organic crude extracts with little attention on its aqueous extracts. Therefore, the current study aimed to investigate the phytochemical profile, in vitro antiobesity, and antidiabetic activities of the aqueous extract of Elettaria cardamomum L. family Zingiberaceae. UPLC-ESI-MS/MS analysis is used for the aqueous extract characterization in both ionization modes. The analysis revealed the tentative identification of forty-seven compounds based on their MS/MS fragmentation pattern and comparison with the reported data. The identified compounds include eight flavones, thirteen phenolic and nonphenolic acids, one coumarin, and nineteen anthocyanins. Moreover, the in vitro antiobesity and antidiabetic activities were also studied. The results showed that E. cardamomum L. aqueous extract inhibits pancreatic lipase and α-amylase enzyme in a concentration-dependent manner, as 1 mg/mL extract was able to inhibit pancreatic lipase and α-amylase by 62.25% ± 0.58 (IC50 = 288.75 ± 1.3 µg/mL) and 70.42% ± 1.5 (IC50 = 220.5 ± 1.3 µg/mL), respectively. Conclusively, the current study indicated that the investigated biological activities of Elettaria cardamomum aqueous extract were attributed to the existence of biologically active metabolites such as flavones, phenolic and nonphenolic acids, coumarins, and anthocyanins. Moreover, it proposed that the aqueous cardamom extract can be used as a natural potential source in different pharmaceutical preparations to protect against variable chronic disorders, especially obesity and diabetes. Deeper in vivo investigations, isolation, purification, and structural elucidation of the major active metabolites from cardamom are recommended.

Effects of Essential Oils of Elettaria cardamomum Grown in India and Guatemala on Gram-Negative Bacteria and Gastrointestinal Disorders

The present study examined the chemical composition and antimicrobial and gastrointestinal activity of the essential oils of Elettaria cardamomum (L.) Maton harvested in India (EC-I) and Guatemala (EC-G). Monoterpenes were present in higher concentration in EC-I (83.24%) than in EC-G (73.03%), whereas sesquiterpenes were present in a higher concentration in EC-G (18.35%) than in EC-I (9.27%). Minimum inhibitory concentrations (MICs) of 0.5 and 0.25 mg/mL were demonstrated against Pseudomonas aeruginosa in EC-G and EC-I, respectively, whereas MICs of 1 and 0.5 mg/mL were demonstrated against Escherichia coli in EC-G and EC-I, respectively. The treatment with control had the highest kill-time potential, whereas the treatment with oils had shorter kill-time. EC-I was observed to be more potent in the castor oil-induced diarrhea model than EC-G. At 100 and 200 mg/kg, P.O., EC-I exhibited 40% and 80% protection, respectively, and EC-G exhibited 20% and 60% protection, respectively, in mice, whereas loperamide (10 mg/kg, i.p., positive control) exhibited 100% protection. In the in vitro experiments, EC-I inhibited both carbachol (CCh, 1 µM) and high K⁺ (80 mM)-induced contractions at significantly lower concentrations than EC-G. Thus, EC-I significantly inhibited P. aeruginosa and E. coli and exhibited more potent antidiarrheal and antispasmodic effects than EC-G.

Low to no cost remedies for the management of diabetes mellitus; global health concern

Purpose

Diabetes mellitus (DM) is a chronic non-communicable endocrine and metabolic disease that is thought to be the fastest emerging health challenge of the twenty-first century. Presently, 90% of diabetic population is handicapped with T2-DM, and the majority of pre-diabetes on the way to T2-DM progression. By keeping in view, a review article has been compiled to highlight the significance of value aided effective, low-cost, safe, and useful remedies that could easily be accessible to the global community in order to moderate the possibility of DM and related complications.

Methods

Literature search for this review was carried out using scientific databases including PubMed, EBSCO, Scopus, Web of science, and google scholar. Whilst, value aided articles were selected on the basis of their therapeutic potential, safety profile and outreach.

Results

Escalating research data validated that herbal remedies and physical activities significantly prevents hyperglycemia, hyperlipidemia, and other complications in people with T2-DM.

Conclusion

Globally, nearly half-billion individuals are living with diabetes. Therefore, it is urged to embrace herbal remedies and physical mediation in our daily routine in order to tackle such devastating disorder.

Botany, traditional uses, phytochemistry and biological activities of cardamom [Elettaria cardamomum (L.) Maton] - A critical review

ETHNOPHARMACOLOGICAL RELEVANCE

Small cardamom [Elettaria cardamomum (L.) Maton. (Family: Zingiberaceae)] capsules (fruits) have been used for traditional medicine applications including for the control of asthma, teeth and gum infections, cataracts, nausea, diarrhea, as well as cardiac, digestive and kidney disorders. The versatile use of cardamom capsules has several other beneficial health effects that are relevant in light of traditional and modern pharmaceutical perspectives.

AIM OF THE STUDY

This review aims to provide a critical and comprehensive evaluation of the traditional and current medical uses of E. cardamomum, and compare these applications with modern research studies. This critical review also discusses the botanical distribution, phytochemical constituents and biological activities of cardamom capsule extracts and essential oil.

MATERIALS AND METHODS

An online survey was conducted of the traditional uses, phytochemical composition, and pharmacological applications of cardamom essential oil (CEO) and extracts. Pertinent data were obtained from several electronic scientific databases (Science Direct, Elsevier, Web of Science, PubMed, Springer, ACS publications, Taylor and Francis, Wiley On-line Library and Google Scholar), and additional information was obtained from textbooks and local prints and scripts.

RESULTS

Cardamom fruits (capsules) are used widely as a spice and flavoring ingredient in foods, and are often recognized for their beneficial health properties. They are also used in fragrances. Phytochemical analyses have described important chemical constituents of cardamom including carbohydrates, proteins, minerals, lipids, essential oils, flavonoids, terpenoids and carotenoids. CEO has several biological roles including antioxidant, antidiabetic, antibacterial, anticancer, gastro-protective and insecticidal activities.

CONCLUSION

The widespread availability and recommendation of synthetic compounds for addressing human health have several side effects besides higher costs. Hence, examining natural bioactive compounds is imperative. This review investigates and presents the pertinent information on cardamom and its traditional uses, as well as potential pharmacological properties of CEO and extracts. Additional research studies are needed to understand the mechanism of action of bioactive constituents.

The effect of omega-3 and vitamin D co-supplementation on glycemic control and lipid profiles in reproductive-aged women with pre-diabetes and hypovitaminosis D: a randomized controlled trial

BACKGROUND

Prediabetes can predispose the individual to type 2 diabetes in the long-term. The present study was conducted to determine the effectiveness of vitamin D and omega-3 co-supplementation on glycemic control and serum lipid profiles in women of reproductive age with prediabetes and hypovitaminosis D.

METHODS

The present factorial, triple-blind, clinical trial was conducted on 168 women of reproductive age with prediabetes and hypovitaminosis D. The participants were assigned to four groups based on block randomization method: the placebo group received omega-3 and vitamin D placebos; the omega-3 group took omega-3 supplements and vitamin D placebos; the vitamin D group received omega-3 placebos and vitamin D supplements and the co-supplementation group. The groups received every 2 weeks 50,000 IU pearls of vitamin D and twice-daily doses of 1000-mg omega-3 tablets or placebos for 8 weeks. Dietary intake, physical activity, anthropometric indices and blood biochemical tests were measured at the beginning and end of the study. Analysis was performed using two-way mixed ANOVA.

RESULTS

A significant reduction was observed in fasting glucose, insulin, homeostasis model assessment-beta cell function, weight and waist circumference in the co-supplementation group compared to the other three groups (P < 0.05). Moreover, high-density lipoprotein-cholesterol levels increased significantly in the co-supplementation group compared to the other three groups (P < 0.05). Despite the fact that homeostasis model assessment-insulin resistance, total cholesterol, triglyceride and low-density lipoprotein-cholesterol levels decreased after intervention in the co-supplementation group, there was no significant difference between the groups in these outcomes.

CONCLUSION

Vitamin D and omega-3 co-supplementation improved fasting serum glucose, insulin, high-density lipoprotein-cholesterol level, homeostasis model assessment-beta cell function, weight and waist circumference in women of reproductive age with prediabetes and hypovitaminosis D. This co-supplementation can therefore be recommended for glycemic control in these women.Trial registration Iranian Registry of Clinical Trials Code: IRCT20100130003226N17. Registered on 9 Feb. 2019.

The effect of co supplementation of omega-3 and vitamin D on cardio metabolic risk factors and psychological distress in reproductive-aged women with prediabetes and hypovitaminosis D: a study protocol for a randomized controlled trial

BACKGROUND

A prediabetic state is a risk factor for type 2 diabetes. There are no approved drugs to manage prediabetes. Among the supplements routinely used by individuals, vitamin D and omega-3 have been studied to reduce fasting blood sugar. However, their co-supplementation has not been studied in individuals with prediabetes. This randomized controlled trial is designed to determine the effects of these two supplements on fasting blood sugar, other cardio metabolic risk factors, and psychological distress in reproductive-aged women with prediabetes and hypovitaminosis D.

METHODS/DESIGN

This 2 × 2 factorial, triple-blind, randomized, placebo-controlled, clinical trial will be done on 168 women of reproductive age diagnosed with prediabetes and hypovitaminosis D. Participants will be randomly assigned equally to four groups: (1) 1000 mg omega-3 fatty acid twice a day + vitamin D placebo every two weeks; (2) omega-3 fatty acid placebo twice a day + 50,000 IU vitamin D every two weeks; (3) 1000 mg omega-3 fatty acid twice a day + 50,000 IU vitamin D every two weeks; (4) omega-3 fatty acid placebo twice a day + vitamin D placebo every two weeks for eight weeks. At the beginning, participants will provide a self-reported questionnaire on the sociodemographic characteristics. At baseline and post-intervention visits, physical activity, Depression Anxiety Stress Scale 21 and Pittsburgh Sleep Quality Index, and a three-day food record will be collected for each individual. Blood pressure, weight, height, and waist circumference will also be measured. At the beginning and at the end, a blood sample will be used for estimating serum glucose indices (fasting blood sugar and insulin, homeostasis model assessment-insulin resistance, homeostasis model assessment-beta cell function), lipids (triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total cholesterol), and vitamin D status. Data analysis using Kolmogorov-Smirnov test, paired t-test, one-way analysis of variance, and repeated measures analysis of variance will be conducted through SPSS-24 software.

DISCUSSION

The primary aim of the present trial is to determine the effect of vitamin D and/or omega-3 on glycemic indices, lipid profiles, psychological distress, blood pressure, and anthropometric indices in prediabetic women with hypovitaminosis D. The results from this trial will provide evidence on the efficacy of these two supplements for preventing or delaying the onset of type 2 diabetes in high-risk individuals.

TRIAL REGISTRATION

Iran Clinical Trials Registry, IRCT20100130003226N17. Registered on 9 February 2019.

Systematics Evaluations of Morphological Traits, Chemical Composition, and Antimicrobial Properties of Selected Varieties of Elettaria cardamomum (L.) Maton

Elettaria cardamomum is cultivated in the Southern part of India showed great extinct of differences in their morphotypes and chemical compositions. In the present study, we have selected three varieties of Elettaria cardamomum “Valley Green, Palakuzhi, and ICRI”, to analyze the morphological perturbations, chemical compositions, and antimicrobial activities. The differences in the morphological character of cardamom varieties (Valley Green, Palakuzhi, and ICRI) were carried out on the basis of panicles, capsules shape, plant height, tiller, and seeds per capsule. The GC-MS analysis of the essential oils resulted in the identification of 27, 29, 30 compounds representing over 97.4%, 95.2%, and 98.8% of the Valley Green (VG), Palakuzhi (PAL), and ICRI fruit oils respectively. Monoterpene, α-terpinyl acetate varied from 35.4 to 47.5%, a major constituent while 1,8-cineole (22.8% to 27.4%) observed the second major compounds revealed in oils of these cultivars. Further, the antimicrobial activities of each essential oils were performed against Staphylococcus aureus, Bacillus subtilis, Escherichia coli, Klebsiella pneumoniae, Candida albicans, and Aspergillus niger. The maximum inhibition percentage against the microbes was observed in Valley Green essential oil as compared to oils of other varieties.

Efficacy and safety of cinnamon in type 2 diabetes mellitus and pre-diabetes patients: A meta-analysis and meta-regression

INTRODUCTION

Cinnamon has been used as a dietary component and in the management of diabetes mellitus. This study systematically reviewed and synthesized evidence on the efficacy of cinnamon for the treatment of type 2 diabetes mellitus (T2DM) and pre-diabetes patients.

METHODS

Databases of Web of Sciences, the Cochrane library, PubMed, CINAHL and SCOPUS were searched. Stata version 13 (College Station, Texas 77845 USA) and RevMan var. 5.3 software were used for meta-analysis. Heterogeneity was assessed using Chi-square and I² tests.

RESULTS

Sixteen randomized controlled studies were included in the meta-analysis. Cinnamon significantly reduced fasting blood glucose (FBG) and homeostatic model assessment for insulin resistance (HOMA-IR) level compared to placebo with weighted mean difference (WMD) of -0.545 (95% CI: -0.910, -0.18) mmol/L, I² = 83.6% and -0.714(-1.388, -0.04), I² = 84.4% respectively. There was no significant change in weighted mean difference of glycosylated hemoglobin A1C (HbA1c) % and lipid profiles (mmol/L). Meta-regression did not show any factor significantly affecting the treatment response.

CONCLUSION

Cinnamon reduced FBG and HOMA-IR, level in T2DM and pre-diabetes patients compared to placebo. High heterogeneity observed among included studies warrants further clinical trials after standardization of cinnamon formulation.

Beneficial effects of green cardamom on serum SIRT1, glycemic indices and triglyceride levels in patients with type 2 diabetes mellitus: a randomized double-blind placebo controlled clinical trial

BACKGROUND

Cardamom has antioxidant and anti-inflammatory effects which may help to remedy diseases. Studies on the health benefits of cardamom in diabetic patients are very limited. Thus, this study is designed to determine the effect of cardamom supplementation on blood lipids and glycemic indices in type 2 diabetic patients. To investigate the mechanism of cardamom effect on blood glucose and lipid levels, serum sirtuin-1 (SIRT1) was assessed.

RESULTS

In a parallel, double-blind randomized, placebo-controlled clinical trial, 83 overweight or obese type 2 diabetic patients were randomly allocated into an intervention (n = 41) or a control group (n = 42). The intervention and the placebo group received 3 g of green cardamom or rusk powder, respectively for 10 weeks. Physical activity level, dietary intake, anthropometric measurements (weight, height and waist circumference), glycemic indices [glucose, insulin, hemoglobin A1c (HbA1c)], blood lipids [triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c) and low-density lipoprotein cholesterol (LDL-c)] and SIRT1 levels were measured. Body mass index and homeostasis model assessment as an index of insulin resistance (HOMA-IR) were calculated before and after intervention. Compared to the control group, a significant decrease in serum HbA1C (-0.4%), insulin (-2.8 µIU dL^-1 ), HOMA-IR (-1.7) and TG (-39.9 mg dL^-1 ), and an increase in SIRT1 (2.3 ng mL^-1 ) was observed in cardamom group. There were no significant changes in serum TC, HDL-c and LDL-c levels between the two groups before and after adjustment for potential confounders including glyclaside dose, duration of disease and weight.

CONCLUSION

Our results showed that cardamom can decrease HbA1c, insulin level, HOMA-IR and TG level via increase in SIRT1 concentration in type 2 diabetes mellitus patients. © 2019 Society of Chemical Industry.

Ursolic acid alleviates inflammation and against diabetes‑induced nephropathy through TLR4‑mediated inflammatory pathway

Ursolic acid (UA) is a triterpenoid isolated from Chinese herbal medicine. It is extensively distributed in the plant kingdom in at least 63 Chinese herbal medicines of 26 families. UA has multiple bioactivities, including anti‑viral hepatitis, antitumor, anti‑oxidation, anti‑bacterium and anti‑inflammation. The aim of this in vitro study was to examine the effects of UA on diabetes‑induced nephropathy and its possible mechanism. In mice with diabetes‑induced nephropathy, UA increased the body weight, reduced kidney/body weight index, protected kidney cells, alleviated inflammation [tumor necrosis factor (TNF)‑α, interleukin (IL)‑1β, IL‑6 and IL‑18 levels] and kidney cell damage. It was also indicated that UA suppressed Toll‑like receptor 4 (TLR4), myeloid differentiation factor 88 and nuclear factor‑κB protein expression in mice with diabetes‑induced nephropathy. The inhibition of TLR4 increased the anti‑inflammation of UA on inflammation in rat with diabetes‑induced nephropathy through the TLR4 signaling pathway. In conclusion, UA alleviates inflammation and inhibits diabetes‑induced nephropathy through a TLR4‑mediated inflammatory pathway. The present findings indicated that UA may be a possible therapeutic agent against diabetic nephropathy.