Revealing metabolic and biochemical variations via 1H NMR metabolomics in streptozotocin-nicotinamide-induced diabetic rats treated with metformin

The increasing prevalence of lean diabetes has prompted the generation of animal models that mimic metabolic disease in humans. This study aimed to determine the optimum streptozotocin-nicotinamide (STZ-NA) dosage ratio to elicit lean diabetic features in a rat model. It also used a proton nuclear magnetic resonance (1H NMR) urinary metabolomics approach to identify the metabolic effect of metformin treatment on this novel rat model. Three different STZ-NA dosage regimens (by body weight: Group A: 110 mg/kg NA and 45 mg/kg STZ; Group B: 180 mg/kg NA and 65 mg/kg STZ and Group C: 120 mg/kg NA and 60 mg/kg STZ) were administered to Sprague-Dawley rats along with oral metformin. Group A diabetic rats (A-DC) showed favorable serum biochemical analyses and a more positive response toward oral metformin administration relative to the other STZ-NA dosage ratio groups. Orthogonal partial least squares-discriminant analysis (OPLS-DA) revealed that glucose, citrate, pyruvate, hippurate, and methylnicotinamide differentiating the OPLS-DA of A-MTF rats (Group A diabetic rats treated with metformin) and A-DC model rats. Subsequent metabolic pathway analyses revealed that metformin treatment was associated with improvement in dysfunctions caused by STZ-NA induction, including carbohydrate metabolism, cofactor metabolism, and vitamin and amino acid metabolism. In conclusion, our results identify the best STZ-NA dosage ratio for a rat model to exhibit lean type 2 diabetic features with optimum sensitivity to metformin treatment. The data presented here could be informative to improve our understanding of non-obese diabetes in humans through the identification of possible activated metabolic pathways in the STZ-NA-induced diabetic rats model.

Antidiabetic effect of Ardisia elliptica extract and its mechanisms of action in STZ-NA-induced diabetic rat model via 1H-NMR-based metabolomics

ETHNOPHARMACOLOGICAL RELEVANCE

Ardisia elliptica Thunb. (AE) (Primulaceae) is a medicinal plant found in the Malay Peninsula and has been traditionally used to treat diabetes. However, limited studies to date in providing scientific evidence to support the antidiabetic efficacy of this plant by in-vitro and in-vivo models.

AIM OF THE STUDY

To investigate the anti-hyperglycemic potential of AE through in-vitro enzymatic activities and streptozotocin-nicotinamide (STZ-NA) induced diabetic rat models using proton-nuclear magnetic resonance (1H-NMR)-based metabolomics approach.

MATERIALS AND METHODS

Anti-α-amylase and anti-α-glucosidase activities of the hydroethanolic extracts of AE were evaluated. The absolute quantification of bioactive constituents, using ultra-high performance liquid chromatography (UHPLC) was performed for the most active extract. Three different dosage levels of the AE extract were orally administered for 4 weeks consecutively in STZ-NA induced diabetic rats. Physical assessments, biochemical analysis, and an untargeted 1H-NMR-based metabolomics analysis of the urine and serum were carried out on the animal model.

RESULTS

Type 2 diabetes mellitus (T2DM) rat model was successfully developed based on the clear separation observed between the STZ-NA induced diabetic and normal non-diabetic groups. Discriminating biomarkers included glucose, citrate, succinate, allantoin, hippurate, 2-oxoglutarate, and 3-hydroxybutyrate, as determined through an orthogonal partial least squares-discriminant analysis (OPLS-DA) model. A treatment dosage of 250 mg/kg body weight (BW) of standardized 70% ethanolic AE extract mitigated increase in serum glucose, creatinine, and urea levels, providing treatment levels comparable to that obtained using metformin, with flavonoids primarily contribute to the anti-hyperglycemic activities. Urinary metabolomics disclosed that the following disturbed metabolism pathways: the citrate cycle (TCA cycle), butanoate metabolism, glycolysis and gluconeogenesis, pyruvate metabolism, and synthesis and degradation of ketone bodies, were ameliorated after treatment with the standardized AE extract.

CONCLUSIONS

This study demonstrated the first attempt at revealing the therapeutic effect of oral treatment with 250 mg/kg BW of standardized AE extract on chemically induced T2DM rats. The present study provides scientific evidence supporting the ethnomedicinal use of Ardisia elliptica and further advances the understanding of the fundamental molecular mechanisms affected by this herbal antidote.

Influence of Different Drying Methods on Anthocyanins Composition and Antioxidant Activities of Mangosteen (Garcinia mangostana L.) Pericarps and LC-MS Analysis of the Active Extract

Mangosteen pericarps (MP) often end up as agricultural waste despite being rich in powerful natural antioxidants such as anthocyanins and xanthones. This study compared the effect of different drying processes and times on phenolic compounds and antioxidant activities of MP. Fresh MP were subjected to 36 and 48 h of freeze-drying (-44 ± 1 °C) and oven-drying (45 ± 1 °C), and 30 and 40 h of sun-drying (31 ± 3 °C). The samples were analyzed for anthocyanins composition, total phenolic content (TPC), total flavonoid content (TFC), antioxidant activities, and color characteristics. Analysis of liquid chromatography-mass spectrometry (LC-MS) with electrospray ionization identified two anthocyanins in MP: cyanidin-3-O-sophoroside and cyanidin-3-O-glucoside. Overall, the drying process, time, and their interactions significantly (p < 0.05) influenced the phenolic compounds, antioxidant activities, and color in MP extracts. Both freeze-drying after 36 h (FD36) and 48 h (FD48) possessed significantly (p < 0.05) higher total anthocyanins (2.1-2.2 mg/g) than other samples. However, FD36 was associated with significantly (p < 0.05) higher TPC (~94.05 mg GAE/g), TFC (~621.00 mg CE/g), and reducing power (~1154.50 μmol TE/g) compared to FD48. Moreover, FD36 is more efficient for industrial applications due to less time and energy consumption. Subsequently, obtained dried MP extracts could be further utilized as an alternative to synthetic food colorants.

Metabolic Alterations in Streptozotocin-nicotinamide-induced Diabetic Rats Treated with Muntingia calabura Extract via 1H-NMR-based Metabolomics

Diabetes mellitus (DM) is a metabolic endocrine disorder caused by decreased insulin concentration or poor insulin response. Muntingia calabura (MC) has been used traditionally to reduce blood glucose levels. This study aims to support the traditional claim of MC as a functional food and blood-glucose-lowering regimen. The antidiabetic potential of MC is tested on a streptozotocin-nicotinamide (STZ-NA)-induced diabetic rat model by using the ¹H-NMR-based metabolomic approach. Serum biochemical analyses reveal that treatment with 250 mg/kg body weight (bw) standardized freeze-dried (FD) 50% ethanolic MC extract (MCE 250) shows favorable serum creatinine (37.77 ± 3.53 µM), urea (5.98 ± 0.84 mM) and glucose (7.36 ± 0.57 mM) lowering capacity, which was comparable to the standard drug, metformin. The clear separation between diabetic control (DC) and normal group in principal component analysis indicates the successful induction of diabetes in the STZ-NA-induced type 2 diabetic rat model. A total of nine biomarkers, including allantoin, glucose, methylnicotinamide, lactate, hippurate, creatine, dimethylamine, citrate and pyruvate are identified in rats' urinary profile, discriminating DC and normal groups through orthogonal partial least squares-discriminant analysis. Induction of diabetes by STZ-NA is due to alteration in the tricarboxylic acid (TCA) cycle, gluconeogenesis pathway, pyruvate metabolism and nicotinate and nicotinamide metabolism. Oral treatment with MCE 250 in STZ-NA-induced diabetic rats shows improvement in the altered carbohydrate metabolism, cofactor and vitamin metabolic pathway, as well as purine and homocysteine metabolism.

In Vitro Anti-Diabetic Activities and UHPLC-ESI-MS/MS Profile of Muntingia calabura Leaves Extract

Anti-diabetic compounds from natural sources are now being preferred to prevent or treat diabetes due to adverse effects of synthetic drugs. The decoction of Muntingia calabura leaves was traditionally consumed for diabetes treatment. However, there has not been any published data currently available on the processing effects on this plant’s biological activity and phytochemical profile. Therefore, this study aims to evaluate the effect of three drying methods (freeze-drying (FD), air-drying (AD), and oven-drying (OD)) and ethanol:water ratios (0, 50, and 100%) on in vitro anti-diabetic activities of M. calabura leaves. In addition, an ultrahigh-performance-liquid chromatography–electrospray ionization tandem mass spectrometry (UHPLC-ESI-MS/MS) method was used to characterize the metabolites in the active extract. The FD M. calabura leaves, extracted with 50% ethanol, is the most active extract that exhibits a high α-glucosidase and α-amylase inhibitory activities with IC₅₀ values of 0.46 ± 0.05 and 26.39 ± 3.93 µg/mL, respectively. Sixty-one compounds were tentatively identified by using UHPLC-ESI-MS/MS from the most active extract. Quantitative analysis, by using UHPLC, revealed that geniposide, daidzein, quercitrin, 6-hydroxyflavanone, kaempferol, and formononetin were predominant compounds identified from the active extract. The results have laid down preliminary steps toward developing M. calabura leaves extract as a potential source of bioactive compounds for diabetic treatment.

Watermelon (Citrullus lanatus) leaf extract attenuates biochemical and histological parameters in high-fat diet/streptozotocin-induced diabetic rats

The present research aimed to investigate the attenuative effects of watermelon (Citrullus lanatus) leaf extract on biochemical and histological parameters in a high-fat diet combined with a low-dose streptozotocin (HFD/STZ)-induced type 2 diabetes mellitus. Forty male Sprague Dawley rats were divided into five groups, including three supplemented groups: 10 mg metformin/kg BW (HFD/STZ +M), 200 mg watermelon leaf extract /kg BW (HFD/STZ + LD), and 400 mg watermelon leaf extract /kg BW (HFD/STZ + HD). The efficacy of the 6-week intervention was evaluated by measuring body weight, fasting blood sugar, serum insulin, lipid profile, superoxide dismutase, catalase, malondialdehyde, and serum liver markers. Kidneys and liver structure were defined by histopathological examination. Results revealed that intervention with watermelon leaf extract attenuated the biochemical parameters and the structural changes in kidneys and liver. In brief, the watermelon leaf extract treatment could effectively decrease complications associated with diabetes better than metformin, and that the treatment with 400 mg/kg BW is the most potent. PRACTICAL APPLICATIONS: This was the first study to investigate the antidiabetic potential of watermelon leaf extract in obese diabetic rats. Data revealed that the watermelon leaf extract significantly attenuated the HFD/STZ-induced diabetes changes, as evidenced by the biochemical and histological data. Hence, watermelon leaf could be an excellent candidate to be developed as a functional food ingredients or nutraceuticals for holistic management of diabetes mellitus and its complications.

Ergogenic property of Morinda citrifolia L. leaf extract affects energy metabolism in obese Sprague Dawley rats

Ergogenic property is the ability to enhance capacity for physical activities through efficient production of energy and is potentially beneficial in weight management for the obese. In this study, ergogenic property of Morinda citrifolia leaf's extract (MCL) was evaluated using AMP-activated protein kinase (AMPK) activity and high fat diet-induced obese rats. Findings from the study showed that MCL demonstrated ergogenic activity via enhancement of AMPK activity using L6 skeletal muscle cell line. Interestingly, the result also revealed that rats treated with the intermediate dosage of MCL experienced the lowest % weight gain. The rats fed the highest dose of 200 mg/kg BW MCL demonstrated the longest swimming time of approximately three times that of green tea and caffeine-fed rats. The highest dose fed rats were also found to have lower glucose and lactate levels, suggesting that energy metabolism was more effective in these rats. In addition, lactate dehydrogenase and creatinine kinase activities, the muscle injury indicators, were found to be the lowest in rats fed the highest MCL dose. The same effect was not seen in rats fed either caffeine or green tea, indicating that MCL treatment is may be protective of the rats' muscles. It was also shown that MCL consisted of various flavonoids with epicatechin, catechin, and quercetin that may be responsible for the effects measured. In conclusion, improvements were seen in rats fed MCL in terms of weight management, endurance capacity, energy metabolism, and muscle injury parameters. PRACTICAL APPLICATIONS: Results of the study revealed that Morinda citrifolia leaf has great potential to be used as functional ingredient in the development of designer food/drink as ergogenic aid for both obese and non-obese individuals. Morinda citrifolia leaf could help in the weight management of obese people and enhance endurance capacity and energy metabolism in active individuals.

Metabolomic analysis reveals the valuable bioactive compounds of Ardisia elliptica

INTRODUCTION

Ardisia elliptica Thunb. (Primulaceae) is a medicinal herb that is traditionally used for the treatment of fever, diarrhoea, measles and herpes. However, there is limited information regarding the correlation of its phytoconstituents with the bioactivity. Optimisation of solvent extraction is vital for maximising retention of bioactive molecules.

OBJECTIVE

This study investigated the metabolite variations in A. elliptica leaves and the correlation with antioxidant activities.

METHODOLOGY

Total phenolic content (TPC), 2,2-diphenyl-1-picrylhydrazyl (DPPH) and nitric oxide (NO) radicals scavenging assays were performed on A. elliptica leaves extracted with four different ethanol ratios (0%, 50%, 70% and absolute ethanol). The correlation of metabolites with antioxidant activities was evaluated using a nuclear magnetic resonance (NMR)-based metabolomics approach.

RESULTS

The results showed that the 50% and 70% ethanolic extracts retained the highest TPC, and the 70% ethanolic extract was the most active, exhibiting half maximal inhibitory concentration (IC₅₀ ) values of 10.18 ± 0.83 and 43.05 ± 1.69 μg/mL, respectively, in both radical scavenging assays. A total of 46 metabolites were tentatively identified, including flavonoids, benzoquinones, triterpenes and phenolic derivatives. The 50% and 70% ethanolic extracts showed similarities in metabolites content and were well discriminated from water and absolute ethanol extracts in a principal component analysis (PCA) model. Moreover, 31 metabolites were found to contribute significantly to the differentiation and antioxidant activity.

CONCLUSION

This study provides information on bioactive compounds in A. elliptica leaves, which is promising as a functional ingredient for food production or for the development of phytomedicinal products.

Optimization of the Drum Drying Parameters and Citric Acid Level to Produce Purple Sweet Potato (Ipomoea batatas L.) Powder Using Response Surface Methodology

Purple sweet potato (PSP) is a rich source of anthocyanins, but the anthocyanin content and color can be affected by the drying method and processing condition. Response surface methodology (RSM) with a Box-Behnken design (BBD) was used to investigate the effects of citric acid (CA) concentration, steam pressure (SP) and rotation speed (DS) on the physicochemical and functional properties of drum-dried purple sweet potato powder (PSPP). The anthocyanins of the PSPP were analyzed using mass spectrometry with electrospray ionization and twelve anthocyanins were identified. The results indicated that the moisture content (4.80 ± 0.17-9.97 ± 0.03%) and water activity (0.290 ± 0.004-0.47 ± 0.001) (p < 0.05) decreased with increasing drum temperature as well as with reduced drum rotating speed. CA had a significant (p < 0.05) effect on the color and total anthocyanin content (101.83 ± 2.20-124.09 ± 2.89 mg/100 g) of the PSPP. High SP and low DS negatively affected the antioxidant properties of the PSPP. DPPH value of the PSPP ranged from 20.41 ± 0.79 to 30.79 ± 1.00 μmol TE/g. The optimal parameters were achieved at 0.59% CA, 499.8 kPa SP and 3 rpm DS.

Metabolite variations and antioxidant activity of Muntingia calabura leaves in response to different drying methods and ethanol ratios elucidated by NMR-based metabolomics

INTRODUCTION

Muntingia calabura from the Muntingiaceae family has been documented for several medicinal uses. The combinations of drying treatment and extracting solvents for a plant species need to be determined and optimised to ensure that the extracts contain adequate amounts of the bioactive metabolites.

OBJECTIVE

Evaluate the metabolite variations and antioxidant activity among M. calabura leaves subjected to different drying methods and extracted with different ethanol ratios using proton nuclear magnetic resonance (¹ H-NMR)-based metabolomics. Methodology The antioxidant activity of M. calabura leaves dried with three different drying methods and extracted with three different ethanol ratios was determined by using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and nitric oxide (NO) scavenging assays. The metabolites variation among the extracts and correlation with antioxidant activity were analysed by ¹ H-NMR-based metabolomics.

RESULTS

Muntingia calabura leaves extracted with 50% and 100% ethanol from air-drying and freeze-drying methods had the highest total phenolic content and the lowest IC₅₀ value for the DPPH scavenging activity. Meanwhile, oven-dried leaves extracted with 100% ethanol had the lowest IC₅₀ value for the NO scavenging activity. A total of 43 metabolites, including sugars, organic acids, amino acids, phytosterols, phenolics and terpene glycoside were tentatively identified. A noticeable discrimination was observed in the different ethanol ratios by the principal component analysis. The partial least-squares analysis suggested that 32 compounds out of 43 compounds identified were the contributors to the bioactivities.

CONCLUSION

The results established set the preliminary steps towards developing this plant into a high value product for phytomedicinal preparations.

Eggshell membrane powder lowers plasma triglyceride and liver total cholesterol by modulating gut microbiota and accelerating lipid metabolism in high-fat diet-fed mice

Obesity is a major global lifestyle disorder associated with gut microbiota. The health benefits of eggshell membrane (ESM) have been shown in previous reports, particularly as regards gut microbiota composition. Here, we investigated whether ESM improves lipid metabolism and alters gut microbiota in high-fat diet-fed mice. A total of 20 C57BL/6J mice aged 6 weeks were given either a control diet (CON), high-fat diet (HFD), or high-fat diet + 8% ESM powder (HESM) for 20 weeks. ESM supplementation in HFD-fed mice reduced plasma triglycerides (TG) and liver total cholesterol (TC) and upregulated the expression of lipid metabolism genes carnitine palmitoyltransferase 1A and suppressor of cytokine signaling 2. Microbiota analysis showed increased relative abundance of the anti-obesity bacterium, Lactobacillus reuteri, at 4, 12, and 16 weeks and reduced the abundance of inflammation-related Blautia hydrogenotrophica, Roseburia faecis, and Ruminococcus callidus at 12 and 20 weeks. ESM-supplemented mice had increased cecal isobutyrate, negatively correlated with B. hydrogenotrophica and Parabacteroides goldsteinii abundance. The results indicate that ESM supplementation in HFD-fed mice reduced plasma TG and liver TC, possibly through alteration of lipid metabolism gene expression and gut microbiota composition, suggesting that ESM may be effective in obesity management.

Metabolomics approach to investigate the ergogenic effect of Morinda citrifolia L. leaf extract on obese Sprague Dawley rats

INTRODUCTION

Natural products are obtaining much acceptance as ergogenic aid, not only among athletes but also among the general population including people with excess body fat. Under normal circumstances, an obese person will have the desire and ability to exercise reduced; mainly because they are easily fatigued. Thus, they need to boost their energy production so that they can be more active and healthier.

OBJECTIVE

In this present work, Morinda citrifolia L. leaf extract (MLE) which is believed to possess ergogenic property, was evaluated on its effect on an obese animal model using ¹ H-NMR based metabolomics.

MATERIAL AND METHODS

Rats were fed with high fat diet (HFD) for 12 weeks for obese development. Once this was achieved, all the rats underwent endurance exercise (forced swimming test) every 2 weeks for 8 weeks together with treatment. The time to exhaustion was recorded for each rat. Three different dosages of MLE: 50 mg/kg, 100 mg/kg and 200 mg/kg of body weight were used together with two positive controls: 5 mg/kg caffeine and 100 mg/kg green tea. Blood was collected before and after treatments for metabolomics study.

RESULTS

Findings showed that feeding the rats at a dose of 200 mg/kg body weight MLE significantly prolonged the exhaustive swimming time of the rats, and altered the metabolites present in their serum. Discriminating metabolites involved were the product of various metabolic pathways, including carbohydrate, lipids metabolism and energy metabolism. Treatment with 200 mg/kg body weight MLE resulted in significant improvement in the metabolic perturbations where the proximity of the obese exercised treated group to that of normal exercised group in the partial least squares discriminant analysis score plot was observed.

CONCLUSION

The present work demonstrated ergogenic property of MLE based on the improved metabolic perturbation in exercised obese rats.

Mangosteen (Garcinia mangostana) flesh supplementation attenuates biochemical and morphological changes in the liver and kidney of high fat diet-induced obese rats

Background

Mangosteen is a native fruit from Southeast Asia. It is rich in phenolic compounds such as xanthones, anthocyanins and phenolic acids. Mangosteen pericarp extract showed inhibitory activity towards pancreatic lipase and may have potential use for obesity treatment. However, there is limited study on the beneficial effects of mangosteen flesh against obesity. This study aimed to investigate the effects of Garcinia mangostana flesh (GMF) on biochemical and morphological changes in the liver and kidney of high-fat diet-induced obese rats.

Methods

Forty healthy Sprague-Dawley rats were randomised into five groups (n = 8) with four groups were fed with high-fat diet (HFD) for 10 weeks and a control group was fed with rat chow diet. Supplementation with GMF in obese rats was continued for 7 weeks starting from week 10th after the initiation of HFD at different doses (200 mg/kg, 400 mg/kg and 600 mg/kg). The positive and negative control rats were given distilled water via oral gavage. Plasma lipid profile, antioxidant enzymes and pro-inflammatory markers were determined using commercial kits. Liver and kidney structure were defined by histology.

Results

The rats fed with HFD for 10 weeks increased plasma LDL-cholesterol, reduced plasma glutathione peroxidase level and had significantly higher body weight compared to normal control rats (p < 0.05). Obese rats also showed elevated level of TNF-α and IL-6 after 17 weeks of HFD. Supplementation with GMF for 7 weeks in obese rats reduced their body weight, improved lipid profile, increased total antioxidant capacity and glutathione peroxidase level and lowered plasma pro-inflammatory markers (TNF-α and IL-6) (p < 0.05). In addition, GMF supplementation attenuated the abnormalities of the liver and kidney tissue caused by high fat diet.

Conclusion

Taken together, the findings suggest that supplementation of Garcinia mangostana flesh may help in reducing body weight and has the potential to ameliorate the biochemical changes of the high fat diet-induced obesity in rats. Further studies on pharmacodynamic and pharmacokinetic are required before the results are translated to human.

Nutritional Composition, Anti-Diabetic Properties and Identification of Active Compounds Using UHPLC-ESI-Orbitrap-MS/MS in Mangifera odorata L. Peel and Seed Kernel

Mangifera odorata fruit, the hybrid forms between M. indica (mango) and M. foetida (bacang), has been shown to exhibit potential antioxidant activity, and the fruit waste could demonstrate functional and nutritional potential. In the present study, the nutritional composition (proximate, sugars, vitamins and minerals analyses), the anti-diabetic activities and phytochemical profile of M. odorata peel and seed kernel were investigated for the first time. The results indicated that seed kernel rich in fat, protein, carbohydrate, and ash while peel contained significantly greater amount of fiber, minerals, β-Carotene and ascorbic acid compared to seed kernel. The samples were then extracted using different solvents (acetone, ethanol, methanol at 60%, v/v and pure deionized water) and their anti-diabetic activities (α-amylase and α-glucosidase inhibition assay) were determined. Seed kernel had the lowest IC50 values for α-amylase and α-glucosidase inhibition assay in 60% ethanol and 60% acetone, respectively. Due to the toxic effect and high volatility of acetone, the ethanolic extracts of samples were further analyses for their phytochemical profile using high performance liquid chromatography-mass spectrometry (LC-MS) and ultra-high-performance liquid chromatography electrospray ionization orbitrap tandem mass spectrometry (UHPLC-ESI-Orbitrap-MS/MS). The most abundant compounds identified were phenolic acid, ellagic acid, and flavonoid. These findings suggest that M. odorata fruit wastes, especially the seed kernel possesses promising ability to be used as functional ingredient in the food industry.

Red pitaya juice supplementation ameliorates energy balance homeostasis by modulating obesity-related genes in high-carbohydrate, high-fat diet-induced metabolic syndrome rats

Background

Red pitaya (Hylocereus polyrhizus) or known as buah naga merah in Malay belongs to the cactus family, Cactaceae. Red pitaya has been shown to give protection against liver damage and may reduce the stiffness of the heart. Besides, the beneficial effects of red pitaya against obesity have been reported; however, the mechanism of this protection is not clear. Therefore, in the present study, we have investigated the red pitaya-targeted genes in obesity using high-carbohydrate, high-fat diet-induced metabolic syndrome rat model.

Methods

A total of four groups were tested: corn-starch (CS), corn-starch + red pitaya juice (CRP), high-carbohydrate, high-fat (HCHF) and high-carbohydrate, high-fat + red pitaya juice (HRP). The intervention with 5 % red pitaya juice was continued for 8 weeks after 8 weeks initiation of the diet. Retroperitoneal, epididymal and omental fat pads were collected and weighed. Plasma concentration of IL-6 and TNF-α were measured using commercial kits. Gene expression analysis was conducted using RNA extracted from liver samples. A total of eighty-four genes related to obesity were analyzed using PCR array.

Results

The rats fed HCHF-diet for 16 weeks increased body weight, developed excess abdominal fat deposition and down-regulated the expression level of IL-1α, IL-1r1, and Cntfr as compared to the control group. Supplementation of red pitaya juice for 8 weeks increased omental and epididymal fat but no change in retroperitoneal fat was observed. Red pitaya juice reversed the changes in energy balance homeostasis in liver tissues by regulation of the expression levels of Pomc and Insr. The increased protein expression levels of IL-6 and TNF-α in HCHF group and red pitaya treated rats confirmed the results of gene expression.

Conclusion

Collectively, this study revealed the usefulness of this diet-induced rat model and the beneficial effects of red pitaya on energy balance homeostasis by modulating the anorectic, orexigenic and energy expenditure related genes.

Usage of Traditional and Complementary Medicine (T & CM): Prevalence, Practice and Perception among Post Stroke Patients Attending Conventional Stroke Rehabilitation in A Teaching Hospital in Malaysia

INTRODUCTION

The lack of evidence that proves the benefit of traditional and complementary medicines (T & CM) in treating chronic medical conditions does not deter its usage among patients worldwide. Prevalence of usage among post-stroke patients in Malaysia especially is unknown. This study aims to determine the prevalence, practice and perception of T & CM use among stroke survivors attending an outpatient rehabilitation program in a teaching hospital.

METHODS

A cross-sectional study was conducted among 104 post stroke patients attending an outpatient rehabilitation program. A structured self-administered questionnaire was used to collect data on sociodemographic and clinical profile of patients, as well as types of therapy used and perception on T & CM usage. Descriptive analysis was done, and bivariate analysis was used to determine associations between categorical data.

RESULTS

Mean age of patients was 62 years (SD 12.2), 54% were Chinese and 75% of the patients had ischaemic stroke. Mean age of T & CM users was younger compared to non- T & CM users (61 years vs. 66 years, p=0.04). Two-thirds (66%) of patients admitted to concurrent T & CM usage while attending conventional post stroke rehabilitation. Acupuncture (40.4%), massage (40.4%) and traditional Chinese medicine (11.5%) were the most common T & CM used. Positive perception was recorded in terms of ability of T & CM usage to relieve post stroke symptoms (68%), and it was safe to use because it was made from 'natural sources'. Negative perception recorded: T & CM caused significant adverse effects (57.6%) and was not safe to be used in combination with other conventional medicines (62.5%).

CONCLUSIONS

Concurrent T & CM usage among post-stroke patients attending structured outpatient rehabilitation program is widely practised especially acupuncture, massage and traditional Chinese medicines. Overall the perception towards its use is favourable.

Effects of red pitaya juice supplementation on cardiovascular and hepatic changes in high-carbohydrate, high-fat diet-induced metabolic syndrome rats

Background

The fruit of Hylocereus polyrhizus, also known as red pitaya, and buah naga in Malay, is one of the tropical fruits of the cactus family, Cactaceae. Red pitaya has been shown to protect aorta from oxidative damage and improve lipid profiles in hypercholesterolemic rats probably due to phytochemicals content including phenolics and flavonoids. The aim of this study was to investigate the changes in cardiac stiffness, hepatic and renal function in high-carbohydrate, high-fat diet-induced obese rats following supplementation of red pitaya juice.

Methods

Total 48 male Wistar rats were divided into 4 groups: corn-starch group (CS), corn-starch + red pitaya juice group (CRP), high-carbohydrate, high fat group (HCHF) and high-carbohydrate, high fat + red pitaya juice (HRP). The intervention with 5% red pitaya juice was started for 8 weeks after 8 weeks initiation of the diet. Heart function was determined ex vivo with Langendorff hearts while plasma liver enzymes, uric acid and urea were measured using commercial kits. Total fat mass was determined with Dual-energy X-ray absorptiometry (DXA) scan. Glucose uptake was measured with Oral Glucose Tolerance Test (OGTT). Liver and cardiac structures were defined by histology.

Results

Supplementation of red pitaya juice for 8 weeks increased energy intake and abdominal circumference but no change in body fat and lean mass respectively. Also, there were a trend of uric acid and glucose normalization for HRP as compared to H-fed rats. Red pitaya juice treatment reduced ALP and ALT but caused significant increment in AST. Diastolic stiffness of the heart was reduced after supplementation of red pitaya juice in corn starch fed rats. However, the reduction was not significant in HRP rats in comparison with H rats.

Conclusion

The present study concluded that red pitaya juice may serve as a complimentary therapy for attenuating some signs of metabolic syndrome.