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Hong KF, Liu PY, Zhang W, Gui DK, Xu YH. The Efficacy and Safety of Astragalus as an Adjuvant Treatment for Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. J Integr Complement Med 2024; 30:11-24. [PMID: 37433206 DOI: 10.1089/jicm.2022.0767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
Objective: This meta-analysis evaluated the beneficial and potential adverse effects of Astragalus in the treatment of patients with type 2 diabetes mellitus (T2DM). Methods: The authors searched for randomized controlled trials of Astragalus treatment for patients with T2DM in the following databases: PubMed, Embase, Cochrane Library, China Knowledge Resource Integrated Database (CNKI), Wanfang Data, China Science and Technology Journal Database (CQVIP), and SinoMed. Two reviewers conducted independent selection of studies, data extraction, and coding, as well as the assessment of risk of bias in the studies included. Standard meta-analysis and, if appropriate, meta-regression were performed using the STATA, v.15.1, software. Results: This meta-analysis encompasses 20 studies and a total of 953 participants. Compared to the control group (CG), the observation group (OG) decreased fasting plasma glucose (FPG) (WMD = -0.67, 95% CI: -1.13∼-0.20, P = 0.005), 2 hours postprandial plasma glucose (2hPG) (WMD = -0.67 (95% CI: -1.13∼-0.20, P=0.005), glycated hemoglobin A1C (HbA1c) (WMD = -0.93, 95% CI: -1.22∼-0.64, P = 0.000), homeostatic model assessment for insulin resistance (HOMA-IR) (WMD = -0.45, 95% CI: -0.99∼0.99, P = 0.104), insulin sensitive index (WMD = 0.42, 95% CI: 0.13-0.72, P = 0.004). The total effective ratio of the OG is more effective than CG (RR = 1.33, 95% CI: 1.26-1.40, P = 0.000), the significant effective ratio (RR = 1.69, 95% CI: 1.48-1.93, P = 0.000). Conclusions: Astragalus may provide specific benefits for T2DM patients as an adjuvant treatment. Nonetheless, the certainty of the evidence and risk of bias fell short of optimal performance, indicating the need for additional clinical research to ascertain potential effects. PROSPERO REGISTRATION NUMBER CRD42022338491.
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Affiliation(s)
- Kin-Fong Hong
- Faculty of Medicine, Macau University of Science and Technology, Taipa, China
| | - Pei-Yu Liu
- Faculty of Medicine, Macau University of Science and Technology, Taipa, China
| | - Wei Zhang
- Faculty of Medicine, Macau University of Science and Technology, Taipa, China
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Ding-Kun Gui
- Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - You-Hua Xu
- Faculty of Medicine, Macau University of Science and Technology, Taipa, China
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Gan WJ, Gao CL, Zhang WQ, Gu JL, Zhao TT, Guo HL, Zhou H, Xu Y, Yu LL, Li LF, Gui DK, Xu YH. Kuwanon G protects HT22 cells from advanced glycation end product-induced damage. Exp Ther Med 2021; 21:425. [PMID: 33747164 PMCID: PMC7967837 DOI: 10.3892/etm.2021.9869] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 09/11/2020] [Indexed: 12/25/2022] Open
Abstract
The incidence of diabetic encephalopathy is increasing as the population ages. Evidence suggests that formation and accumulation of advanced glycation end products (AGEs) plays a pivotal role in disease progression, but limited research has been carried out in this area. A previous study demonstrated that Kuwanon G (KWG) had significant anti-oxidative stress and anti-inflammatory properties. As AGEs are oxidative products and inflammation is involved in their generation it is hypothesized that KWG may have effects against AGE-induced neuronal damage. In the present study, mouse hippocampal neuronal cell line HT22 was used. KWG was shown to significantly inhibit AGE-induced cell apoptosis in comparison with a control treatment, as determined by both MTT and flow cytometry. Compared with the AGEs group, expression of pro-apoptotic protein Bax was reduced and expression of anti-apoptotic protein Bcl-2 was increased in the AGEs + KWG group. Both intracellular and extracellular levels of acetylcholine and choline acetyltransferase were significantly elevated after KWG administration in comparison with controls whilethe level of acetylcholinesterase decreased. These changes in protein expression were accompanied by increased levels of superoxide dismutase and glutathione peroxidase synthesis and reduced production of malondialdehyde and reactive oxygen species. Intracellular signaling pathway protein levels were determined by western blot and immunocytochemistry. KWG administration was found to prevent AGE-induced changes to the phosphorylation levels of Akt, IκB-α, glycogen synthase kinase 3 (GSK3)-α and β, p38 MAPK and NF-κB p65 suggesting a potential neuroprotective effect of KWG against AGE-induced damage was via the PI3K/Akt/GSK3αβ signaling pathway. The findings of the present study suggest that KWG may be a potential treatment for diabetic encephalopathy.
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Affiliation(s)
- Wen-Jun Gan
- Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR 999078, P.R. China
| | - Chen-Lin Gao
- Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR 999078, P.R. China.,Department of Endocrinology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 510500, P.R. China
| | - Wen-Qian Zhang
- Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR 999078, P.R. China
| | - Jun-Ling Gu
- Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR 999078, P.R. China
| | - Ting-Ting Zhao
- Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR 999078, P.R. China
| | - Heng-Li Guo
- Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR 999078, P.R. China
| | - Hua Zhou
- Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR 999078, P.R. China
| | - Yong Xu
- Department of Endocrinology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 510500, P.R. China
| | - Li-Li Yu
- Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR 999078, P.R. China
| | - Li-Fang Li
- Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR 999078, P.R. China
| | - Ding-Kun Gui
- Department of Nephrology, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai 200233, P.R. China
| | - You-Hua Xu
- Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR 999078, P.R. China
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Zhang WQ, Zhao TT, Gui DK, Gao CL, Gu JL, Gan WJ, Huang W, Xu Y, Zhou H, Chen WN, Liu ZL, Xu YH. Sodium Butyrate Improves Liver Glycogen Metabolism in Type 2 Diabetes Mellitus. J Agric Food Chem 2019; 67:7694-7705. [PMID: 31250637 DOI: 10.1021/acs.jafc.9b02083] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Liver plays a central role in modulating blood glucose level. Our most recent findings suggested that supplementation with microbiota metabolite sodium butyrate (NaB) could ameliorate progression of type 2 diabetes mellitus (T2DM) and decrease blood HbA1c in db/db mice. To further investigate the role of butyrate in homeostasis of blood glucose and glycogen metabolism, we carried out the present study. In db/db mice, we found significant hypertrophy and steatosis in hepatic lobules accompanied by reduced glycogen storage, and expression of GPR43 was significantly decreased by 59.38 ± 3.33%; NaB administration significantly increased NaB receptor G-protein coupled receptor 43 (GPR43) level and increased glycogen storage in both mice and HepG2 cells. Glucose transporter 2 (GLUT2) and sodium-glucose cotransporter 1 (SGLT1) on cell membrane were upregulated by NaB. The activation of intracellular signaling Protein kinase B (PKB), also known as AKT, was inhibited while glycogen synthase kinase 3 (GSK3) was activated by NaB in both in vivo and in vitro studies. The present study demonstrated that microbiota metabolite NaB possessed beneficial effects on preserving blood glucose homeostasis by promoting glycogen metabolism in liver cells, and the GPR43-AKT-GSK3 signaling pathway should contribute to this effect.
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Affiliation(s)
- Wen-Qian Zhang
- Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine , Macau University of Science and Technology , Avenida Wai Long , Taipa , Macao 999078 , People's Republic of China
| | - Ting-Ting Zhao
- Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine , Macau University of Science and Technology , Avenida Wai Long , Taipa , Macao 999078 , People's Republic of China
| | - Ding-Kun Gui
- Department of Nephrology , Shanghai Jiaotong University Affiliated Sixth People's Hospital , Shanghai 200080 , People's Republic of China
| | - Chen-Lin Gao
- Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine , Macau University of Science and Technology , Avenida Wai Long , Taipa , Macao 999078 , People's Republic of China
- Department of Endocrinology , Affiliated Hospital of Southwest Medical University , Luzhou , Sichuan 646000 , People's Republic of China
| | - Jun-Ling Gu
- Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine , Macau University of Science and Technology , Avenida Wai Long , Taipa , Macao 999078 , People's Republic of China
| | - Wen-Jun Gan
- Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine , Macau University of Science and Technology , Avenida Wai Long , Taipa , Macao 999078 , People's Republic of China
| | - Wei Huang
- Department of Endocrinology , Affiliated Hospital of Southwest Medical University , Luzhou , Sichuan 646000 , People's Republic of China
| | - Yong Xu
- Department of Endocrinology , Affiliated Hospital of Southwest Medical University , Luzhou , Sichuan 646000 , People's Republic of China
| | - Hua Zhou
- Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine , Macau University of Science and Technology , Avenida Wai Long , Taipa , Macao 999078 , People's Republic of China
- Macau Institute for Applied Research in Medicine and Health , Avenida Wai Long , Taipa , Macao 999078 , People's Republic of China
| | - Wei-Ni Chen
- Department of Endocrinology , Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine , Zhuhai 519000 , People's Republic of China
| | - Zhi-Long Liu
- Department of Endocrinology , Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine , Zhuhai 519000 , People's Republic of China
| | - You-Hua Xu
- Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine , Macau University of Science and Technology , Avenida Wai Long , Taipa , Macao 999078 , People's Republic of China
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