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Bahreini N, Saghafi-Asl M, Nikpayam O, Safaei E, Sadra V, Fakhr L, Beyrampour-Basmenj H, Asgharian P, Asghari-Jafarabadi M. Effects of dried okra extract on lipid profile, renal function and some RAGE-related inflammatory genes expression in patients with diabetic nephropathy: A randomized controlled trial. Complement Ther Med 2024; 81:103027. [PMID: 38336011 DOI: 10.1016/j.ctim.2024.103027] [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: 07/24/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Diabetic nephropathy (DN) is a common complication of type 2 diabetes. Okra (Abelmoschus esculentus L) is reported to have anti-diabetic effects. The present study aimed to investigate the effects of dried okra extract (DOE) supplementation on lipid profile, renal function indices, and expression of inflammatory genes, as well as serum level of soluble Receptor for Advanced glycation end products (sRAGE) in patients with DN. METHODS In this triple-blind randomized placebo-controlled clinical trial, 64 eligible patients with DN received either 125 mg of DOE or placebo daily along with DN-related nutritional recommendations for 10 weeks. Changes in kidney indices including proteinuria and estimated glomerular filtration rate (eGFR), lipid profile, serum SRAGE, as well as the expression of RAGE, ICAM-1, and IL-1 genes were measured over 10 weeks. RESULTS After adjustment for the potential confounders, between-group analyses showed no significant differences in terms of lipid profile, kidney function indices, sRAGE, and RAGE-related inflammatory genes expression after 10 weeks. CONCLUSION Daily 125 mg DOE along with nutritional recommendations on top of usual care did not lead to significant changes in renal function indices, lipid profile, and inflammatory genes expression in patients with DN.
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Affiliation(s)
- Nazgol Bahreini
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Saghafi-Asl
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Science, Tabriz, Iran; Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Omid Nikpayam
- Department of Nutritional Sciences, School of Health, Golestan University of Medical Sciences, Iran
| | - Ehsan Safaei
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahideh Sadra
- Endocrine Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Laleh Fakhr
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hanieh Beyrampour-Basmenj
- Department of Medical Biotechnology, School of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parina Asgharian
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari-Jafarabadi
- Cabrini Research, Cabrini Health, VIC 3144, Australia; School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, VIC 3800, Australia; Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Nikpayam O, Saghafi-Asl M, Safaei E, Bahreyni N, Sadra V, Asgharian P. The effect of Abelmoschus esculentus L. (Okra) extract supplementation on glycaemic control, inflammation, kidney function and expression of PPAR- α, PPAR- γ, TGF- β and Nrf-2 genes in patients with diabetic nephropathy: a triple-blind, randomised, placebo-controlled trial. Br J Nutr 2024; 131:648-657. [PMID: 37840235 DOI: 10.1017/s0007114523002180] [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] [Indexed: 10/17/2023]
Abstract
The present study was carried out to evaluate the effects of okra extract supplementation on kidney function, glycaemic control, inflammation and gene expression in patients with diabetic nephropathy (DN). A total of sixty-four DN patients based on the inclusion and exclusion criteria were recruited in this triple-blind placebo-controlled randomised clinical trial. Participants were randomly allocated to receive a 125-mg capsule of dried okra extract (DOE) (n 32) or placebo (n 32) for 10 weeks. At the baseline and endpoint of the trial, kidney function, glycaemic indices, inflammation and gene expression were evaluated. Statistical analysis showed that fasting blood glucose, HbA1c and insulin resistance significantly reduced in the DOE group although between-group analysis did not show any significant difference. Also, no significant difference was observed in urine protein, urine creatinine and high-sensitivity C-reactive protein between the two groups. Furthermore, gene expression of PPAR-α, PPAR-γ, transforming growth factor-beta and Nrf-2 did not affect the end of the trial in comparison with the baseline. According to the present study, DOE did not have impressive effects on kidney function, inflammation, glycaemic management and gene expression in patients with DN.
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Affiliation(s)
- Omid Nikpayam
- Department of Nutrition, School of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Maryam Saghafi-Asl
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Science, Tabriz, Iran
| | - Ehsan Safaei
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nazgol Bahreyni
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahideh Sadra
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parina Asgharian
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Singh P, Ansari N, Mishra AK, Agrawal M, Agrawal SB. Growth, ultrastructural and physiological characteristics of Abelmoschus cytotypes under elevated ozone stress: a study on ploidy-specific responses. FUNCTIONAL PLANT BIOLOGY : FPB 2024; 51:FP23229. [PMID: 38310884 DOI: 10.1071/fp23229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/09/2024] [Indexed: 02/06/2024]
Abstract
Tropospheric ozone (O3 ) is a significant abiotic stressor whose rising concentration negatively influences plant growth. Studies related to the differential response of Abelmoschus cytotypes to elevated O3 treatment are scarce and need further exploration to recognise the role of polyploidisation in stress tolerance. In this study, we analysed the changes in growth pattern, ultrastructure, physiology and foliar protein profile occurring under O3 stress in Abelmoschus moschatus (monoploid), Abelmoschus esculentus (diploid) and Abelmoschus caillei (triploid). Our findings showed that higher stomatal conductance in A. moschatus triggered higher O3 intake, causing damage to stomatal cells and photosynthetic pigments. Additionally, it caused a reduction in photosynthetic rates, leading to reduced plant growth, total biomass and economic yield. This O3 -induced toxicity was less in diploid and triploid cytotypes of Abelmoschus . Protein profiling by sodium dodecyl sulpate-polyacrylamide gel electrophoresis showed a significant decrease in the commonly found RuBisCO larger and smaller subunits. The decrease was more prominent in monoploid compared to diploid and triploid. This study provides crucial data for research that aim to enhance plant ability to withstand O3 induced oxidative stress. Our findings may help in developing a tolerant variety through plant breeding techniques, which will be economically more advantageous in reaching the objective of sustainable production at the high O3 levels projected under a climate change scenario.
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Affiliation(s)
- Priyanka Singh
- Laboratory of Air Pollution and Global Climate Change, Department of Botany, Institute of Science, Banaras Hindu University, Varanasi, 221005, India
| | - Naushad Ansari
- Laboratory of Air Pollution and Global Climate Change, Department of Botany, Institute of Science, Banaras Hindu University, Varanasi, 221005, India
| | - Amit Kumar Mishra
- Department of Botany, School of Life Sciences, Mizoram University, Aizawl, Mizoram, 796004, India
| | - Madhoolika Agrawal
- Laboratory of Air Pollution and Global Climate Change, Department of Botany, Institute of Science, Banaras Hindu University, Varanasi, 221005, India
| | - Shashi Bhushan Agrawal
- Laboratory of Air Pollution and Global Climate Change, Department of Botany, Institute of Science, Banaras Hindu University, Varanasi, 221005, India
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Tavakolizadeh M, Peyrovi S, Ghasemi-Moghaddam H, Bahadori A, Mohkami Z, Sotoudeh M, Ziaee M. Clinical efficacy and safety of okra (Abelmoschus esculentus (L.) Moench) in type 2 diabetic patients: a randomized, double-blind, placebo-controlled, clinical trial. Acta Diabetol 2023; 60:1685-1695. [PMID: 37507536 DOI: 10.1007/s00592-023-02149-1] [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: 03/21/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023]
Abstract
AIMS The recent trend toward the use of natural functional and medical supplements has motivated the focus on the search and revival of traditional medicinal plant applications for many years. As a valuable dietary crop, okra fruit (Abelmoschus esculentus (L.) Moench) has been used for thousands of years as a medicinal food. This clinical trial aimed to assess the efficacy and safety of the okra pod capsule as an adjuvant treatment in controlling type 2 diabetes mellitus and provide clinical trial-based evidence about its anti-inflammatory effects. METHODS A total of 100 type II diabetic patients, aged between 40 and 60 years, were randomly assigned into two groups of okra and placebo. The first group was administered 1000 mg of powdered okra fruit three times a day for 3 months, while the other group received a placebo capsule with the same dosage. Both groups continued the standard antidiabetic therapy (consisting of metformin and gliclazide, as well as a nutritional regimen). At the start and three months later, various factors were measured, including FBG, insulin, HbA1c, cholesterol, triglycerides, HDL, LDL, CRP, liver and renal function tests, blood pressure, and BMI changes. RESULTS According to the results, patients who received okra treatment exhibited a significant decrease in FBG, HbA1c, total cholesterol, and triglyceride levels when compared to both the baseline and the placebo group. Patients in the okra group have lower levels of hs-CRP compared with the placebo group after 3 months of treatment. No liver, kidney, and blood pressure or other side effects were observed in the groups associated with okra treatment. CONCLUSIONS The present study demonstrated that adjunctive consumption of okra, in type 2 diabetic patients with 1000 mg three times a day for three months, improves lipid profile, glycemic control, and chronic inflammation without any tangible adverse effects. CLINICAL TRIAL REGISTRY IRCT.Ir (IRCT20120112008712N2). https://www.irct.ir/trial/42042 .
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Affiliation(s)
- Mahdi Tavakolizadeh
- Department of Pharmacognosy, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Saeid Peyrovi
- Medicinal Plants Research Center, Maragheh University of Medical Sciences, Maragheh, Iran
| | | | - Ali Bahadori
- Department of Medical Microbiology, Sarab Faculty of Medical Sciences, Sarab, Iran
| | - Zeynab Mohkami
- Department of Agriculture and Plant Breeding, Agriculture Institute, Research Institute of Zabol, Zabol, Iran
| | - Mahtab Sotoudeh
- Department of Pharmacognosy, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mojtaba Ziaee
- Medicinal Plants Research Center, Maragheh University of Medical Sciences, Maragheh, Iran.
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Fakudze NT, Sarbadhikary P, George BP, Abrahamse H. Ethnomedicinal Uses, Phytochemistry, and Anticancer Potentials of African Medicinal Fruits: A Comprehensive Review. Pharmaceuticals (Basel) 2023; 16:1117. [PMID: 37631032 PMCID: PMC10458058 DOI: 10.3390/ph16081117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/01/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
Africa is home to diverse medicinal plants that have been used for generations for the treatment of several different cancers and, presently, they are gaining interest from researchers as promising approaches to cancer treatment. This review aims to provide a comprehensive review of dietary and medicinal African fruits including their traditional uses, botanical description, ethnobotanical uses, bioactive phytochemical compositions, and anticancer properties investigated to date in vitro, in vivo, and in clinical studies. Data on recent updates concerning the traditional uses and anticancer properties of these fruits were collected from a myriad of available publications in electronic databases, such as Web of Science, PubMed, ScienceDirect, Scopus, SpringerLink, and Google Scholar. The results suggest that approximately 12 native or commercially grown African fruits belonging to different plant species, including Tribulus terrestris, Xanthium strumarium, Withania somnifera, Xylopia aethiopica, Abelmoschus esculentus, Carissa macrocarpa, Carpobrotus edulis, Syzygium cumini, Kigelia Africana, Annona muricata, Persea americana, and Punica granatum, have been reported for their potential as treatment options for the management of cancer. We further found that approximately eight different fruits from native plant species from Africa, namely, Sclerocarya birrea, Dovyalis caffra, Parinari curatellifolia, Mimusops caffra, Carpobrotus edulis, Vangueria infausta, Harpephyllum caffrum, and Carissa macrocarpa, have been widely used for the traditional treatment of different ailments but somehow failed to gain the interest of researchers for their use in anticancer research. In this review, we show the potential use of various fruits as anticancer agents, such as Tribulus terrestris, Xanthium strumarium, Withania somnifera, Xylopia aethiopica, Abelmoschus esculentus, Carissa macrocarpa, Carpobrotus edulis, Syzygium cumini, Kigelia Africana, Annona muricata, Persea americana, and Punica granatum; unfortunately, not enough reported research data have been published to gain thorough mechanistic insights and clinical applications. Additionally, we discuss the possibility of the utilization of potential phytochemicals from fruits like Persea americana and Punica granatum in anticancer research, as well as future directions.
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Affiliation(s)
| | - Paromita Sarbadhikary
- Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Doornfontein, P.O. Box 1701, Johannesburg 2028, South Africa; (N.T.F.); (H.A.)
| | - Blassan P. George
- Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Doornfontein, P.O. Box 1701, Johannesburg 2028, South Africa; (N.T.F.); (H.A.)
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Mokgalaboni K, Lebelo SL, Modjadji P, Ghaffary S. Okra ameliorates hyperglycaemia in pre-diabetic and type 2 diabetic patients: A systematic review and meta-analysis of the clinical evidence. Front Pharmacol 2023; 14:1132650. [PMID: 37077817 PMCID: PMC10107009 DOI: 10.3389/fphar.2023.1132650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/22/2023] [Indexed: 04/05/2023] Open
Abstract
Background: Despite the use of available pharmaceutical drugs, high rates of metabolic diseases and cardiovascular disorders are alarming. This calls for alternative therapies that can attenuate these complications. Therefore, we investigated the beneficial effects of okra on glycaemic control in pre-diabetes and type 2 diabetes mellitus (T2D).Methods: MEDLINE and Scopus were searched for relevant studies. Collected data were analysed using RevMan and reported as mean difference and 95% confidence intervals (CI). Eight studies, including 331 patients with pre-diabetes or T2D, were eligible.Results: Our findings showed that okra treatment reduced the levels of fasting blood glucose: mean difference (MD) = −14.63 mg/dL; 95% CI (-25.25, −4.00, p = 0.007); I2 = 33%, p = 0.17 compared to placebo. Glycated haemoglobin, however, did not differ significantly between the groups: MD = 0.01%; 95%CI (-0.51, 0.54, p = 0.96); I2 = 23%, p = 0.28.Conclusion: this systematic review and meta-analysis found that okra treatment improves glycaemic control in patients with pre-diabetes or T2D. The findings suggest that okra may be used as a supplemental dietary nutrient, especially in pre-diabetic and T2D patients due to its potential to regulate hyperglycaemia.
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Affiliation(s)
- Kabelo Mokgalaboni
- Department of Life and Consumer Sciences, College of Agriculture and Environmental Sciences, Florida Campus, University of South Africa, Roodepoort, South Africa
- *Correspondence: Kabelo Mokgalaboni, ; Saba Ghaffary,
| | - Sogolo Lucky Lebelo
- Department of Life and Consumer Sciences, College of Agriculture and Environmental Sciences, Florida Campus, University of South Africa, Roodepoort, South Africa
| | - Perpetua Modjadji
- Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Public Health, School of Healthcare Sciences, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa
| | - Saba Ghaffary
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- *Correspondence: Kabelo Mokgalaboni, ; Saba Ghaffary,
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Yang D, Lew HL, Mak YY, Ou SJL, Lim JA, Lu Y, Seah CLY, Tan MQH, Huang D, Tai ES, Liu MH. Incorporation of okra (Abelmoschus esculentus (L.) Moench) seed powder into fresh rice noodles with tapioca starch improves postprandial glycemia, insulinemia and satiety in healthy human volunteers. J Funct Foods 2023. [DOI: 10.1016/j.jff.2022.105382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Panighel G, Ferrarese I, Lupo MG, Sut S, Dall'Acqua S, Ferri N. Investigating the in vitro mode of action of okra (Abelmoschus esculentus) as hypocholesterolemic, anti-inflammatory, and antioxidant food. FOOD CHEMISTRY: MOLECULAR SCIENCES 2022; 5:100126. [PMID: 35937040 PMCID: PMC9352527 DOI: 10.1016/j.fochms.2022.100126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 11/15/2022]
Abstract
Okra leaf butanol extract and fruit extract induce the LDLR expression in human hepatoma cell line Huh7. Okra leaf butanol extract reduced the mRNA levels of proinflammatory cytokines IL-1β, IL-6 and TNF-α in THP1-derived macrophages. Okra fruit extract showed a sequestering ability of cholic acid providing an additional mechanism of hypocholesterolemic activity. Leaf ethyl acetate extract exerted significant antioxidant activity with IC50 comparable to ascorbic acid.
Okra (Abelmoschus esculentus) have been introduced as food relatively recently in Europe. It is native to India and one of the most important vegetables in Nigeria. The leaves can be consumed but also the fruit is rich in nutrients and bioactive compounds (i.e., dietary fiber, vitamins, oils, polysaccharides, polyphenols) and several health promoting actions have been ascribed, including a lipid-lowering properties. In this work the effects of fruit and leaf extracts on expression of key mediators of cholesterol metabolism, i.e., the low-density lipoprotein receptor (LDLR) and proprotein convertase subtilisin/kexin type 9 (PCSK9), were investigated in human hepatoma cell line Huh7. Furthermore, effects on proinflammatory cytokines (IL-1β, IL-6 and TNF-α) expressed by THP1-derived macrophages were studied to assess potential anti-inflammatory actions. Okra fruit extract significantly induced the mRNA and protein levels of the LDLR by 1.4 ± 0.3 and 4.8 ± 1.5-fold, respectively without any significant modification of PCSK9 expression. In addition, fruit extract showed a significant sequestering ability of cholic acid. Leaf butanol extract exerted similar action by inducing the expression of both the LDLR (+3.1 ± 1.6-fold vs control) and PCSK9 (+1.3 ± 0.4-fold vs control). The evaluation of the potential anti-inflammatory effect revealed a significant action of leaf butanol extract with reduced mRNA levels of IL-1β (−28 ± 8 % vs control), IL-6 (−11 ± 1 % vs control) and TNF-α (−43 ± 8 % vs control), while fruit extract did not show any anti-inflammatory activity. Finally, leaf ethyl acetate extract showed a significant antioxidant capacity comparable to ascorbic acid. Taken together, we provided evidence that leaf butanol extract and, more effectively, fruit extract induced the LDLR expression, effect that may explain the previously reported hypocholesterolemic action of okra. In addition, okra’s extracts reduced the expression of pro-inflammatory cytokines from THP1-derived macrophages, an effect that may suggest a vascular protective action of okra.
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Nikpayam O, Safaei E, Bahreyni N, Sadra V, Saghafi-Asl M, Fakhr L. The effect of Abelmoschus esculentus L. (Okra) extract supplementation on dietary intake, appetite, anthropometric measures, and body composition in patients with diabetic nephropathy. Health Promot Perspect 2022; 12:169-177. [PMID: 36276416 PMCID: PMC9508394 DOI: 10.34172/hpp.2022.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/13/2022] [Indexed: 11/09/2022] Open
Abstract
Background: Diabetes is a risk factor for chronic kidney disease because it induces nephropathy. Okra is a rich source of antioxidants, vitamins, minerals, and fibers, of which favorable effects in diabetes have been reported in many animal studies. The present trial aimed to investigate the effect of dried okra extract (DOE) supplementation on anthropometric measures, body composition, appetite, and dietary intake in diabetic nephropathy (DN) patients. Methods: In this triple-blind placebo-controlled randomized clinical trial, 64 DN patients were randomly allocated to receive a 125-mg capsule of DOE (n=32) or placebo (n=32) for 10 weeks. At baseline and endpoint of the trial, anthropometric variables, body composition indices, dietary intake, and appetite scores were evaluated. Results: The results showed that energy (P=0.047, CI: -425.87, -3.25, ES: 0.539) and carbohydrate (P=0.038, CI: -85.64, -2.53, ES: 0.555) intake as well as desire to eat salty food (P=0.023) were reduced in DOE group at the endpoint, compared to the baseline values. However, anthropometric measures, body composition, and appetite score were not significantly different between the two study groups. Conclusion: In conclusion, the present clinical trial showed that DOE could significantly decrease energy intake and carbohydrate consumption in the DN patients. Further clinical trials are needed to determine the effects of this supplement.
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Affiliation(s)
- Omid Nikpayam
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ehsan Safaei
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nazgol Bahreyni
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahideh Sadra
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Saghafi-Asl
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Science, Tabriz, Iran
| | - Laleh Fakhr
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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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.
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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
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11
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da Silva MM, Gomes MFP, de Moura EDOC, Veras MM, Kubota MC, Takano AP, dos Santos ACC, José CGDR, Souza GADS, Cardoso NM, Estadella D, Lambertucci RH, Medeiros A. Aerobic exercise training combined or not with okra consumption as a strategy to prevent kidney changes caused by metabolic syndrome in Zucker rats. PLoS One 2022; 17:e0269418. [PMID: 35657982 PMCID: PMC9165804 DOI: 10.1371/journal.pone.0269418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 05/20/2022] [Indexed: 11/18/2022] Open
Abstract
The complications of Metabolic Syndrome (MetS) include kidney disease, and most dialysis patients are diagnosed with MetS. The benefit of exercise training (ET) for MetS treatment is already well defined in the literature, but the antidiabetic and antihyperlipidemic benefits of okra (O) have been discovered only recently. The aim of this study was to evaluate the effects of O and/or ET supplementation on renal function and histology; serum urea and creatinine value; inflammation (IL-6, IL-10, TNF-α) and oxidative stress in renal tissue. For this, 32 Zucker rats (fa/fa) were randomly separated into four groups of 8 animals each: Metabolic Syndrome (MetS), MetS + Okra (MetS + O), MetS + Exercise Training (MetS + ET), and MetS + Exercise Training and Okra (MetS + ET + O), and 8 Zucker lean (fa/+) rats comprised the Control group (CTL). Okra was administered by orogastric gavage 2x/day (morning and night, 100 mg/kg) and ET performed on the treadmill, at moderate intensity, 1h/day, 5x/week for 6 weeks. Although the renal function was not altered, the animals with MetS showed greater fibrotic deposition accompanied by a worse stage of renal injury, in addition to increased kidney weight. Although all interventions were beneficial in reducing fibrosis, only ET combined with O was able to improve the degree of renal tissue impairment. ET improved the anti-inflammatory status and reduced nitrite levels, but the combination of ET and O was more beneficial as regards catalase activity. Okra consumption alone did not promote changes in inflammatory cytokines and oxidative stress in the kidney. In conclusion, ET combined or not with O seems to be beneficial in preventing the progression of renal disease when renal function is not yet altered.
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Affiliation(s)
- Monique Marques da Silva
- Interdisciplinary Graduate Program in Health Sciences, Federal University of São Paulo, Santos, Brazil
| | | | | | - Mariana Matera Veras
- Laboratory of Environmental Air Pollution, Department of Pathology, University of São Paulo - School of Medicine, São Paulo, Brazil
| | - Melina Chiemi Kubota
- Interdisciplinary Graduate Program in Health Sciences, Federal University of São Paulo, Santos, Brazil
| | - Ana Paula Takano
- Laboratory of Environmental Air Pollution, Department of Pathology, University of São Paulo - School of Medicine, São Paulo, Brazil
| | | | | | | | - Naiara Magalhães Cardoso
- Interdisciplinary Graduate Program in Health Sciences, Federal University of São Paulo, Santos, Brazil
| | - Debora Estadella
- Interdisciplinary Graduate Program in Health Sciences, Federal University of São Paulo, Santos, Brazil
- Biosciences Department, Federal University of São Paulo, Santos, Brazil
| | - Rafael Herling Lambertucci
- Interdisciplinary Graduate Program in Health Sciences, Federal University of São Paulo, Santos, Brazil
- Biosciences Department, Federal University of São Paulo, Santos, Brazil
| | - Alessandra Medeiros
- Interdisciplinary Graduate Program in Health Sciences, Federal University of São Paulo, Santos, Brazil
- Biosciences Department, Federal University of São Paulo, Santos, Brazil
- * E-mail:
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12
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Saatchi A, Aghamohammadzadeh N, Beheshtirouy S, Javadzadeh Y, Afshar FH, Ghaffary S. Anti‐hyperglycemic effect of
Abelmoschus culentesus
(Okra) on patients with diabetes type 2: a randomized clinical trial. Phytother Res 2022; 36:1644-1651. [DOI: 10.1002/ptr.7341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 10/04/2021] [Accepted: 11/08/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Ali Saatchi
- Drug Applied Research Center Tabriz University of Medical Sciences Tabriz Iran
- Faculty of Pharmacy Tabriz University of Medical Sciences Tabriz Iran
| | | | | | - Yousef Javadzadeh
- Drug Applied Research Center Tabriz University of Medical Sciences Tabriz Iran
| | - Fariba Heshmati Afshar
- Drug Applied Research Center Tabriz University of Medical Sciences Tabriz Iran
- Faculty of Pharmacy Tabriz University of Medical Sciences Tabriz Iran
| | - Saba Ghaffary
- Drug Applied Research Center Tabriz University of Medical Sciences Tabriz Iran
- Hematology and Oncology Research Center Tabriz University of Medical Sciences Tabriz Iran
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13
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The effects of okra (Abelmoschus esculentus L.) products on glycemic control and lipid profile: A comprehensive systematic review. J Funct Foods 2021. [DOI: 10.1016/j.jff.2021.104795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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