The effects of resveratrol on glycemic control and cardiometabolic parameters in patients with T2DM: A systematic review and meta-analysis

The efficacy of resveratrol supplementation on inflammation and oxidative stress in type-2 diabetes mellitus patients: randomized double-blind placebo meta-analysis

Background

The effects of resveratrol supplementation on inflammation and oxidative stress in patients with type 2 diabetes mellitus (T2DM) were controversial. A meta-analysis was performed to assess the changes in levels of inflammation and oxidative stress in patients with T2DM.

Methods

Relevant literatures before November 6, 2024 were screened through Web of Science,Embase,the Cochrane Library and other sources (ClinicalTrials, ProQuest Dissertations and Theses). The quality of the literature was evaluated according to the Cochrane Handbook of Systematic Reviews. The study quality was assessed using the risk-of-bias 2 tool and the Grading of Recommendations Assessment,Development and Evaluation (GRADE) system. Review Manager 5.3 conducted meta-analysis of the data included in the literature.

Results

This meta-analysis was conducted in six randomized controlled trials involving 533 participants. Our results showed that supplementation with resveratrol significantly reduced C-reactive protein levels(SMD = -1.40, 95%CI(-2.60, -0.21), P = 0.02; Level of evidence: low), lipid peroxide levels (SMD = -0.99, 95%CI(-1.36, -0.61), P < 0.00001; Level of evidence: low), 8-isoprostanes(SMD = -0.79, 95%CI(-1.16, -0.42), P < 0.0001; Level of evidence: low) and oxidative stress score (SMD = -1.62, 95%CI(-2.49, -0.75), P = 0.0003; Level of evidence: very low). In addition, compared to placebo, Supplementation with resveratrol significantly increased glutathione peroxidase levels (SMD = 0.38, 95%CI(0.03, 0.74), P = 0.04; Level of evidence:low) and catalase levels (SMD = 0.33, 95%CI(0.03, 0.63), P = 0.03; Level of evidence: low). However, no significant difference was observed in improving interleukin-6 levels (SMD = -1.35, 95%CI(-2.75, -0.05), P = 0.06; Level of evidence: very low), tumor necrosis factor α levels (SMD = -3.30, 95%CI(-7.47, 0.87), P = 0.12; Level of evidence: very low), superoxide dismutase levels (SMD = 0.39, 95%CI(-0.26, 1.04), P = 0.24; Level of evidence: very low), total antioxidant capacity levels (SMD = 0.39, 95%CI(-0.23, 1.00), P = 0.21; Level of evidence: very low) and malondialdehyde levels (SMD = -3.36, 95%CI(-10.30, 3.09), P = 0.29; Level of evidence: very low).

Conclusion

Resveratrol improved inflammation and oxidative stress in T2DM patients to some extent. This provides a new idea and method for clinical treatment. However, due to the limitations of the study, more large-sample, multi-center clinical studies are needed to verify this conclusion.

Network Pharmacology, Molecular Docking, and Molecular Dynamics Study to Explore the Effect of Resveratrol on Type 2 Diabetes

This network pharmacology study represents a significant step in understanding the potential of Resveratrol as an antidiabetic agent and its molecular targets. Targets for Type 2 diabetes were obtained from the MalaCards and DisGeNET databases, while targets for Resveratrol were sourced from the STP and CTD databases. Subsequently, we performed matching to identify common disease-compound targets. The identified genes were analyzed using the ShinGO-0.76.3 database for functional enrichment analysis and KEGG pathway mapping. A protein-protein interaction network was then constructed using Cytoscape software, and hub genes were identified. These hub genes were subjected to molecular docking and dynamic simulations using AutoDock Vina and Gromacs software. According to functional enrichment and KEGG pathway analysis, Resveratrol influences insulin receptors, endoplasmic reticulum functions, and oxidoreductase activity and is involved in the estrogen and HIF-1 pathways. Ten hub genes were identified, including ESR1, PTGS2, SRC, NOS3, MMP9, IGF1R, CYP19A1, MTOR, MMP2, and PIK3CA. The proteins associated with these genes exhibited high interaction with Resveratrol in the molecular docking analysis, and molecular dynamics showed a stable interaction of Resveratrol with ESR1, MMP9, PIK3CA, and PTGS2. In conclusion, our work enhances the understanding of the antidiabetic activity of Resveratrol, which future studies should experimentally corroborate.

Advancing Longevity: Exploring Antiaging Pharmaceuticals in Contemporary Clinical Trials Amid Aging Dynamics

Aging is an inevitable biological process that significantly impacts human health, leading to a decline in cellular function and an increase in cellular damage. This study elucidates the burgeoning potential of antiaging pharmaceuticals in mitigating the thriving burden of chronic conditions linked to advancing age. It underscores the pivotal role of these pharmacotherapeutic agents in fostering longevity free from debilitating age-related afflictions, notably cardiovascular disorders, neoplastic processes, and neurodegenerative pathologies. While commendable strides have been made evident in preclinical models, it is crucial to thoroughly investigate their effectiveness and safety in human groups. In addition, ethical concerns about fair access, societal impacts, and careful resource distribution are significant in discussions about developing and using antiaging medications. By approaching the development and utilization of antiaging medications with diligence and foresight, we can strive toward a future where individuals can enjoy extended lifespans free from the debilitating effects of age-related ailments.

Effect of resveratrol supplementation on metabolic risk markers and anthropometric parameters in individuals with obesity or overweight: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Obesity, a progressively widespread disease with a multifaceted etiology, affects nearly 800 million people worldwide. Recent trials suggest that resveratrol, a polyphenolic compound, can be effective for metabolic risk markers and anthropometric parameters in Individuals with Obesity or Overweight. However, a comprehensive analysis is necessary to consolidate these results.

OBJECTIVES

To evaluate the impact of 4-week resveratrol supplementation on metabolic risk markers and anthropometric parameters in individuals with obesity or overweight.

METHODS

A comprehensive search was executed across PubMed, Cochrane Library, Scopus, Google Scholar, and clinicaltrials.gov, yielding 43 studies after the omission of 20 duplicates. RevMan 5.4 software was used to statistically analyze randomized controlled studies to gauge the impact of resveratrol on the said outcomes in Individuals with Obesity or Overweight. Quality of bias and potential publication bias were measured using the Cochrane Risk of Bias tool and CMA4 software, respectively. Certainty of the evidence was appraised using GRADEpro software. Data was quantified as the standardized mean difference (SMD) and 95 % confidence intervals (CI).

RESULTS

The meta-analysis included 5 trials with 419 participants, evaluating the effect of intervention. Resveratrol showed no significant impact on triglycerides (SMD = 0.11, 95%CI [-0.14, 0.35], P = 0.39, I2 = 0 %), total cholesterol (SMD = 0.04, 95%CI [-0.26, 0.33], P = 0.82, I2 = 0 %), or HbA1c (SMD = 0.00, 95%CI [-0.99, 1.00], P = 0.99, I2 = 80 %). Similarly, no significant effect was observed for insulin levels (SMD = -0.00, 95%CI [-0.25, 0.24], P = 0.97, I2 = 0 %), AST (SMD = 0.15, 95%CI [-0.35, 0.65], P = 0.55, I2 = 0 %), or ALT (SMD = -0.03, 95%CI [-0.46, 0.39], P = 0.98, I2 = 0 %). Additionally, resveratrol had no significant effect on BMI (MD = 0.21, 95%CI [-0.970, 1.39], P = 0.70, I2 = 0 %).

CONCLUSIONS

Our results tagged with p-value>0.05 are an evidence-based indication that resveratrol supplementation does not lead to significant improvements in metabolic or anthropometric parameters. This suggests that resveratrol may not be an effective standalone intervention for managing obesity-related outcomes. Therefore, future research should be redirected to evaluating its potential effects on other health metrics to elucidate its efficacy and therapeutic potential better.

Preclinical evidence and possible mechanisms of cardioprotective effects of resveratrol in diabetic cardiomyopathy: a systematic review and meta-analysis

INTRODUCTION

Diabetic cardiomyopathy (DCM) is a significant complication of diabetes, characterized primarily by the development of heart failure in individuals with diabetes. Numerous animal studies have indicated that resveratrol enhances cardiac function in diabetic cardiomyopathy; however, its reliability and underlying mechanism remain unclear. This study aims to assess the cardioprotective effects of resveratrol on DCM and explore its potential mechanism.

METHODS

We searched PubMed, EMBASE, WOS, Cochrane Library, CNKI, CBM, Chinese VIP, and Wan Fang Database until March 31st, 2024, without language restrictions. Continuous outcome measures were analyzed using weighted mean difference or standardized mean difference, and heterogeneity was assessed with I2. The risk of bias in animal experiments was evaluated using the SYRCLE tool, and evidence reliability was determined with the GRADE tool. All data were analyzed using Review Manager 5.4.1 and Stata 17. This study has been registered on the PROSPERO (CRD42024523944).

RESULTS

A total of 18 studies meeting the criteria were identified. The analysis revealed that the resveratrol intervention group exhibited significant improvements in LVEF (WMD = 17.88), LVFS (WMD = 8.77), HW/BW (SMD=-2.92), SOD (SMD = 4.53), and MDA (SMD=-5.07) compared to the control group. The GRADE grading assessment indicated moderate certainty for LVEF, HW/BW, and MDA, while certainty for other factors was considered low.

CONCLUSION

Our research suggests that resveratrol may protect cardiac function in DCM through anti-inflammatory and anti-oxidative stress effects. However, these findings are based on preclinical data, and further extensive trials are needed to confirm their effectiveness and safety before clinical application.

Emerging and multifaceted potential contributions of polyphenols in the management of type 2 diabetes mellitus

Type 2 diabetes mellitus (T2DM) is recognized as a serious public health concern with a considerable impact on human life, long-term health expenditures, and substantial health losses. In this context, the use of dietary polyphenols to prevent and manage T2DM is widely documented. These dietary compounds exert their beneficial effects through several actions, including the protection of pancreatic islet β-cell, the antioxidant capacities of these molecules, their effects on insulin secretion and actions, the regulation of intestinal microbiota, and their contribution to ameliorate diabetic complications, particularly those of vascular origin. In the present review, we intend to highlight these multifaceted actions and the molecular mechanisms by which these plant-derived secondary metabolites exert their beneficial effects on type 2 diabetes patients.

Dietary (poly)phenols and cardiometabolic health: from antioxidants to modulators of the gut microbiota

(Poly)phenols are plant secondary metabolites widely abundant in plant foods and beverages comprising a very large number of compounds with diverse structure and biological activities. Accumulating evidence indicates that these compounds exert beneficial effects against cardiometabolic diseases, and this review will provide a summary of current knowledge in this area. Epidemiological and clinical data collectively suggest that intake of flavonoids reduces the risk of cardiovascular disease (CVD), with the evidence being particularly strong for the flavan-3-ol subclass. However, to provide adequate dietary recommendations, a better understanding of their estimated content in foods and intake among the general public is needed. Regarding mechanisms of action, we now know that it is unlikely that (poly)phenols act as direct antioxidants in vivo, as it was hypothesised for decades with the popularity of in vitro antioxidant capacity assays. One of the reasons is that upon ingestion, (poly)phenols are extensively metabolised into a wide array of circulating metabolites with different bioactivities than their precursors. Well-conducted in vitro and in vivo studies and human nutrigenomic analysis have revealed new molecular targets that may be underlying the health benefits of (poly)phenols, such as the nitric oxide pathway. Recently, a bi-directional relationship was established between (poly)phenols and the gut microbiota, suggesting that individual gut microbial metabolising capacity may be a key factor explaining the variability in the cardiometabolic response to (poly)phenols. Future research is needed to elucidate which are the key factors affecting such capacity, and whether it can be modulated, along with the mechanisms of action.

Comprehensive Approach to Medical Nutrition Therapy in Patients with Type 2 Diabetes Mellitus: From Diet to Bioactive Compounds

In the pathogenesis of type 2 diabetes mellitus (T2DM), diet plays a key role. Individualized medical nutritional therapy, as part of lifestyle optimization, is one of the cornerstones for the management of T2DM and has been shown to improve metabolic outcomes. This paper discusses major aspects of the nutritional intervention (including macro- and micronutrients, nutraceuticals, and supplements), with key practical advice. Various eating patterns, such as the Mediterranean-style, low-carbohydrate, vegetarian or plant-based diets, as well as healthy eating plans with caloric deficits have been proven to have beneficial effects for patients with T2DM. So far, the evidence does not support a specific macronutrient distribution and meal plans should be individualized. Reducing the overall carbohydrate intake and replacing high glycemic index (GI) foods with low GI foods have been shown as valid options for patients with T2DM to improve glycemic control. Additionally, evidence supports the current recommendation to reduce the intake of free sugars to less than 10% of total energy intake, since their excessive intake promotes weight gain. The quality of fats seems to be rather important and the substitution of saturated and trans fatty acids with foods rich in monounsaturated and polyunsaturated fats lowers cardiovascular risk and improves glucose metabolism. There is no benefit of supplementation with antioxidants, such as carotene, vitamins E and C, or other micronutrients, due to the lack of consistent evidence showing efficacy and long-term safety. Some studies suggest possible beneficial metabolic effects of nutraceuticals in patients with T2DM, but more evidence about their efficacy and safety is still needed.

Potential of Polyphenols for Improving Sleep: A Preliminary Results from Review of Human Clinical Trials and Mechanistic Insights

Global epidemiologic evidence supports an interrelationship between sleep disorders and fruits and vegetable ingestion. Polyphenols, a broad group of plant substances, are associated with several biologic processes, including oxidative stress and signaling pathways that regulate the expression of genes promoting an anti-inflammatory environment. Understanding whether and how polyphenol intake is related to sleep may provide avenues to improve sleep and contribute to delaying or preventing the development of chronic disease. This review aims to assess the public health implications of the association between polyphenol intake and sleep and to inform future research. The effects of polyphenol intake, including chlorogenic acid, resveratrol, rosmarinic acid, and catechins, on sleep quality and quantity are discussed to identify polyphenol molecules that may improve sleep. Although some animal studies have investigated the mechanisms underlying the effects of polyphenols on sleep, the paucity of trials, especially randomized controlled trials, does not allow for conducting a meta-analysis to reach clear conclusions about the relationships among these studies to support the sleep-improving effects of polyphenols.

Can Bioactive Food Substances Contribute to Cystic Fibrosis-Related Cardiovascular Disease Prevention?

Advances in cystic fibrosis (CF) care have significantly improved the quality of life and life expectancy of patients. Nutritional therapy based on a high-calorie, high-fat diet, antibiotics, as well as new therapies focused on CFTR modulators change the natural course of the disease. They do so by improving pulmonary function and growing BMI. However, the increased weight of such patients can lead to unwanted long-term cardiovascular effects. People with CF (pwCF) experience several cardiovascular risk factors. Such factors include a high-fat diet and increased dietary intake, altered lipid metabolism, a decrease in the level of fat-soluble antioxidants, heightened systemic inflammation, therapeutic interventions, and diabetes mellitus. PwCF must pay special attention to food and eating habits in order to maintain a nutritional status that is as close as possible to the proper physiological one. They also have to benefit from appropriate nutritional counseling, which is essential in the evolution and prognosis of the disease. Growing evidence collected in the last years shows that many bioactive food components, such as phytochemicals, polyunsaturated fatty acids, and antioxidants have favorable effects in the management of CF. An important positive effect is cardiovascular prevention. The possibility of preventing/reducing cardiovascular risk in CF patients enhances both quality of life and life expectancy in the long run.

Efficacy and safety of dorzagliatin for type 2 diabetes mellitus: A meta-analysis and trial sequential analysis

Objective

To evaluate the efficacy and safety of dorzagliatin in the treatment of type 2 diabetes mellitus (T2DM) by using meta-analysis and trial sequential analysis (TSA).

Method

Search for clinical trials of dorzagliatin for T2DM in eight databases, with a time limit of build to July 2022. The included studies that met the requirements were carried out for meta-analysis and TSA.

Results

In terms of efficacy endpoints, meta-analysis showed that dorzagliatin decreased glycated hemoglobin A1c(HbA1c) [mean difference (MD) -0.65%, 95% confidence interval (CI) -0.76 ~ -0.54, P < 0.00001], fasting plasma glucose (FPG) (MD -9.22 mg/dL, 95% CI -9.99 ~ -8.44, P < 0.00001), 2 h postprandial glucose (2h-PPG) (MD -48.70 mg/dL, 95% CI -55.45 ~ -41.96, P < 0.00001), homeostasis model assessment 2 of insulin resistance (HOMA2-IR) (MD -0.07, 95% CI -0.14 ~ -0.01, P = 0.03) and increased homeostasis model assessment 2 of ß-cells function (HOMA2-β) (MD 2.69, 95% CI 1.06 ~ 4.31, P = 0.001) compared with placebo. And TSA revealed that the benefits observed for the current information set were conclusive, except for HOMA2-IR. In comparison with placebo, dorzagliatin increased triglyceride(TG) (MD 0.43 mmol/L, 95% CI 0.30 ~ 0.56, P < 0.00001), total cholesterol (TC) (MD 0.13 mmol/L, 95% CI 0.05 ~ 0.21, P = 0.001), body weight (MD 0.38 kg, 95% CI 0.12-0.63, P = 0.004) and body mass index (BMI) (MD 0.14 kg/m², 95% CI 0.05-0.24, P = 0.003), while low density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were comparable. And TSA demonstrated that TG, TC, body weight, and BMI were conclusive. In terms of safety endpoints, dorzagliatin increased total adverse events (AEs) [risk ratio (RR) 1.56, 95% CI 1.06 ~ 2.30, P = 0.03], while serious AEs, hyperlipidemia, and hypoglycaemia were all comparable. And TSA indicated that the results need to be confirmed by additional studies. Harbord regression showed no publication bias.

Conclusion

Dorzagliatin was effective in lowering glycemia, reducing insulin resistance and improving islet ß-cells function without affecting blood pressure, LDL-C, and HDL-C. Although dorzagliatin caused a mild increase in TG and TC, it did not increase the incidence of hyperlipidemia, and the small increases in body weight and BMI were not clinically significant enough. In terms of safety, the total AEs caused by dorzagliatin may be a cumulative effect of single AEs, with no drug-related adverse event being reported at a higher incidence than placebo alone. Dorzagliatin's serious AEs, hyperlipidemia, and hypoglycemia are comparable to that of placebo, and dorzagliatin has a good safety profile.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=371802 identifier: CRD42022371802.

Association of Polyphenols Consumption with Risk for Gestational Diabetes Mellitus and Preeclampsia: A Systematic Review and Meta-Analysis

Gestational Diabetes Mellitus (GDM) and preeclampsia (PE) affects 6-25% of pregnancies and are characterized by an imbalance in natural prooxidant/antioxidant mechanisms. Due to their antioxidant and anti-inflammatory properties, polyphenols consumption during the pregnancy might exert positive effects by preventing GDM and PE development. However, this association remains inconclusive. This systematic review and metanalysis is aimed to analyze the association between polyphenol-rich food consumption during pregnancy and the risk of GDM and PE. A systematic search in MEDLINE, EMBASE, and Web of Science (Clarivate Analytics, London, United Kingdom) for articles dated between 1 January 1980 and July 2022 was undertaken to identify randomized controlled trials and observational studies evaluating polyphenol-rich food consumption and the risk of GDM and PE. The Newcastle-Ottawa Scale was used to evaluate the quality of these included studies. Twelve studies were included, of which eight articles evaluated GDM and four studied PE. A total of 3785 women presented with GDM (2.33%). No association between polyphenol consumption and GDM was found (ES = 0.85, 95% CI 0.71-1.01). When total polyphenol intake was considered, a lower likelihood to develop GDM was noted (ES = 0.78, 95% CI 0.69-0.89). Furthermore, polyphenol consumption was not associated with PE development (ES = 0.90, 95% CI 0.57-1.41). In conclusion, for both outcomes, pooled analyses showed no association with polyphenol-rich food consumption during pregnancy. Therefore, association of polyphenol intake with a decreased risk of GDM and PE remains inconclusive.

The Cost-Effectiveness of Supplemental Carnosine in Type 2 Diabetes

In this paper, we assess the cost-effectiveness of 1 g daily of carnosine (an over the counter supplement) in addition to standard care for the management of type 2 diabetes and compare it to standard care alone. Dynamic multistate life table models were constructed in order to estimate both clinical outcomes and costs of Australians aged 18 years and above with and without type 2 diabetes over a ten-year period, 2020 to 2029. The dynamic nature of the model allowed for population change over time (migration and deaths) and accounted for the development of new cases of diabetes. The three health states were 'Alive without type 2 diabetes', 'Alive with type 2 diabetes' and 'Dead'. Transition probabilities, costs, and utilities were obtained from published sources. The main outcome of interest was the incremental cost-effectiveness ratio (ICER) in terms of cost per year of life saved (YoLS) and cost per quality-adjusted life year (QALY) gained. Over the ten-year period, the addition of carnosine to standard care treatment resulted in ICERs (discounted) of AUD 34,836 per YoLS and AUD 43,270 per QALY gained. Assuming the commonly accepted willingness to pay threshold of AUD 50,000 per QALY gained, supplemental dietary carnosine may be a cost-effective treatment option for people with type 2 diabetes in Australia.

Effects of Resveratrol on Metabolic Indicators in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

BACKGROUND AND AIMS

Previous studies on the effects of resveratrol on metabolic indicators reported contradictory findings, and these indicators have not been frequently studied in patients with type 2 diabetes. In this study, we aimed to examine the effects of resveratrol on metabolic indicators in a specific group of people with type 2 diabetes using the most recent literature.

METHODS

We used RevMan 5.4 and Stata 14.0 software to identify randomized controlled studies on the impact of resveratrol on metabolic indicators in patients with type 2 diabetes using relevant search terms and keywords such as "resveratrol" and "type 2 diabetes" in the China National Knowledge Infrastructure, PubMed, Cochrane, and Embase. Data were expressed as the weighted mean difference (WMD) and 95% confidence interval (CI).

RESULTS

This meta-analysis included 19 studies involving 1151 patients with type 2 diabetes, including 584 patients treated with resveratrol and 567 patients who received placebo. Compared with the control data, large doses of resveratrol (≥1000 mg) reduced fasting blood glucose levels (WMD: -18.76 mg/dL, 95% CI: -23.43, -14.09; P < 0.00001). Additionally, resveratrol reduced systolic blood pressure (WMD: -7.97 mmHg, 95% CI: -10.63, -5.31; P < 0.00001) and diastolic blood pressure (WMD: -3.55 mmHg, 95% CI: -5.18, -1.93; P < 0.00001) in patients with type 2 diabetes but did not improve waist circumference (WMD: 0.05 cm, 95% CI: -1.77, 1.88; P=0.95), triglyceride levels (WMD: -4.49 mg/dL, 95% CI: -24.23, 15.25; P=0.66), or high-density lipoprotein cholesterol levels (WMD: -1.05 mg/dL, 95% CI: -2.44, 0.33; P=0.14) in patients with type 2 diabetes.

CONCLUSION

This systematic review and meta-analysis updated the most recent literature and provided new evidence, proving that resveratrol treatment can reduce systolic blood pressure and diastolic blood pressure. High-dose resveratrol can reduce fasting blood glucose in patients with type 2 diabetes, although it has no effect on waist circumference, triglyceride, and high-density lipoprotein cholesterol.