Indigenous plant medicines for health care: treatment of Diabetes mellitus and hyperlipidemia

Co-Administration of Vitamin E and Atorvastatin Improves Insulin Sensitivity and Peroxisome Proliferator-Activated Receptor-γ Expression in Type 2 Diabetic Patients: A Randomized Double-Blind Clinical Trial

BACKGROUND

Negative effects of statins on glucose metabolism have been reported. The present study aimed to investigate the effects of co-administration of vitamin E and atorvastatin on glycemic control in hyperlipidemic patients with type 2 diabetes mellitus (T2DM).

METHODS

A randomized double-blind clinical trial was conducted at Vali-e-Asr Teaching Hospital (Zanjan, Iran) from July 2017 to March 2018. A total of 30 T2DM female patients were allocated to two groups, namely atorvastatin with placebo (n=15) and atorvastatin with vitamin E (n=15). The patients received daily 20 mg atorvastatin and 400 IU vitamin E or placebo for 12 weeks. Anthropometric and biochemical measures were recorded pre- and post-intervention. Peroxisome proliferator-activated receptor-γ (PPAR-γ) expression was measured in peripheral blood mononuclear cells (PBMCs). Independent sample t test and paired t test were used to analyze between- and within-group variables, respectively. The analysis of covariance (ANCOVA) was used to adjust the effect of baseline variables on the outcomes. P<0.05 was considered statistically significant.

RESULTS

After baseline adjustment, there was a significant improvement in homeostatic model assessment for insulin resistance (HOMA-IR) (P=0.04) and serum insulin (P<0.001) in the atorvastatin with vitamin E group compared to the atorvastatin with the placebo group. In addition, co-administration of vitamin E with atorvastatin significantly upregulated PPAR-γ expression (OR=5.4, P=0.04) in the PBMCs of T2DM patients.

CONCLUSION

Co-administration of vitamin E and atorvastatin reduced insulin resistance and improved PPAR-γ mRNA expression. Further studies are required to substantiate our findings.

TRIAL REGISTRATION NUMBER

IRCT 20170918036256N.

Effect of the combination of Leptadenia hastata (pers) decne and Momordica balsamina linn leaf extracts on lipid profile of streptozotocin-induced diabetic rats

Background

Changes in blood lipid level (dyslipidemia) play a central role in the onset and pathogenesis of macrovascular complications of diabetes mellitus. Traditional herbal healers commonly use anti-diabetic polyherbal formulations to provide a multi-therapeutic approach for the treatment of diabetes mellitus and its associated complications. The effect of the aqueous leaf extracts of Leptadenia hastata (pers) Decne, Momordica balsamina Linn and their combination on lipid profile of streptozotocin (STZ)-induced diabetic rats was therefore evaluated in the present study.

Results

We evaluated the serum lipid profile and blood glucose level of STZ-induced diabetic rats (60 mg/kg body weight) treated with the aqueous leaf extracts of L. hastata (400 mg/kg) and M. balsamina (200 mg/kg) alone and in combination (400 + 200 mg/kg) after a period of 4 weeks. A significantly decreased (p < 0.05) level of total cholesterol (TC), triglyceride (TG), very low-density lipoprotein (VLDL) and low-density lipoprotein (LDL) cholesterol levels and increased (p < 0.05) level of high-density lipoprotein (HDL) cholesterol was observed in all the treated groups when compared to the untreated diabetic rats. Furthermore, the combination treatment was potentially a more effective blood lipid-lowering (p < 0.05) agent when compared to the single treatments.

Conclusion

Results from this study demonstrated the blood lipid-lowering potential of the aqueous leaf extracts of L. hastata, M. balsamina, and their combination. However, the polyherbal combination could be more potent in controlling diabetes mellitus, associated dyslipidemia, and its complications.

A review on the phytochemistry and pharmacology of the herb Scoparia dulcis L. for the potential treatment of metabolic syndrome

This review discusses the chemical constituents and pharmacological effects of Scoparia dulcis L. (S. dulcis) plants. So far, approximately 160 compounds have been identified from S. dulcis, among which 115 compounds may be related to the treatment of metabolic syndrome. Extracts of S. dulcis have effects of reducing fasting blood glucose level, increasing the plasma insulin level, and stimulating insulin secretion to treat diabetes. They also produce antihyperlipidemic effects by increasing serum high-density lipoprotein levels, the anti-atherogenic index of plasma, and HMG-CoA reductase activity. The chemical composition of glutinol and glutinone, isolated from S. dulcis, provide potential anti-inflammatory effects. These compounds can also reduce total cholesterol, triacylglycerol, and low-density lipoprotein (LDL)-cholesterol and increase high-density lipoprotein (HDL)-cholesterol to provide the anti-atherosclerotic effect. S. dulcis exerts anti-arthritic properties through its effect on cytokine levels, significantly reducing IFN-γ and IL-6 levels and elevating IL-10 levels. The extracts carry out hepatoprotective effect by preventing the descent of the antioxidative enzymes of superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GRd), and glutathione-S-transferase (GST). Therefore, S. dulcis provides new potential for medicine given its numerous therapeutic properties and can be promoted as a complementary or alternative therapy for patients with chronic conditions.

Hypolipidemic effects of Hypericum Scabrum extract on the serum lipid profile and obesity in high-fat diet fed rats

Diets included high-fat (HFD) and high calories intake is correlated with greater risk of obesity and oxidative stress, which lead to increase the risk of related diseases such as cardiovascular and metabolic disease. In the present study, we have examined the hypolipidemic activity of Hypericum Scabrum extract on HFD fed rats. Fifty-four male Wistar rats divided into six groups: 1) control, 2) H. Scabrum extract (100 mg/kg gavage per day), 3) H. Scabrum extract (300 mg/kg), 4) HFD, 5) HFD and H. Scabrum extract (100 mg/kg), 6) HFD and H. Scabrum extract (300 mg/kg). The groups were fed their diet and treatment for 3 months. Biochemical analysis showed elevated lipid serum profile in HFD rats compared to control group. H. Scabrum extract supplementation significantly ameliorated triglyceride, total cholesterol and LDL-cholesterol. H. Scabrum extract supplementation leading to increase HDL-cholesterol in HFD treated groups. This experiment showed that H. Scabrum extract decreased HFD complications and might be beneficial herbal drug for treatment of hyperlipidemia and obesity.

Efficacy of curcumin/turmeric on liver enzymes in patients with non-alcoholic fatty liver disease: A systematic review of randomized controlled trials

Background

Several studies reported that curcumin supplementation could improve non-alcoholic fatty liver disease (NAFLD). The aim of this study was to evaluate the efficacy of curcumin/turmeric supplementation on liver enzymes in patients with NAFLD.

Methods

PubMed, Scopus, Web of Science and Google Scholar were systematically searched until December 2017. We included randomized controlled trials (RCTs) which examined effect of curcumin/turmeric supplementation on NAFLD in adult participants. Main outcome was alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Potential risks of bias (ROB) were assessed by using Cochrane ROB tool.

Results

All included studies showed low ROB in most of item of Cochrane ROB tool. Meta-analysis of 4 randomized controlled trials including 228 subjects showed a trend toward significant reduction of ALT blood concentrations in subgroup with ≥1000 mg/day curcumin supplementation (–11.36 IU/L, 95% CI: –22.75 to 0.02; I²:51%). Meta-analysis showed a significant reduction of AST in studies with 8-weeks administration (–9.22 IU/L, 95% CI: –12.77 to –5.67; I²: 49%).

Conclusion

This review suggests that curcumin/turmeric might have a favorable effect on NAFLD in higher dosage. Further high-quality studies with large-scale and higher dosage are warranted.

MDG-1, a Potential Regulator of PPARα and PPARγ, Ameliorates Dyslipidemia in Mice

Hyperlipidemia is a serious epidemic disease caused by lipid metabolism disorder, which is harmful to human health. MDG-1, a β-d-fructan polysaccharide extracted from Ophiopogon japonicus, has been shown to improve abnormal blood lipid levels and alleviate diabetes. However, the underlying mechanism on hyperlipidemia is largely unknown. In this study, male C57BL/6 mice were randomly separated into three groups, respectively: low-fat diet (Con), high-fat diet (HFD), and high-fat diet plus 5‰ MDG-1 (HFD + MDG-1). Body weight was measured and the serum lipid levels were analyzed. Using gene microarray, various core pathways, together with levels of gene expression within hepatocytes, were analyzed. RT-PCR was used to confirm the identity of the differentially expressed genes. MDG-1 could prevent obesity in HFD-induced mice and improve abnormal serum lipids. Besides, MDG-1 could regulate hyperlipidemia symptoms, specifically, and decrease fasting blood glucose, improve glucose tolerance, and ameliorate insulin resistance. According to results from gene microarray, most of the identified pathways were involved in the digestion and absorption of fat, biosynthesis, and catabolism of fatty acids as well as the secretion and biological synthesis of bile acids. Furthermore, MDG-1 may act upon peroxisome proliferator-activated receptors (PPAR) α and γ, activating PPARα whilst inhibiting PPARγ, thus having a potent hypolipidemic effect.

Prevalence and Risk Factors of Comorbidities among Hypertensive Patients in China

Hypertension is a severe threat to human being's health due to its association with many comorbidities. Many research works have explored hypertension's prevalence and treatment. However, few considered impact of patient's socioeconomic status and geographical disparities. We intended to fulfill that research gap by analyzing the association of the prevalence of hypertension and three important comorbidities with various socioeconomic and geographical factors. We also investigated the prevalence of those comorbidities if the patient has been diagnosed with hypertension. We obtained a large collection of medical records from 29 hospitals across China. We utilized Bayes' Theorem, Pearson's chi-squared test, univariate and multivariate regression methods and geographical detector methods to analyze the association between disease prevalence and risk factors. We first attempted to quantified and analyzed the spatial stratified heterogeneity of the prevalence of hypertension comorbidities by q-statistic using geographical detector methods. We found that the demographic and socioeconomic factors, and hospital class and geographical factors would have an enhanced interactive influence on the prevalence of hypertension comorbidities. Our findings can be leveraged by public health policy makers to allocate medical resources more effectively. Healthcare practitioners can also be benefited by our analysis to offer customized disease prevention for populations with different socioeconomic status.

Inhibitory effect of herbal medicines and their trapping abilities against methylglyoxal-derived advanced glycation end-products

Background

Methylglyoxal (MG) is one of the most reactive glycating agents, which result the formation of advanced glycation end-products (AGEs) that have been implicated in the progression of age-related diseases. Inhibition of MG-induced AGE formation is the imperative approach for alleviating diabetic complications. The objective of this study was to investigate the MG-trapping abilities of herbal medicines and their inhibitory activities on the formation of MG-derived AGEs.

Methods

The aqueous extract of herbal medicines was measured for the content of total phenolic compounds and the antioxidant activity by Folin-Ciocalteu assay and the 1,1-diphenyl 2-picrylhydrazyl (DPPH) radical scavenging activity, respectively. The extracts were investigated the MG-trapping ability by high performance liquid chromatography (HPLC). The extracts were incubated with BSA and MG at 37 °C for 1 day. The formation of MG-derived AGEs was measured.

Results

Total phenolic compounds of eleven herbal medicines showed marked variations, ranging from 12.16 to 272.36 mg gallic acid equivalents/g extract. All extracts (1 mg/mL) markedly exhibited the DPPH radical scavenging activity (0.31–73.52 %) and the MG-trapping abilities (13.97–58.97 %). In addition, they also inhibited the formation of MG-derived AGEs by 4.01–79.98 %. The results demonstrated that Rhinacanthus nasutus, Syzygium aromaticum, and Phyllanthus amarus were the potent inhibitors against the formation of MG-derived AGEs. The positive correlations between the contents of phenolics and % MG trapping (r = 0.912, p < 0.01) and % inhibition of MG-derived AGEs (r = 0.716, p < 0.01) were observed in the study. Furthermore, there was a moderate positive correlation between % MG trapping and % inhibition of MG-derived AGEs (r =0.584, p < 0.01).

Conclusions

Rhinacanthus nasutus, Syzygium aromaticum, and Phyllanthus amarus could reduce the formation of MG-derived AGEs through their MG-trapping abilities. These findings are relevant for focusing on potential herbal medicines to prevent or ameliorate AGE-mediated diabetic complications.

The effects of Momordica charantia on obesity and lipid profiles of mice fed a high-fat diet

BACKGROUND/OBJECTIVES

The present study was conducted to investigate the effects of dried Momordica charantia aqueous extracts (MCA) and ethanol extracts (MCE) on obesity and lipid profiles in mice fed a high-fat diet.

MATERIALS/METHODS

Forty two ICR mice were randomly divided into six groups. The normal group was fed a basal diet, and other groups were fed a 45% high-fat diet (HFD) for 7 weeks. The normal and HFD groups were also orally administered distilled water each day for 7 weeks. The remaining groups received Momordica charantia extract (0.5 or 1.0 g/kg/day MCA, and 0.5 or 1.0 g/kg/day MCE). In order to measure the anti-obesity and lipid profile improvement effects, body and visceral tissue weight, lipid profiles, plasma insulin levels, hepatic malondialdehyde (MDA) levels and superoxide dismutase (SOD) activity were measured.

RESULTS

Both MCA and MCE significantly decreased body and visceral tissue weight relative to those of the HFD group (P < 0.05). Additionally high doses of MCE and MCA significantly reduced the plasmatic insulin levels compared to the HFD groups (P < 0.05) to concentrations comparable to those found in the normal group. MCA and MCE supplementation also significantly modulated the lipid profiles in plasma, liver, and feces compared to mice fed the HFD (P < 0.05). Furthermore MCA and MCE significantly increased hepatic SOD activity, and reduced MDA generation in the liver of the HFD mice (P < 0.05).

CONCLUSIONS

Results from the present study suggest that Momordica charantia extracts have anti-obesity effects and the ability to modulate lipid prolife of mice fed a HFD by suppressing body weight gain, visceral tissue weight, plasma and hepatic lipid concentrations, and lipid peroxidation along with increasing lipid metabolism.

Effects of combined dietary supplementation with fenofibrate and Schisandrae Fructus pulp on lipid and glucose levels and liver function in normal and hypercholesterolemic mice

Background

Currently, combined therapy using herbs and synthetic drugs has become a feasible therapeutic intervention against some diseases. The purpose of this study was to assess the effects of supplementation with fenofibrate (FF), a chemical drug used for the treatment of hyperlipidemia, and the aqueous extract of Schisandrae Fructus (SF, a Chinese herb) pulp (AqSF-P) or an SF-related synthetic analog, bicyclol (BY), on serum/hepatic lipid levels and liver status in normal and hypercholesterolemic (HCL) mice.

Methods

Male mice obtained from the Institute of Cancer Research (ICR) were fed on a normal diet (ND) or high cholesterol/bile salt (0.5%/0.15%, w/w) diet (HCBD) containing FF (0.03% or 0.1%, w/w) with or without AqSF-P (0.3%−9.0%, based on crude herbal material, w/w) or BY (0.025%, w/w) for 10 days. Then serum lipid levels and alanine aminotransferase (ALT) activity, as well as hepatic triglyceride (TG), total cholesterol (TC), and glucose levels, were measured.

Results

Oral supplementation with FF significantly reduced serum and hepatic TG, TC, and hepatic glucose levels (approximately 79%) in mice fed with ND or HCBD. FF supplementation combined with AqSF-P or BY increased FF-induced reduction in hepatic TC and TG contents in ND-fed mice (up to 67%) and in HCBD-fed mice (up to 54%), when compared with FF supplementation alone. Hepatic glucose-lowering effect of FF was enhanced (up to 19%) by AqSF-P cosupplementation in both normal and HCL mice. FF supplementation enhanced the excretion of fecal TC (by 75%) in mice fed with HCBD. Fecal TC contents were increased by 14%/9% in the combination therapy with FF and AqSF-P in ND-/HCBD-fed mice. Serum ALT activity was elevated by 45% in HCBD-fed mice. FF caused a significant increase in ALT activity by 198% and 120% in normal and HCL mice, respectively. BY markedly attenuated the ALT activity by 54% in mice fed with ND supplemented with 0.1% FF and by 42% in mice fed with HCBD supplemented with 0.03% FF.

Conclusion

AqSF-P cosupplementation augmented the hepatic lipid-/glucose-lowering effects of FF. BY ameliorated FF-induced liver injury in normal and HCL mice.

The antidiabetic effect of low doses of Moringa oleifera Lam. seeds on streptozotocin induced diabetes and diabetic nephropathy in male rats

The antidiabetic activity of two low doses of Moringa seed powder (50 and 100 mg/kg body weight, in the diet) on streptozotocin (STZ) induced diabetes male rats was investigated. Forty rats were divided into four groups. The diabetic positive control (STZ treated) group showed increased lipid peroxide, increased IL-6, and decreased antioxidant enzyme in the serum and kidney tissue homogenate compared with that of the negative control group. Immunoglobulins (IgA, IgG), fasting blood sugar, and glycosylated hemoglobin (HbA_1c) were also increased as a result of diabetes in G2 rats. Moreover albumin was decreased, and liver enzymes and α-amylase were not affected. In addition, the renal functions and potassium and sodium levels in G2 were increased as a sign of diabetic nephropathy. Urine analysis showed also glucosuria and increased potassium, sodium, creatinine, uric acid, and albumin levels. Kidney and pancreas tissues showed also pathological alteration compared to the negative control group. Treating the diabetic rats with 50 or 100 mg Moringa seeds powder/kg body weight in G3 and G4, respectively, ameliorated the levels of all these parameters approaching the negative control values and restored the normal histology of both kidney and pancreas compared with that of the diabetic positive control group.