1
|
Ebrahimzadeh A, Mohseni S, Safargar M, Mohtashamian A, Niknam S, Bakhoda M, Afshari S, Jafari A, Ebrahimzadeh A, Fooladshekan S, Mohtashami A, Ferns GA, Babajafari S, Sohrabi Z. Curcumin effects on glycaemic indices, lipid profile, blood pressure, inflammatory markers and anthropometric measurements of non-alcoholic fatty liver disease patients: A systematic review and meta-analysis of randomized clinical trials. Complement Ther Med 2024; 80:103025. [PMID: 38232906 DOI: 10.1016/j.ctim.2024.103025] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 01/07/2024] [Accepted: 01/11/2024] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVES Curcumin has antioxidant properties and has been proposed as a potential treatment for NAFLD. The aim of current systematic review and meta-analysis was to evaluate previous findings for the effect of curcumin supplementation on glycaemic indices, lipid profile, blood pressure, inflammatory markers, and anthropometric measurements of NAFLD patients. METHODS Relevant studies published up to January 2024 were searched systematically using the following databases: PubMed, SCOPUS, WOS, Science Direct, Ovid and Cochrane. The systematic review and meta-analysis were conducted according to the 2020 PRISMA guidelines. The quality of the papers was assessed the using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Pooled effect sizes were calculated using a random-effects model and reported as the WMD and 95% CI. Also, subgroup analyses were done to find probable sources of heterogeneity among studies. RESULTS Out of 21010 records initially identified, 21 eligible RCTs were selected for inclusion in a meta-analysis. Overall, 1191 participants of both genders, 600 in the intervention and 591 in the control group with NAFLD were included. There are several limitations in the studies that were included, for instance, the results are weakened substantially by potential bias or failure to account for potential adulteration (with pharmaceuticals) or contamination (with other herbs) of the curcumin supplements that were tested. However, previous studies have reported curcumin to be a safe complementary therapy for several conditions. Our study indicated that curcumin supplementation in doses of 50-3000 mg/day was associated with significant change in FBG [WMD: -2.83; 95% CI: -4.61, -1.06), I2 = 51.3%], HOMA-IR [WMD: -0.52; 95% CI: -0.84, -0.20), I2= 82.8%], TG [WMD: -10.31; 95% CI: -20.00, -0.61), I2 = 84.5%], TC [WMD: -11.81; 95% CI: -19.65, -3.96), I2 = 94.6%], LDL [WMD: -8.01; 95% CI: -15.79, -0.24), I2 = 96.1%], weight [WMD: -0.81; 95% CI: -1.28, -0.35), I2= 0.0%] and BMI [WMD: -0.35; 95% CI: -0.57, -0.13), I2= 0.0%] in adults with NAFLD. There was no significant change in HbA1C, plasma insulin, QUICKI, HDL, SBP, DBP, CRP, TNF-α and WC after curcumin therapy. Subgroup analysis suggested a significant changes in serum FBG, TG, SBP, WC in RCTs for intervention durations of ≥ 8 weeks, and SBP, TG, LDL, HDL, BMI, WC in RCTs with sample size > 55 participants. CONCLUSION Curcumin supplementation in doses of 50-3000 mg/day over 8-12 weeks was associated with significant reductions in levels of FBG, HOMA-IR, TG, TC, LDL, weight and BMI in patients with NAFLD. Previous studies have reported curcumin as a safe complementary therapy for several diseases. We would suggest that should curcumin supplements be used clinically in specific conditions, it should be used with caution. Also, difference in grades of NAFLD may effect the evaluated outcomes, so it is suggested that future studies be conducted with an analyses on subgroups according to their NAFLD grade. Furthermore, because of the failure to conduct independent biochemical assessment of the turmeric/curcumin product used in most studies as well as potential sources of bias, results should be interpreted with caution.
Collapse
Affiliation(s)
- Armin Ebrahimzadeh
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shokouh Mohseni
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Safargar
- Department of Nutrition, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Abbas Mohtashamian
- Student Research Committee, Department of Nutrition, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Sara Niknam
- Clinical Biochemistry Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mohammadreza Bakhoda
- Department of Clinical Biochemistry, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Sanaz Afshari
- Department of Computer Engineering, Arak Branch, Islamic Azad University, Arak, Iran
| | - Amirhossein Jafari
- Department of Medical Laboratory Sciences, Faculty of Paramedical, Kashan University of Medical Sciences, Kashan, Iran
| | - Anahita Ebrahimzadeh
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Fooladshekan
- Dental Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Alireza Mohtashami
- Department of Pediatric Dentistry, School of Dentistry, Mashhad University of Medical Sciences, Park Square, Mashhad, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, United Kingdom
| | - Siavash Babajafari
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Zahra Sohrabi
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
2
|
Juneja D, Deepak D, Nasa P. What, why and how to monitor blood glucose in critically ill patients. World J Diabetes 2023; 14:528-538. [PMID: 37273246 PMCID: PMC10236998 DOI: 10.4239/wjd.v14.i5.528] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/17/2023] [Accepted: 03/07/2023] [Indexed: 05/15/2023] Open
Abstract
Critically ill patients are prone to high glycemic variations irrespective of their diabetes status. This mandates frequent blood glucose (BG) monitoring and regulation of insulin therapy. Even though the most commonly employed capillary BG monitoring is convenient and rapid, it is inaccurate and prone to high bias, overestimating BG levels in critically ill patients. The targets for BG levels have also varied in the past few years ranging from tight glucose control to a more liberal approach. Each of these has its own fallacies, while tight control increases risk of hypoglycemia, liberal BG targets make the patients prone to hyperglycemia. Moreover, the recent evidence suggests that BG indices, such as glycemic variability and time in target range, may also affect patient outcomes. In this review, we highlight the nuances associated with BG monitoring, including the various indices required to be monitored, BG targets and recent advances in BG monitoring in critically ill patients.
Collapse
Affiliation(s)
- Deven Juneja
- Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, New Delhi 110017, India
| | - Desh Deepak
- Department of Critical Care, King's College Hospital, Dubai 340901, United Arab Emirates
| | - Prashant Nasa
- Department of Critical Care, NMC Speciality Hospital, Dubai 7832, United Arab Emirates
- Department of Critical Care, College of Medicine and Health Sciences, Al Ain 15551, United Arab Emirates
| |
Collapse
|