scholarly journals Effect of Steviol Glycosides on Human Health with Emphasis on Type 2 Diabetic Biomarkers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 1965 ◽  
Author(s):  
Bundgaard Anker ◽  
Rafiq ◽  
Jeppesen

The natural sweetener from Stevia rebaudiana Bertoni, steviol glycoside (SG), has been proposed to exhibit a range of antidiabetic properties. The objective of this systematic review was to critically evaluate evidence for the effectiveness of SGs on human health, particularly type 2 diabetic (T2D) biomarkers, collecting data from randomized controlled trials (RCTs). Electronic searches were performed in PubMed and EMBASE and the bibliography of retrieved full-texts was hand searched. Using the Cochrane criteria, the reporting quality of included studies was assessed. Seven studies, nine RCTs, including a total of 462 participants were included. A meta-analysis was performed to assess the effect of SGs on following outcomes: BMI, blood pressure (BP), fasting blood glucose (FBG), lipids, and glycated hemoglobin (HbA1c). The meta-analysis revealed an overall significant reduction in systolic BP in favour of SGs between SG and placebo, mean difference (MD): −6.32 mm Hg (−7.69 to 0.46). The overall effect of BMI, diastolic BP, FBG, total cholesterol, and high-density lipoprotein cholesterol (HDL-C) was a non-significant reduction in favour of SGs, and a non-significant increase in low-density lipoprotein cholesterol and triglyceride, while no significant effect of HbA1c was found. Heterogeneity was significant for several analyses. More studies investigating the effect of SGs on human health, particularly T2D biomarkers, are warranted.

2018 ◽  
Vol 21 ◽  
pp. 222-235 ◽  
Author(s):  
Boyu Li ◽  
Ying Wang ◽  
Zhikang Ye ◽  
Hui Yang ◽  
Xiangli Cui ◽  
...  

PURPOSE: Non-alcoholic fatty liver disease (NAFLD) affects about 75% of patients with type 2 diabetes mellitus (T2DM). We conducted a meta-analysis to determine the effect of canagliflozin on fatty liver indexes in T2DM patients. METHODS: A literature search of PubMed, Embase and Cochrane was conducted up to March 30, 2017. The liver function test and lipid profile were extracted from randomized controlled trials (RCTs) to evaluate the effect of canagliflozin on fatty liver. Weighted mean differences (WMDs) or relative risks and 95% confidence intervals (CIs) were computed by using either fixed or random-effects models. Sensitivity analysis and publication bias were evaluated. RESULTS: Our results showed that canagliflozin decreased serum concentrations of  alanine amino transferase (WMD: -11.68 [95% CI: -18.95, -10.95]; P<0.001), aspartate amino transferase (WMD: -7.50 [95% CI: -10.61, -4.38]; P<0.001), gamma-glutamyl transferase (WMD: -15.17 [95% CI: -17.73, -12.61]; P<0.001), triglycerides (WMD: -0.10 [95% CI: -0.15, -0.05]; P<0.001) but increased low-density lipoprotein cholesterol (WMD: 0.1 [95% CI: 0.06, 0.13]; P<0.001), high-density lipoprotein cholesterol (WMD: 0.06 [95% CI: 0.05, 0.07]; P<0.001) at week 26 or 52. CONCLUSIONS: Our results indicated that canagliflozin may have a protective effect on fatty liver in T2DM patients. The limitation was that the liver biopsy was hard to obtain in published studies. More RCTs specified on NAFLD are needed to get further information. This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.


PLoS ONE ◽  
2016 ◽  
Vol 11 (3) ◽  
pp. e0150999 ◽  
Author(s):  
Patricia Melo Aguiar ◽  
Giselle de Carvalho Brito ◽  
Tácio de Mendonça Lima ◽  
Ana Patrícia Alves Lima Santos ◽  
Divaldo Pereira Lyra ◽  
...  

2021 ◽  
Vol 2021 ◽  
pp. 1-22
Author(s):  
Jing Guo ◽  
Hongdong Chen ◽  
Xueqin Zhang ◽  
Wenjiao Lou ◽  
Pingna Zhang ◽  
...  

Objective. Rhizoma Coptidis is an herb that has been frequently used in many traditional formulas for the treatment of diabetic mellitus (DM) over thousands of years. Berberine, the main active component of Rhizoma Coptidis, has been demonstrated to have the potential effect of hypoglycemia. To determine the potential advantages of berberine for diabetic care, we conducted this systematic review and meta-analysis to examine the efficacy and safety of berberine in the treatment of patients with type 2 DM. Methods. Eight databases including PubMed, Embase, Web of Science, the Cochrane library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Database (SinoMed), Wanfang Database, and Chinese VIP Information was searched for randomized controlled trials (RCTs) reporting clinical data regarding the use of berberine for the treatment of DM. Publication qualities were also considered to augment the credibility of the evidence. Glycemic metabolisms were the main factors studied, including glycosylated hemoglobin (HbA1c), fasting plasm glucose (FPG), and 2-hour postprandial blood glucose (2hPG). Insulin resistance was estimated by fasting blood insulin (FINS), homeostasis model assessment-insulin resistance (HOMA-IR), and body mass index (BMI). Lipid profiles were also assessed, including triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), and high-density lipoprotein (HDL), along with inflammation factors such as C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). Serum creatinine (Scr), blood urea nitrogen (BUN), and adverse events were applied to evaluate the safety of berberine. Results. Forty-six trials were assessed. Analysis of berberine applied alone or with standard diabetic therapies versus the control group revealed significant reductions in HbA1c ( MD = − 0.73 ; 95% CI (−0.97, −0.51)), FPG ( MD = − 0.86 , 95% CI (−1.10, −0.62)), and 2hPG ( MD = − 1.26 , 95% CI (−1.64, −0.89)). Improved insulin resistance was assessed by lowering FINS ( MD = − 2.05 , 95% CI (−2.62, −1.48)), HOMA-IR ( MD = − 0.71 , 95% CI (−1.03, −0.39)), and BMI ( MD = − 1.07 , 95% CI (−1.76, −0.37)). Lipid metabolisms were also ameliorated via the reduction of TG ( MD = − 0.5 , 95% CI (−0.61, −0.39)), TC ( MD = 0.64 , 95% CI (−0.78, −0.49)), and LDL ( MD = 0.86 , 95% CI (−1.06, −0.65)) and the upregulation of HDL ( MD = 0.17 , 95% CI (0.09, 0.25)). Additionally, berberine improved the inflammation factor. Conclusion. There is strong evidence supporting the clinical efficacy and safety of berberine in the treatment of DM, especially as an adjunctive therapy. In the future, this may be used to guide targeted clinical use of berberine and the development of medications seeking to treat patients with T2DM and dyslipidemia.


Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1995
Author(s):  
Man-Yun Li ◽  
Jin-Hua Chen ◽  
Chiehfeng Chen ◽  
Yi-No Kang

The association of egg consumption and serum cholesterol concentrations in healthy people has been discussed for a long time. In this study, we aimed to explore association of egg consumption with on low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) concentrations and the LDL-c/HDL-c ratio through meta-analysis. This systematic review only included randomized controlled trials (RCTs) investigating egg consumption in healthy populations without combination therapy. We extracted mean and standard deviation for LDL-c/HDL-c ratio, LDL-c/HDL-c. The extracted data were pooled in a random-effects model and were presented as mean difference (MD) with 95% confidence interval (CI). Moreover, subgroup analyses were conducted for understanding effects of more egg consumption (MEC) on different intervention periods, egg-consumption levels, classification of responders. Overall, 17 RCTs met the eligibility criteria and pooled results showed MEC group had a higher LDL-c/HDL-c ratio than the control group (MD = 0.14, p = 0.001, I2 = 25%). The MEC group also had higher LDL-c than the control group (MD = 8.14, p < 0.0001, I2 = 18%). Moreover, for the subset of intervention over two months, the MEC group seemed to have a larger effect size than the subset of intervention within two months. This synthesis, the largest meta-analysis on this topic, shows the impact of egg consumption on lipid profiles among healthy subjects. Notably, longer time with MEC may lead to higher LDL-c/HDL-c ratio and LDL-c. However, RCTs with long tern follow-up are needed to guarantee the association between egg consumption and human health.


2018 ◽  
Vol 8 (4) ◽  
pp. 565-574 ◽  
Author(s):  
Sepideh Mahboobi ◽  
Fatemeh Rahimi ◽  
Sadegh Jafarnejad

Purpose: Diabetes Mellitus (T2DM) as a chronic disease, is on rise in parallel with other non-communicable diseases. Several studies have shown that probiotics and prebiotics might exert beneficial effects in chronic diseases including diabetes. Because of controversial results from different trials, the present study aims to assess the effects of prebiotic/synbiotic consumption on metabolic parameters in patients with type2 diabetes. Methods: A systematic literature search was performed on randomized controlled trial published in PubMed/Medline, SciVerse Scopus, Google scholar, SID and Magiran up to March 2018. Of a total number of 255 studies found in initial literature search, ten randomized controlled trials were included in the meta-analysis. The pooled mean net change were calculated in fasting blood-glucose [FBG], Hemoglobin A1c [HbA1c] and lipid markers (total cholesterol [TC], triglyceride [TG], low-density lipoprotein cholesterol [LDL-C], high density lipoprotein cholesterol [HDL-C]). The meta-analyses was conducted using Revman Software (v5.3). Results: The pooled estimate indicated a significant difference for the mean change in FBG, HbA1c and HDL in treatment group in comparison with control group. Subgroup analysis by intervention showed a significant difference in TG, LDL and HDL (synbiotic group) and in TG, TC, FBG, HDL and HbA1c (prebiotic group) compared with placebo. In another subgroup analysis, high quality studies showed significant reductions in TG, TC, FBG and HbA1c in intervention group compared with placebo group. Conclusion: In summary, diets supplemented with either prebiotics or synbiotics can result in improvements in lipid metabolism and glucose homeostasis in type 2 diabetic patients.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Zahra Mosallanezhad ◽  
Cain Clark ◽  
Fatemeh Bahreini ◽  
Zahra Motamed ◽  
Abdolhamid Mosallanezhad ◽  
...  

Purpose The purpose of this systematic review and meta-analysis was to investigate the efficacy of propolis on glycemic indices in type 2 diabetic patients. Design/methodology/approach Web of science (ISI), Embase, Scopus and PubMed were systematically searched to find randomized controlled trials (RCTs) assessing the effects of propolis intake on glycemic controls in type 2 diabetic patients, from inception up to September 1, 2020. A random-effects model was used to pool weighted mean difference (WMD). Meta-regression was performed to detect the potential sources of inter-study heterogeneity. Findings Seven trials were included in the meta-analysis. Compared to controls, propolis intake significantly improved serum fasting blood sugar (FBS) (WMD = −13.62 mg/dl, 95% CI = [−23.04, −4.20], P = 0.005, I2 = 58.5%) and hemoglobin A1C (HbA1c) (WMD = −0.52%, 95% CI = [−0.86, −0.18], P = 0.002, I2 = 64.0%). In contrast, receiving propolis did not change serum insulin (WMD = −1.46 (uIU/ml), 95% CI = [−2.94, 0.02], P = 0.05, I2 = 75.0%) and homeostatic model assessment for insulin resistance (HOMA-IR) (WMD = −0.98 (%), 95% CI = [−2.00, 0.04], P = 0.06, I2 = 82.3%) compared to controls. Originality/value The present meta-analysis demonstrated that propolis intake significantly reduces serum FBS and HbA1c in diabetic patients but does not alter serum insulin and HOMA-IR. Further large-scale RCT’s are needed to approve these effects.


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