The effects of propolis supplementation on metabolic parameters: A systematic review and meta-analysis of randomized controlled clinical trials

Document Type : Review Article


1 Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran


Objective: Propolis is a sticky, resinous substance produced by honeybees from various plants. Various biological properties of propolis and its extracts have been recognized in previous studies including the antiseptic, anti-inflammatory, antioxidant, antiviral, hepatoprotective, antitumor, antibacterial and antimycotic properties. This study aimed to summarize the effect of propolis on metabolic parameters in human adults using systematic review and meta-analysis.
Materials and Methods: A comprehensive systematic search was performed in ISI Web of Science, PubMed, Scopus, and Google Scholar up to July 2020 for controlled clinical trials evaluating the impact of propolis on lipid profile and liver enzyme biomarkers. A random effects model was used to calculate the weighted mean difference (WMD) and 95% confidence interval (CI) as the difference between the mean for the intervention and control groups.
Results: The present meta-analysis included six randomized controlled trials. There was significant reduction in Aspartate Aminotransferase (AST) in comparison to the control groups (WMD=-2.01; 95% CI: -3.93--0.10; p=0.039). However, a non-significant effect was observed in Triglycerides (TG), Total cholesterol (TC), low-density lipoprotein (LDL), High-density lipoprotein (HDL) (WMD=-0.05 mg/dl; 95% CI: -0.27-0.18; p=0.688; WMD=7.08 mg/dl; 95% CI: -37.31-51.46; p=0.755; WMD=-0.94 mg/dl; 95% CI: -6.64-4.77; p=0.747; WMD=3.14 mg/dl; 95% CI: -1.84-8.13; p=0.216, respectively).
Conclusion: Current meta-analysis revealed that propolis supplementation can reduce AST; nevertheless, there was no significant effect on lipid profile indices and ALT.


Afsharpour F, Hashemipour S, Khademhaghighian H, Koushan Y. 2017. Effects of
Iranian propolis on glycemic status,
inflammatory factors, and liver enzyme
levels in type 2 diabetic patients: a
randomized, double-blind, placebocontrolled, clinical trial. J Nutr Sci Diet, 9-
Afsharpour F, Javadi M., Hashemipour S,
Koushan Y. 2019. Propolis supplementation
improves glycemic and antioxidant status in
patients with type 2 diabetes: A randomized,
double-blind, placebo-controlled study.
Complement Ther Med, 43: 283-288.
Attia YA, Al-Hamid AA, Ibrahim MS, AlHarthi M, Bovera F, Elnaggar AS. 2014.
Productive performance, biochemical and
hematological traits of broiler chickens
supplemented with propolis, bee pollen, and
mannan oligosaccharides continuously or
Propolis and metabolic parameters
AJP, Vol. 11, No. 6, Nov-Dec 2021 563
intermittently. Livest Sci, 164: 87-95.
Azab E, Algridi MA, Lashkham NM. 2015.
Hypolipidemic and antiatherogenic effects
of aqueous extract of Libyan propolis in lead
acetate intoxicated male albino mice. IJSR,
4: 1060-1068.
Bankova VS, de Castro SL, Marcucci MC.
2000. Propolis: recent advances in
chemistry and plant origin. Apidologie, 31:
Barakat LA, Mahmoud RH. 2011. The
antiatherogenic, renal protective and
immunomodulatory effects of purslane,
pumpkin and flax seeds on
hypercholesterolemic rats. N Am J Med Sci,
3: 411-417.
Bhadauria M, Nirala SK, Shukla S. 2007.
Duration-dependent hepatoprotective
effects of propolis extract against carbon
tetrachloride-induced acute liver damage in
rats. Adv Ther, 24: 1136-1145.
Bok S-H, Lee S-H, Park Y-B, Bae K-H, Son KH, Jeong T-S, Choi M.-S. 1999. Plasma and
hepatic cholesterol and hepatic activities of
and acyl CoA: cholesterol transferase are
lower in rats fed citrus peel extract or a
mixture of citrus bioflavonoids. J Nutr, 129:
Carr TP, Parks JS, Rudel LL. 1992. Hepatic
ACAT activity in African green monkeys is
highly correlated to plasma LDL cholesteryl
ester enrichment and coronary artery
atherosclerosis. Arterioscler Thromb, 12:
Castaldo S, Capasso F. 2002. Propolis, an old
remedy used in modern medicine.
Fitoterapia, 73: S1-S6.
Daniel M. 2006. Medicinal plants: chemistry
and properties, Science publishers.
El-Mihi KA, Kenawy HI, El-Karef A,
Elsherbiny NM, Eissa LA. 2017. Naringin
attenuates thioacetamide-induced liver
fibrosis in rats through modulation of the
PI3K/Akt pathway. Life sci, 187: 50-57.
Fukuda T, Fukui M, Tanaka M, Senmaru T,
Iwase H, Yamazaki M, Aoi W, Inui T,
Nakamura N, Marunaka Y. 2015. Effect of
Brazilian green propolis in patients with
type 2 diabetes: A double-blind randomized
placebo-controlled study. Biomed Rep, 3:
Fuliang H, Hepburn H, Xuan H, Chen M, Daya
S, Radloff S. 2005. Effects of propolis on
blood glucose, blood lipid and free radicals
in rats with diabetes mellitus. Pharmacol
Res, 51: 147-152.
Gao W, Pu L, Wei J, Yao Z, Wang Y, Shi T,
Zhao L, Jiao C, Guo C. 2018. Serum
antioxidant parameters are significantly
increased in patients with type 2 diabetes
mellitus after consumption of Chinese
propolis: A randomized controlled trial
based on fasting serum glucose level.
Diabetes Ther, 9: 101-111.
Guo F, Moellering DR, Garvey WT. 2014. The
progression of cardiometabolic disease:
validation of a new cardiometabolic disease
staging system applicable to obesity.
Obesity, 22: 110-118.
Hesami S, Hashemipour S, Shiri-Shahsavar
MR, Koushan Y, Haghighian HK. 2019.
Administration of Iranian Propolis
attenuates oxidative stress and blood
glucose in type II diabetic patients: a
randomized, double-blind, placebocontrolled, clinical trial. Caspian J Intern
Med, 10: 48-54.
Higgins JP, Thomas J, Chandler J, Cumpston
M, Li T, Page MJ, Welch VA. 2019.
Cochrane handbook for systematic reviews
of interventions, John Wiley & Sons.
Hulver MW, Berggren JR, Carper MJ,
Miyazaki M, Ntambi JM, Hoffman EP,
Thyfault JP, Stevens R, Dohm GL,
Houmard JA. 2005. Elevated stearoyl-CoA
desaturase-1 expression in skeletal muscle
contributes to abnormal fatty acid
partitioning in obese humans. Cell Metab, 2:
Jalali M, Ranjbar T, Mosallanezhad Z,
Mahmoodi M, Moosavian SP, Ferns G,
Jalali R, Sohrabi Z. 2020. Effect of Propolis
supplementation on serum CRP and TNF-α
levels in adults: A systematic review and
meta-analysis of clinical trials. Complement
Ther Med, 50: 102380.
Jasprica I, Mornar A, Debeljak Ž, SmolčićBubalo A, Medić-Šarić M, Mayer L, Romic
Ž, Bucan K, Balog T, Sobocanec S. 2007. In
vivo study of propolis supplementation
effects on antioxidative status and red blood
cells. J Ethnopharmacol, 110: 548-554.
Jin XL, Wang K, Li QQ, Tian WL, Xue XF, Wu
LM, Hu FL. 2017. Antioxidant and antiinflammatory effects of Chinese propolis
during palmitic acid-induced lipotoxicity in
cultured hepatocytes. J Funct Foods, 34:
Karimian J, Hadi A, Pourmasoumi M,
Gheflati et al.
AJP, Vol. 11, No. 6, Nov-Dec 2021 564
Najafgholizadeh A, Ghavami A. 2019. The
efficacy of propolis on markers of glycemic
control in adults with type 2 diabetes
mellitus: A systematic review and metaanalysis. Phytother Res, 33: 1616-1626.
Kismet K, Sabuncuoglu M, Kilicoglu S,
Kilicoglu B, Devrim E, Erel S, Sunay A,
Erdemli E, Durak I, Akkus M. 2008. Effect
of propolis on oxidative stress and
histomorphology of liver tissue in
experimental obstructive jaundice. Eur Surg
Res, 41: 231-237.
Kitamura H, Naoe Y, Kimura S, Miyamoto T,
Okamoto S, Toda C, Shimamoto Y,
Iwanaga, T, Miyoshi I. 2013. Beneficial
effects of Brazilian propolis on type 2
diabetes in ob/ob mice: Possible
involvement of immune cells in mesenteric
adipose tissue. Adipocyte, 2: 227-236.
Kocot J, Kiełczykowska M, Luchowska-Kocot
D, Kurzepa J, Musik I. 2018. Antioxidant
potential of propolis, bee pollen, and royal
jelly: Possible medical application. Oxid
Med Cell Longev, 2018: 7074209.
Kurowska EM, Manthey JA. 2004.
Hypolipidemic effects and absorption of
citrus polymethoxylated flavones in
hamsters with diet-induced
hypercholesterolemia. J Agric Food Chem,
52: 2879-2886.
Lisičić D, Benković V, Đikić D, Blažević AS,
Mihaljević J, Oršolić N, Knežević A H.
2014. Addition of propolis to irinotecan
therapy prolongs survival in ehrlich ascites
tumor-bearing mice. Cancer Biother
Radiopharm, 29: 62-69.
Listenberger LL, Han X, Lewis SE, Cases S,
Farese RV, Ory DS, Schaffer JE. 2003.
Triglyceride accumulation protects against
fatty acid-induced lipotoxicity. Proc Natl
Acad Sci, 100: 3077-3082.
Mani F, Damasceno H, Novelli E, Martins E,
Sforcin J. 2006. Propolis: Effect of different
concentrations, extracts and intake period on
seric biochemical variables. J
Ethnopharmacol, 105: 95-98.
Moher D, Shamseer L, Clarke M, Ghersi D,
Liberati A, Petticrew M, Shekelle P, Stewart
LA. 2015. Preferred reporting items for
systematic review and meta-analysis
protocols (PRISMA-P) 2015 statement. Syst
Rev, 4: 1.
Mujica V, Orrego R, Pérez J, Romero P, Ovalle
P, Zúñiga-Hernández J, Arredondo M,
Leiva E. 2017. The role of propolis in
oxidative stress and lipid metabolism: a
randomized controlled trial. Evid Based
Complement Alternat Med, 2017: 4272940.
Nabavi S, Rafraf M, Somi M-h, HomayouniRad A, Asghari-Jafarabadi M. 2015.
Probiotic yogurt improves body mass index
and fasting insulin levels without affecting
serum leptin and adiponectin levels in nonalcoholic fatty liver disease (NAFLD). J
Funct Foods, 18: 684-691.
Nader MA, El-Agamy DS, Suddek GM. 2010.
Protective effects of propolis and
thymoquinone on development of
atherosclerosis in cholesterol-fed rabbits.
Arch Pharm Res, 33: 637-643.
Nakamura A, Osonoi T, Terauchi Y. 2010.
Relationship between urinary sodium
excretion and pioglitazone‐induced edema.
J Diabetes Investig, 1: 208-211.
Omar N, Allithy A, Baghdadi H, Zolaly M,
Abdel-haleem M, Helmy M, Ayat M, Elsayed S. 2016. Hepatoprotective effects
exerted by propolis against doxorubicininduced rat liver toxicity: a biochemical and
histopathological study. Am J Cancer
Prevention, 4: 36-40.
Pasupuleti VR, Sammugam L, Ramesh N, Gan
SH. 2017. Honey, propolis, and royal jelly:
a comprehensive review of their biological
actions and health benefits. Oxid Med Cell
Longev, 2017: 1259510.
Paulino N, Barbosa AP, Paulino AS, Marcucci
MC. 2014. Hepatoprotective effect of green
propolis is related with antioxidant action in
vivo and in vitro. Oxid Antioxid Med Sci, 3:
Rocha M, Apostolova N, Herance JR, Rovira‐
Llopis S, Hernandez‐ Mijares A, Victor
VM. 2014. Perspectives and potential
applications of mitochondria‐targeted
antioxidants in cardiometabolic diseases and
type 2 diabetes. Med Res Rev, 34: 160-189.
Samadi N, Mozaffari-Khosravi H, Rahmanian
M, Askarishahi M. 2017. Effects of bee
propolis supplementation on glycemic
control, lipid profile and insulin resistance
indices in patients with type 2 diabetes: a
randomized, double-blind clinical trial. J
Integr Med, 15: 124-134.
Silveira MAD, Teles F, Berretta AA, Sanches
TR, Rodrigues CE, Seguro AC, Andrade L.
2019. Effects of Brazilian green propolis on
proteinuria and renal function in patients
with chronic kidney disease: a randomized,
double-blind, placebo-controlled trial. BMC
Propolis and metabolic parameters
AJP, Vol. 11, No. 6, Nov-Dec 2021 565
Nephrol, 20: 140.
Soory M. 2012. Nutritional antioxidants and
their applications in cardiometabolic
diseases. Infect Disord Drug Targets
(Formerly Curr Drug Targets Infect Disord),
12: 388-401.
Tolba MF, Azab SS, Khalifa AE, Abdel‐
Rahman SZ, Abdel‐ Naim AB. 2013.
Caffeic acid phenethyl ester, a promising
component of propolis with a plethora of
biological activities: A review on its anti‐
inflammatory, neuroprotective,
hepatoprotective, and cardioprotective
effects. IUBMB life, 65: 699-709.
Toreti VC, Sato HH, Pastore GM, Park YK.
2013. Recent progress of propolis for its
biological and chemical compositions and
its botanical origin. Evid Based
Complement Alternat Med, 2013: 697390.
Viuda‐ Martos M, Ruiz‐ Navajas Y,
Fernández‐ López J, Pérez‐ Álvarez J.
2008. Functional properties of honey,
propolis, and royal jelly. J Food Sci, 73:
Wali AF, Avula B, Ali Z, Khan IA, Mushtaq A,
Rehman MU, Akbar S, Masoodi M H. 2015.
Antioxidant, hepatoprotective potential and
chemical profiling of propolis ethanolic
extract from Kashmir Himalaya region
Biomed Res Int, 2015: 393462.
Won Seo K, Park M, Jung Song Y, Kim SJ, Ro
Yoon K. 2003. The protective effects of
propolis on hepatic injury and its
mechanism. Phytother Res, 17: 250-253.
Xiao F, Waldrop SL, Bronk SF, Gores GJ,
Davis LS, Kilic G. 2015. Lipoapoptosis
induced by saturated free fatty acids
stimulates monocyte migration: a novel
role for Pannexin1 in liver cells. Purinergic
signal, 11: 347-359.
Xuan H, Li Z, Wang J, Wang K, Fu C, Yuan J,
Hu F. 2014. Propolis reduces
phospholipase C activity and increases
annexin a7 level in oxidized-LDLstimulated human umbilical vein
endothelial cells. Evid Based Complement
Alternat Med, 2014: 465383.
Ye M, Xu M, Ji C, Ji J, Ji F, Wei W, Yang S,
Zhou B. 2019. Alterations in the
Transcriptional Profile of the Liver Tissue
and the Therapeutic Effects of Propolis
Extracts in Alcohol-induced Steatosis in
Rats. An Acad Bras Cienc, 91.
Yu Y, Si Y, Song G, Luo T, Wang J, Qin S.
2011. Ethanolic extract of propolis
promotes reverse cholesterol transport and
the expression of ATP‐binding cassette
transporter A1 and G1 in mice. Lipids, 46:
Zakerkish M, Jenabi M, Zaeemzadeh N,
Hemmati AA, Neisi N. 2019. The effect of
Iranian propolis on glucose metabolism,
lipid profile, insulin resistance, renal
function and inflammatory biomarkers in
patients with type 2 diabetes mellitus: A
randomized double-blind clinical trial. Sci
Rep, 9: 1-11.