The antihyperglycemic and hypolipidemic effects of Ribes khorassanicum hydro-ethanolic extract co-administration in type 2 diabetic patients: A randomized double blind placebo controlled trial

Document Type : Original Research Article

Authors

1 Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Division of Neurocognitive Sciences, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran

4 Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

5 Department of Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Objective: The present randomized clinical trial assessed the antihyperglycemic and hypolipidemic effects of hydro-ethanolic extract of Ribes khorassanicum.
Materials and Methods: Eighty type 2 diabetic patients were randomly allocated to placebo or intervention groups and respectively received placebo or extract capsules (700 mg, bid) beside their conventional medication for 3 months. Patients' blood pressure and blood levels of fasting blood glucose (FBS), glycosylated hemoglobin (HbA1c), 2 hr postprandial glucose (2hPPG), triglyceride, total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured at the beginning of the study and after 3 months of treatment. For determination of plant safety, liver enzymes (SGOT and SGPT) and kidney function (in terms of urea, creatinine, and microalbumin levels) were assessed and patients were asked to report adverse effects.
Results: The R. khorasanicum hydro-ethanolic extract supplementation significantly decreased the levels of FBS, total cholesterol, triglyceride, and LDL-C in the extract group compared to the placebo group (p<0.05-p<0.01). However, 2hPPG, HbA1c, HDL-C, SGOT, SGPT, urea, creatinine, and urine microalbumin values were not significantly different between the placebo and the extract groups. No adverse effects were reported by the patients.
Conclusion: Co-supplementation of diabetic patients with R. khorasanicum extract ameliorated hyperglycemia and hyperlipidemia without causing any adverse effects; therefore, the plant extract may be recommended as a complementary therapy to improve diabetes-induced metabolic disturbances.

Keywords


Adibi F, Ejtehadi H, Abrishamchi P. 2007.
Phytochemicals and antibacterial effects of
ribes khorassanicum Saghafi & Assadi, an
endemic plant species to North-East of
Khorasan. J Med Plant Res, 4: 64-73.
Akkarachiyasit S, Charoenlertkul P, YibchokAnun S, Adisakwattana S. 2010. Inhibitory
activities of cyanidin and its glycosides and
synergistic effect with acarbose against
intestinal alpha-glucosidase and pancreatic
alpha-amylase. Int J Mol Sci, 11: 3387-
3396.
Baena-Diez JM, Penafiel J, Subirana I, Ramos
R, Elosua R, Marín-Ibañez A, Guembe MJ,
Rigo F, Tormo-Díaz MJ, Moreno-Iribas C,
Cabré JJ, Segura A, García-Lareo M, de la
Cámara AG, Lapetra J, Quesada M,
Marrugat J, Medrano MJ, Berjón J, Frontera
G, Gavrila D, Barricarte A, Basora J, García
JM, Pavone NC, Lora-Pablos D, Mayoral E,
Franch J, Mata M, Castell C, Frances A,
Grau M. 2016. Risk of cause-Specific death
in individuals with diabetes: A competing
risks analysis. Diabetes Care, 39: 1987-
1995.
Belwal T, Nabavi SF, Nabavi SM,
Habtemariam S. 2017. Dietary anthocyanins
and insulin resistance: when food becomes a
medicine. Nutrients, 9: 1111.
Da Silva Pinto M, Kwon Y-I, Apostolidis E,
Lajolo FM, Genovese MI, Shetty K. 2010.
Evaluation of red currants (Ribes rubrum l.),
black currants (Ribes nigrum l.), red and
green gooseberries (Ribes uva‚Äźcrispa) for
potential management of type 2 diabetes and
hypertension using in vitro models. J Food
Biochem, 34: 639-660.
Ribes khorassanicum anti-diabetic effects
AJP, Vol. 12, No. 2, Mar-Apr 2022 153
Fatehi-Hassanabad Z, Gholamnezhad Z,
Jafarzadeh M, Fatehi M. 2005. The antiinflammatory effects of aqueous extract of
ginger root in diabetic mice. Daru, 13: 70-
73.
Feshani AM, Kouhsari SM, Mohammadi S.
2011. Vaccinium arctostaphylos, a common
herbal medicine in Iran: molecular and
biochemical study of its antidiabetic effects
on alloxan-diabetic Wistar rats. J
Ethnopharmacol, 133: 67-74.
Garg SK, Brackett S, Reinicke T, Hirsch IB.
2020. New medications for the treatment of
diabetes. Diabetes Technol Ther, 22: S149-
s173.
Gholamnezhad Z, Hadjzadeh M-A-R,
Sotoudeh R, Aghaei A, Kasraie N. 2021.
The effects of Ribes khorasanicum hydroethanolic extract on STZ-induced diabetic
complications in rats. Vet Res Forum, doi:
10.30466/vrf.2020.113744.2707.
Governa P, Baini G, Borgonetti V, Cettolin G,
Giachetti D, Magnano AR, Miraldi E, Biagi
M. 2018. Phytotherapy in the management
of diabetes: A review. Molecules, 23: 105.
Grussu D, Stewart D, McDougall GJ. 2011.
Berry polyphenols inhibit α-Amylase in
vitro: identifying active components in
rowanberry and raspberry. J Agric Food
Chem, 59: 2324-2331.
Hamounpeima I, Hosseini M, Mohebbati R,
Shafei MN. 2019. Effect of hydroalcoholic
extract of Ribes khorasanicum on acute
hypertension induced by L-NAME in rat. J
Pharmacopunct, 22: 160-165.
Hippisley-Cox J, Coupland C. 2016. Diabetes
treatments and risk of amputation,
blindness, severe kidney failure,
hyperglycaemia, and hypoglycaemia: open
cohort study in primary care. bmj, 352:
i1450.
Hosseini A, Mollazadeh H, Amiri MS,
Sadeghnia HR, Ghorbani A. 2017. Effects of
a standardized extract of Rheum
turkestanicum Janischew root on diabetic
changes in the kidney, liver and heart of
streptozotocin-induced diabetic rats.
Biomed Pharmacother, 86: 605-611.
Hussain A, Ali I, Ijaz M, Rahim A. 2017.
Correlation between hemoglobin A1c and
serum lipid profile in Afghani patients with
type 2 diabetes: hemoglobin A1c
prognosticates dyslipidemia. Ther Adv
Endocrinol Metab, 8: 51-57.
Jacob B, Narendhirakannan RT. 2019. Role of
medicinal plants in the management of
diabetes mellitus: a review. 3 Biotech, 9: 4.
Joharchi MR, Amiri MS. 2012. Taxonomic
evaluation of misidentification of crude
herbal drugs marketed in Iran. Avicenna J
Phytomed, 2: 105-112.
Karuranga S, Duke L. 2018. Tackling the
complications of diabetes. Diabetes Res
Clin Pract, 141: 294-296.
Kianbakht S, Abasi B, Dabaghian FH. 2013.
Anti-hyperglycemic effect of Vaccinium
arctostaphylos in type 2 diabetic patients: a
randomized controlled trial. Forsch
Komplementmed, 20: 17-22.
Kianbakht S, Abasi B, Hashem Dabaghian F.
2014. Improved lipid profile in
hyperlipidemic patients taking Vaccinium
arctostaphylos fruit hydroalcoholic extract:
A randomized double-Blind placebocontrolled clinical trial. Phytother Res, 28:
432-436.
Kianbakht S, Hashem-Dabaghian F. 2019.
Antihypertensive efficacy and safety of
Vaccinium arctostaphylos berry extract in
overweight/obese hypertensive patients: A
randomized, double-blind and placebocontrolled clinical trial. Complement Ther
Med, 44: 296-300.
Latti AK, Kainulainen PS, Hayirlioglu-Ayaz S,
Ayaz FA, Riihinen KR. 2009.
Characterization of anthocyanins in
caucasian blueberries (Vaccinium
arctostaphylos L.) native to Turkey. J Agric
Food Chem, 57: 5244-5249.
Li D, Zhang Y, Liu Y, Sun R, Xia M. 2015.
Purified anthocyanin supplementation
reduces dyslipidemia, enhances antioxidant
capacity, and prevents insulin resistance in
diabetic patients. J Nutr, 145: 742-748.
Mir Heidar H. 2004. Herbal knowledge: Usage
of herbs in prevention and treatment of
diseases, with latest research around the
world, vol 4. Daftare Nashre Farhange
Eslami, Tehran.
Mohtashami R, Fallah Huseini H, Nabati F,
Hajiaghaee R, Kianbakht S. 2019. Effects of
standardized hydro-alcoholic extract of
Vaccinium arctostaphylos leaf on
hypertension and biochemical parameters in
hypertensive hyperlipidemic type 2 diabetic
patients: a randomized, double-blind and
placebo-controlled clinical trial. Avicenna J
Phytomed, 9: 44-53.
Saeedi P, Petersohn I, Salpea P, Malanda B,
Karuranga S, Unwin N, Colagiuri S,
Dashti et al.
AJP, Vol. 12, No. 2, Mar-Apr 2022 154
Guariguata L, Motala AA, Ogurtsova K,
Shaw JE, Bright D, Williams R. 2019.
Global and regional diabetes prevalence
estimates for 2019 and projections for 2030
and 2045: Results from the international
diabetes federation diabetes atlas, 9th
edition. Diabetes Res Clin Pract, 157:
107843.
Saghafi F, Assadi M. 1996. Ribes Khorasanica
(Grossulariaceae), a new species from NE.
IRAN. Iran J Bot, 7: 7-10.
Soltani R, Hakimi M, Asgary S, Ghanadian
SM, Keshvari M, Sarrafzadegan N. 2014.
Evaluation of the effects of Vaccinium
arctostaphylos L. fruit extract on serum
lipids and hs-CRP levels and oxidative
stress in adult patients with hyperlipidemia:
A randomized, double-blind, placebocontrolled clinical trial. Evid Based
Complement Alternat Med, 2014: 217451.
Sotoudeh R, Hajzadeh M-a-r, Gholamnezhad Z,
Aghaee A. 2019. The anti-diabetic and
antioxidant effects of a combination of
Commiphora mukul, Commiphora myrrha
and Terminalia chebula in diabetic rats.
Avicenna J Phytomed, 9: 454-464.
Taghavizadeh Yazdi ME, Khara J,
Housaindokht MR, Sadeghnia HR,
Esmaeilzadeh Bahabadid S, Amiri MS,
Darroudi M. 2018. Biocomponents and
antioxidant activity of Ribes khorasanicum.
Int J Basic Sci Med, 3: 99-103.
Turrini E, Ferruzzi L, Fimognari C. 2017.
Possible effects of dietary anthocyanins on
diabetes and insulin resistance. Curr Drug
Targets, 18: 629-640.
You Q, Chen F, Wang X, Luo PG, Jiang Y.
2011. Inhibitory effects of muscadine
anthocyanins on alpha-glucosidase and
pancreatic lipase activities. J Agric Food
Chem, 59: 9506-9511.
Zolfaghari F, Pourzadi N, Sahbaei F, Zolfaghari
F, Kazemi SS, Davari AR. 2015. The effect
of blueberry solution on blood pressure and
fasting blood sugar in patients with noninsulin dependent diabetes mellitus: a
double-blind clinical trial. Feyz, 19: 278-
283