Insulin resistance improvement by cinnamon powder in polycystic ovary syndrome: A randomized double‐blind placebo controlled clinical trial

Abstract

Our aim is to assess the effect of cinnamon powder capsules on insulin resistance, anthropometric measurements, glucose and lipid profiles, and androgens of women with polycystic ovarian syndrome (PCOS). Out of 80 women that were diagnosed as PCOS by Rotterdam Criteria, 66 were enrolled in this randomized double-blind placebo-controlled clinical trial. All of the PCOS women were taking medroxy progesterone acetate 10 mg/day for the last 10 days of their menstrual cycles. The cases were randomly allocated to 2 groups. The women in the first group were treated by cinnamon powder capsules 1.5 g/day in 3 divided doses for 12 weeks and the second group by similar placebo capsules. Anthropometric measurements, fasting blood sugar, fasting insulin, blood glucose 2 hr after taking 75 g oral glucose, HbA1c, testosterone, dehydroepiandrosterone sulphate, homeostatic model assessment for insulin resistance, triglyceride, and cholesterol (low-density lipoprotein, high-density lipoprotein, and total) before and after the intervention were evaluated and compared as outcome measures. Fasting insulin (p = .024) and homeostatic model assessment for insulin resistance (p = .014) were reduced after 12 weeks in the cinnamon group compared with the placebo. There was also a significant decrease in low-density lipoprotein in cinnamon group (p = .004) as compared with baseline that caused significant difference with placebo (p = .049). However, changes in other outcome measurements did not lead to statistically significant difference with placebo. The present results suggest that complementary supplementation of cinnamon significantly reduced fasting insulin and insulin resistance in women with PCOS.

Effects of cinnamon supplementation on body weight and composition in adults: A systematic review and meta‐analysis of controlled clinical trials

“…The majority of the studies used cinnamon powder in the form of capsule (17 studies) (Akilen et al, ; Aldayel, ; Askari et al, ; Azimi et al, ; Blevins et al, ; Borzoei et al, ; Gupta Jain et al, ; Haghighian et al, ; Hajimonfarednejad et al, ; Mirfeizi et al, ; Nakhaei et al, ; Shishehbor et al, ; Soni & Bhatnagar, ; Torabi et al, ; Vafa et al, ; Wainstein et al, ; Zare et al, ), and the four remaining studies used the cinnamon extract (Anderson et al, ; Talaat & Ammar, ; Weitgasser et al, ; Ziegenfuss et al, ). The 11 trials were conducted in individuals with T2DM (Akilen et al, ; Azimi et al, ; Blevins et al, ; Haghighian et al, ; Mirfeizi et al, ; Soni & Bhatnagar, ; Torabi et al, ; Vafa et al, ; Wainstein et al, ; Weitgasser et al, ; Zare et al, ), and the other trials included women with polycystic ovarian syndrome (PCOS) (three trials) (Borzoei et al, ; Hajimonfarednejad et al, ; Talaat & Ammar, ), participants with overweight (two trials) (Aldayel, ; Nakhaei et al, ), MetS and prediabetes (three trials) (Anderson et al, ; Gupta Jain et al, ; Ziegenfuss et al, ), nonalcoholic fatty liver disease (NAFLD) (one trials) (Askari et al, ), and rheumatoid arthritis (RA) (one trial) (Shishehbor et al, ). In general, the administered dose of cinnamon for these included trials ranged between 336 mg/d of cinnamon extract to 10,000 mg/day of cinnamon powder.…”

“…No indication of bias because of selective reporting or attrition was observed. In total, seven trials had a low risk of bias (Akilen et al, ; Askari et al, ; Gupta Jain et al, ; Hajimonfarednejad et al, ; Shishehbor et al, ; Wainstein et al, ; Zare et al, ), 12 trials were judged to be “unclear risk” (Anderson et al, ; Blevins et al, ; Borzoei et al, ; Haghighian et al, ; Mirfeizi et al, ; Nakhaei et al, ; Soni & Bhatnagar, ; Talaat & Ammar, ; Torabi et al, ; Vafa et al, ; Weitgasser et al, ; Ziegenfuss et al, ), and two studies were “high risk” (Aldayel, ; Azimi et al, ).…”

“…Twenty trials with twenty‐two treatment arms (n = 1458) reported the effect of the cinnamon on BMI (Akilen et al, ; Aldayel, ; Anderson et al, ; Askari et al, ; Blevins et al, ; Borzoei et al, ; Gupta Jain et al, ; Haghighian et al, ; Hajimonfarednejad et al, ; Mirfeizi et al, ; Nakhaei et al, ; Shishehbor et al, ; Soni & Bhatnagar, ; Talaat & Ammar, ; Torabi et al, ; Vafa et al, ; Wainstein et al, ; Weitgasser et al, ; Zare et al, ). The meta‐analysis revealed that cinnamon supplementation reduces the BMI by −0.40 kg/m 2 (95% CI: −0.58, −0.23 kg/m 2 ; p < .001) and a substantial heterogeneity was seen between the included studies (Cochran's Q test, Q statistic = 99.32, p < .001, I 2 = 78.9%) (Figure ).…”

“…Pooled analysis of a total of 431 adults from seven RCTs (Akilen et al, ; Aldayel, ; Askari et al, ; Azimi et al, ; Gupta Jain et al, ; Hajimonfarednejad et al, ; Wainstein et al, ) demonstrated a marginal effect of cinnamon on WC (WMD = –1.76 cm, 95% CI: −3.57, −0.045 cm; p = .056; Cochran's Q test, Q statistic = 65.17; p < .001; I 2 = 90.8%) (Figure ). The subgroup analysis based on sex revealed that cinnamon (WMD = −2.42 cm, 95% CI: −4.03, −0.80 cm; p = .003) significantly reduces WC in women, and there was no evidence of heterogeneity between the studies (Cochran's Q test, Q statistic = 1.17, p = .28, I 2 = 14.5%).…”

“…The excluded references with their reason are provided in Table S2. In total, 21 articles were eligible and were included in the present systematic review and meta-analysis (Akilen, Tsiami, Devendra, & Robinson, 2010;Aldayel, 2016;Anderson et al, 2016;Askari et al, 2014;Azimi et al, 2014;Blevins et al, 2007;Borzoei, Rafraf, & Asghari-Jafarabadi, 2018;Gupta Jain et al, 2017;Haghighian, Naimi, Gargari, Ali-Asgharzadeh, & Nemati, 2011;Hajimonfarednejad et al, 2018;Mirfeizi et al, 2016;Nakhaei, Ghofrani, Bakhsheshi, & Nakhaei, 2018;Shishehbor et al, 2018;Soni & Bhatnagar, 2015;Talaat & Ammar, 2018;Torabi, Asad, & Tabrizi, 2016;Vafa et al, 2012;Wainstein et al, 2011;Weitgasser et al, 2007;Zare et al, 2018;Ziegenfuss et al, 2006).…”