Silymarin in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Voroneanu, Luminița; Nistor, Ionuţ; Dumea, Raluca; Apetrii, Mugurel; Covic, Adrian

doi:10.1155/2016/5147468

Cited by 78 publications

(50 citation statements)

References 40 publications

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“…In contrast, plant-derived antidiabetic agents can alleviate diabetic complications through glycaemic control, antioxidant mechanism, and inhibition of pathological signal transductions involved in inflammation, fibrosis, and apoptosis ( Figure 2). Curcumin [73], resveratrol [74], naringenin [34], quercetin [75], apigenin [76,77], myricitrin [78,79], baicalin [80,81], luteolin [82,83], mangiferin [59,84,85], emodin [86,87], rosmarinic acid [88], berberine [89], stevioside [90,91], asiatic acid [92][93][94], glycyrrhizin [95][96][97][98], baicalin [99,100], silymarin [101], gallic acid [102][103][104], catechins [105,106], thymoquinone [107], and ferulic acid [108][109][110] have been revealed to attenuate diabetic vascular complications via modulating multiple molecular targets.…”

Section: Plant-derived Small Molecules As Antidiabetic Agentsmentioning

confidence: 99%

Plant-Based Antidiabetic Nanoformulations: The Emerging Paradigm for Effective Therapy

Dewanjee

Chakraborty

Mukherjee

et al. 2020

IJMS

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Diabetes mellitus is a life-threatening metabolic syndrome. Over the past few decades, the incidence of diabetes has climbed exponentially. Several therapeutic approaches have been undertaken, but the occurrence and risk still remain unabated. Several plant-derived small molecules have been proposed to be effective against diabetes and associated vascular complications via acting on several therapeutic targets. In addition, the biocompatibility of these phytochemicals increasingly enhances the interest of exploiting them as therapeutic negotiators. However, poor pharmacokinetic and biopharmaceutical attributes of these phytochemicals largely restrict their clinical usefulness as therapeutic agents. Several pharmaceutical attempts have been undertaken to enhance their compliance and therapeutic efficacy. In this regard, the application of nanotechnology has been proven to be the best approach to improve the compliance and clinical efficacy by overturning the pharmacokinetic and biopharmaceutical obstacles associated with the plant-derived antidiabetic agents. This review gives a comprehensive and up-to-date overview of the nanoformulations of phytochemicals in the management of diabetes and associated complications. The effects of nanosizing on pharmacokinetic, biopharmaceutical and therapeutic profiles of plant-derived small molecules, such as curcumin, resveratrol, naringenin, quercetin, apigenin, baicalin, luteolin, rosmarinic acid, berberine, gymnemic acid, emodin, scutellarin, catechins, thymoquinone, ferulic acid, stevioside, and others have been discussed comprehensively in this review.

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Section: Plant-derived Small Molecules As Antidiabetic Agentsmentioning

confidence: 99%

Plant-Based Antidiabetic Nanoformulations: The Emerging Paradigm for Effective Therapy

Dewanjee

Chakraborty

Mukherjee

et al. 2020

IJMS

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“…Silymarin reduced fasting blood glucose but had no effect on lipid profiles. Few data are available on the effects of silymarin on diabetic complications in randomized controlled trials (Voroneanu et al, ) or its pharmacokinetics profile. Regarding drug interactions, silymarin may interact with metronidazole (Izzo et al, ) and ribavirin (Liao et al, ), lowering the plasma concentrations of both drugs and thus compromising its pharmacokinetics and therapeutic efficacy.…”

Section: Final Considerationsmentioning

confidence: 99%

Effects of Silymarin on Diabetes Mellitus Complications: A Review

2017

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Diabetes mellitus is a common metabolic disorder that is caused by a deficit in the production of (type 1) or response to (type 2) insulin. Diabetes mellitus is characterized by a state of chronic hyperglycemia and such symptoms as weight loss, thirst, polyuria, and blurred vision. These disturbances represent one of the major causes of morbidity and mortality nowadays, despite available treatments, such as insulin, insulin secretagogues, insulin sensitizers, and oral hypoglycemic agents. However, many efforts have been made to discover new drugs for diabetes treatment, including medicinal plant extracts. Silymarin is a powder extract of the seeds from Silybum marianum, a plant from the Asteraceae family. The major active ingredients include four isomers: silybin, isosilybin, silychristin, and silydianin. Silymarin is indicated for the treatment of hepatic disorders, such as cirrhosis, chronic hepatitis, and gallstones. Moreover, several studies of other pathologies, including diabetes, sepsis, osteoporosis, arthritis, hypercholesterolemia, cancer, viral infections, and Alzheimer's and Parkinson's diseases, have tested the effects of silymarin and reported promising results. This article reviews data from clinical, in vivo, and in vitro studies on the use of silymarin, with a focus on the complications of diabetes, including nephropathy, neuropathy, healing delays, oxidative stress, hepatotoxicity, and cardiomyopathy. Copyright © 2017 John Wiley & Sons, Ltd.

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“…Silymarin is a traditional herbal remedy administered in alternative medicine (Flora, Hahn, Rosen, & Benner, ; Voroneanu, Nistor, Dumea, Apetrii, & Covic, ). Silymarin is used as an anticarcinogenic (Agarwal, Agarwal, Ichikawa, Singh, & Aggarwal, ), anti‐inflammatory (Sherif & Al‐Gayyar, ), neuro‐protective (Borah et al, ), cardio‐protective (Rao & Viswanath, ), and lipid‐lowering agent (Krečman, Škottová, Walterová, Ulrichová, & Šimánek, ; Kshirsagar, Ingawale, Ashok, & Vyawahare, ).…”

Section: Introductionmentioning

confidence: 99%

Effects of silymarin supplementation on blood lipids: A systematic review and meta‐analysis of clinical trials

Mohammadi

Hadi

Arab

et al. 2019

Phytotherapy Research

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Dyslipidemia is a leading cause of endothelial dysfunction and cardiovascular disease.Several studies used silymarin as an herbal supplement in hyperlipidemic subjects. The aim of the present systematic review and meta-analysis was to examine the effect of silymarin supplementation on blood lipids. PubMed, Scopus, Ovid (Cochrane library), ISI Web of Science, and Google Scholar were systematically searched until March 2018 to find intervention studies that examined the impact of silymarin supplementation on blood lipids in adults. Changes in blood lipids and potential sources of between-study variation were extracted. We run a subgroup analysis to determine potential sources of inter-study heterogeneity. Ten clinical trials fulfilled the eligibility criteria. Meta-analysis indicated that silymarin supplementation in combination with other treatments (not silymarin alone) reduced total cholesterol (change: −25.45 mg/dl; 95% confidence interval [CI] [−47.89, −3.01 mg/dl]) and low-density lipoprotein (change: −28.25 mg/dl; 95% CI [−53.09, −3.42 mg/dl]). Also, silymarin increased high-density lipoprotein concentration (change: 4.82 mg/dl; 95% CI [2.01, 7.63 mg/dl]). Blood concentration of triglyceride was significantly after silymarin supplementation in comparison with controls (change: −22.55 mg/dl; 95% CI [−44.32, −0.78 mg/dl]). Present systematic review and meta-analysis revealed that silymarin supplementation in combination with other treatments had a favorable effect on blood lipids. KEYWORDS high-density lipoprotein, low-density lipoprotein, meta-analysis, silymarin, systematic review, total cholesterol

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Silymarin in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Cited by 78 publications

References 40 publications

Plant-Based Antidiabetic Nanoformulations: The Emerging Paradigm for Effective Therapy

Plant-Based Antidiabetic Nanoformulations: The Emerging Paradigm for Effective Therapy

Effects of Silymarin on Diabetes Mellitus Complications: A Review

Effects of silymarin supplementation on blood lipids: A systematic review and meta‐analysis of clinical trials

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