The Metabolic Effects of Cynara Supplementation in Overweight and Obese Class I Subjects with Newly Detected Impaired Fasting Glycemia: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial

Abstract

Impaired fasting glucose (IFG) is a condition that precedes diabetes and increases the risk of developing it. Studies support the hypoglycemic effect of Cynarascolymus (Cs) extracts due to the content of chlorogenic acid, which is a potent inhibitor of glucose 6-phosphate translocase and of dicaffeoylquinic acid derivatives that modulate the activity of alpha-glucosidase. Given this background, we investigated whether a new highly standardized Cs extract could improve glycemic control, insulin sensitivity and other metabolic parameters (total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C) Triglycerides, Apolipo protein B (ApoB), Apolipo protein A (ApoA), waist circumference, visceral adipose tissue (VAT) by dual-energy X-ray absorptiometry (DXA) in overweight subjects with newly diagnosed IFG. Fifty-four subjects (females/males 26/28, mean ± SD age 51.5 ± 6.2) were randomly assigned to the supplemented group (n = 27) and placebo (n = 27). After multiple testing correction, statistically significant interactions between time and group were observed for the primary endpoint glycemia (β = 0.36, p < 0.0001) and for the secondary endpoints HDL (β = −0.10, p < 0.0001), total cholesterol/HDL (β = 0.27, p < 0.0001), LDL (β = 0.15, p = 0.005), LDL/HDL (β = 0.23, p = 0.001), insulin (β = 1.28, p = 0.04), glycated hemoglobin (β = 0.21, p = 0.0002), A1c-derived average glucose (β = 0.34, p = 0.0002), ApoB (β = 6.00, p = 0.01), ApoA (β = −4.50, p = 0.04), ApoB/ApoA (β = 0.08, p = 0.003), waist circumference (β = 1.89, p = 0.05), VATβ = 222.37, p = 0.005). In conclusion, these results confirm that Cs supplementation has a significant effect on metabolic parameters in IFG patients.

Effects of artichoke leaf extract supplementation or artichoke juice consumption on lipid profile: A systematic review and dose–response meta‐analysis of randomized controlled trials

“…These studies were published from the year 2000 to 2020 and were mostly conducted in Iran (Fallah Huseini et al, 2012; Gatmiri et al, 2019; Panahi et al, 2018; Rangboo et al, 2016; Rezazadeh et al, 2019; Rezazadeh, Aliashrafi, et al, 2018; Rezazadeh, Rezazadeh, & Ebrahimi‐Mameghani, 2018; Roghani‐Dehkordi & Kamkhah, 2009). The rest were carried out in Italy (Mariangela Rondanelli et al, 2013; Rondanelli et al, 2011; Rondanelli et al, 2014; Rondanelli et al, 2020), Poland (Skarpanska‐Stejnborn et al, 2008), and Russia (Englisch et al, 2000), and UK (Bundy et al, 2008). Apart from two studies that were exclusively conducted among men (Roghani‐Dehkordi & Kamkhah, 2009; Skarpanska‐Stejnborn et al, 2008), other studies were among both genders (Bundy et al, 2008; Englisch et al, 2000; Fallah Huseini et al, 2012; Gatmiri et al, 2019; Panahi et al, 2018; Rangboo et al, 2016; Rezazadeh et al, 2019; Rezazadeh, Aliashrafi, et al, 2018; Rezazadeh, Rezazadeh, & Ebrahimi‐Mameghani, 2018; Rondanelli et al, 2011; Rondanelli et al, 2013; Rondanelli et al, 2014; Rondanelli et al, 2020).…”

“…After full‐text review, four more studies were excluded due to the following reasons: irrelevant outcomes ( n = 2), without sufficient data ( n = 1), and review paper ( n = 1). Finally, a total of 14 RCTs was included for the final systematic review and meta‐analysis (Bundy, Walker, Middleton, Wallis, & Simpson, 2008; Englisch et al, 2000; Fallah Huseini, Kianbakht, & Heshmat, 2012; Gatmiri et al, 2019; Panahi et al, 2018; Rangboo et al, 2016; Rezazadeh et al, 2019; Khatereh Rezazadeh, Rezazadeh, & Ebrahimi‐Mameghani, 2018; Roghani‐Dehkordi & Kamkhah, 2009; Rondanelli et al, 2013; Rondanelli, Giacosa, Orsini, Opizzi, & Villani, 2011; Rondanelli et al, 2014; Rondanelli et al, 2020; Skarpanska‐Stejnborn et al, 2008).…”

“…The rest were carried out in Italy (Mariangela Rondanelli et al, 2013; Rondanelli et al, 2011; Rondanelli et al, 2014; Rondanelli et al, 2020), Poland (Skarpanska‐Stejnborn et al, 2008), and Russia (Englisch et al, 2000), and UK (Bundy et al, 2008). Apart from two studies that were exclusively conducted among men (Roghani‐Dehkordi & Kamkhah, 2009; Skarpanska‐Stejnborn et al, 2008), other studies were among both genders (Bundy et al, 2008; Englisch et al, 2000; Fallah Huseini et al, 2012; Gatmiri et al, 2019; Panahi et al, 2018; Rangboo et al, 2016; Rezazadeh et al, 2019; Rezazadeh, Aliashrafi, et al, 2018; Rezazadeh, Rezazadeh, & Ebrahimi‐Mameghani, 2018; Rondanelli et al, 2011; Rondanelli et al, 2013; Rondanelli et al, 2014; Rondanelli et al, 2020). All included RCTs utilized a parallel‐group design.…”

Chlorogenic Acid-Induced Gut Microbiota Improves Metabolic Endotoxemia

“…A twice-daily dietary supplement based on CGA improved blood glucose, insulin sensitivity, and other metabolic parameters (TC, TG, and visceral adipose tissue, etc.) in overweight patients ( 12 ).…”

Health Beneficial Phytochemicals in Dioscorea caucasica Lipsky Leaves and Tubers and Their Inhibitory Effects on Physiologically Important Enzymes

“…Based on the strong inhibition of glucose release from complex carbohydrates, herbal infusions containing phenolic acids were suggested as natural preparations for preventing type II diabetes [ 6 ]. The hypoglycemic effect of di -caffeoylquinic acid derivatives may be also explained by the modulation of α-glucosidase, while chlorogenic acid is a potent inhibitor of glucose 6-phosphate translocase [ 63 ].…”