The Effect of Selected Herbal Medicines on Bone Turnover Markers: A Systematic Review and Meta-Analysis.

Objective: To evaluate systematically the therapeutic effects of five herbal medicines (curcumin, black seed, ginger, cinnamon, and flaxseed oil) on bone turnover markers as a primary outcome. Materials and methods: A comprehensive systematic search of the literature was conducted in the electronic databases consisting of the Cochrane Library, MEDLINE, Web of Science, Scopus, Embase, ProQuest, and Google scholar, as well as SID, Magiran, and Irandoc for Persian literature up to December 2020. All Randomized controlled trials and quasi-experiments evaluated the impact of studied herbal medicines on bone turnovers of Bone Specific Alkaline Phosphatase (BSAP), osteocalcin, C-terminal Telopeptide type 1 Collagen (CTX-I), Deoxypyridinoline (DPD) were analyzed. Results: Sixteen interventional studies comprised 968 participants included in systematic review. Ten of eligible studies with 603 participants included in meta-analysis. Curcumin, black seed and flaxseed did not have a significant effect on BSAP (SMD=-1.76, 95%CI: -6.85 to 3.33, p=0.50, I2=0.99, 6 trials, 241 participants), CTx (SMD=-0.17ng/mL, 95%CI:-0.43 to 0.09, p=0.21, I2=1.000, 5 trials, 216 participants), DPD (MD=0.82nmol/mmol, 95%CI:-0.05 to 1.68, p=0.06, I2=0.000, 2 trials, 67 participants), osteocalcin (SMD=-2.02ng/mL, 95%CI:-4.49 to 0.45, p=0.11, I2=0.79, Six trials, 229 participants). As secondary outcomes, femoral neck Bone Mineral Density (BMD) increased significantly (p=0.03, I2=0.12) but lumbar spine BMD didn't differ (p=0.28, I2=0.97). Curcumin significantly increased total hip BMD (p<0.001, I2=0.12). QiangGuYin containing cinnamon as a combined Chinese medicine had significant effect on P1NP, ß-CTx, and BMD. Conclusion: Studied herbs except for QiangGuYin had no significant effects on bone turnover markers. Due to high heterogeneity between trials, further high-quality trials are suggested.

Probiotics Supplementation Improves Quality of Life, Clinical Symptoms, and Inflammatory Status in Patients With Psoriasis.

BACKGROUND: Studies have proposed a link between psoriasis and imbalanced gut microbiome. Therefore, the modulation of the gut microbiota with probiotics may improve clinical outcomes, chronic inflammation, and cardiovascular risk factors in patients with psoriasis. METHODS: In a randomized double-blind placebo-controlled clinical trial, forty-six patients with psoriasis randomly assigned into probiotic capsules contains multi-strain at least 1.6× 109 CFU/g bacteria or placebo for two months. Psoriasis Area and Severity Index (PASI), blood pressure, quality of life (QOL) pro-inflammatory cytokines (hs-CRP and IL1-β), and lipopolysaccharides (LPS) were measured. RESULTS: Improvements in QOL was significant in patients taking probiotics supplementation comparing to the placebo group and PASI (-5.06±2.10 vs 0.30±1.80, P=0.049) as well. After the intervention, a considerable reduction in serum LPS levels (-7.21±10.33 vs -2.74±0.97 mmol/L, P=0.010), hs-CRP levels (-1.67±0.95 vs -0.70+ 0.38 mg/L, P=0.013), and IL1- β levels (-1.64±1.10 vs 0.17+ -0.20 mg/L, P=0.043) in the probiotics group. CONCLUSION: This study shows that probiotics significantly improved the quality of life and seriousness in psoriatic patients. Moreover, it enhances cardiovascular risk factors and inflammatory/oxidative stress markers. TRIAL REGISTRATION: This trial also was recorded in the Iranian registry of clinical trials (https://www.irct.ir) (code: IRCT20191124045483N1). J Drugs Dermatol. 2022;21(6):637-644. doi:10.36849/JDD.6237.

Relationship between the levels of serum fibroblast growth factor 19 and metabolic factors in obese and normal weight subjects with and without type 2 diabetes mellitus: a case-control study.

OBJECTIVES: Fibroblast growth factor 19 (FGF-19) is a metabolic regulating factor with an anti-diabetic effect. This study aimed to evaluate FGF-19 in patients with type 2 diabetes mellitus (T2DM) and its relationship with some metabolic risk factors. METHODS: In this case-control study, 80 diabetic patients and 80 non-diabetic individuals were divided into two subgroups based on body mass index (BMI): obese people (BMI≥30) and participants with normal weight (25>BMI≥18.5). Furthermore, stratified analysis by gender was also performed. The metabolic factors were measured and compared in all groups. The relationship between FGF-19 and the measured items was investigated in each group. RESULTS: The FGF-19 levels did not show a significant difference between groups. The serum levels of FGF-19 were negatively associated with some metabolic items, such as BMI, low-density lipoprotein (LDL), total cholesterol (TC) (p<0.01), and LDL/high-density lipoprotein (HDL) ratio (p=0.02) only in the healthy group with normal weight. According to the gender-based classification of individuals, FGF-19 showed a significant inverse relationship with BMI, weight (WT), waist circumference (WC), and hip circumference (HC) (p<0.05) in diabetic men; besides, FGF-19 in non-diabetic women had a significant negative association with TC, LDL, and LDL/HDL ratio (p<0.05). CONCLUSIONS: The levels of FGF-19 were negatively correlated to WT, BMI, WC and HC in diabetic males. More studies are needed to warrant these results.

A comprehensive insight into the effect of glutamine supplementation on metabolic variables in diabetes mellitus: a systematic review.

Diabetes mellitus is one of the most important threats to human health in the twenty-first century. The use of complementary and alternative medicine to prevent, control, and reduce the complications of diabetes mellitus is increasing at present. Glutamine amino acid is known as a functional food. The purpose of this systematic review is to determine the potential role of glutamine supplementation on metabolic variables in diabetes mellitus. For this review, PubMed, SCOPUS, Embase, ProQuest, and Google Scholar databases were searched from inception through April 2020. All clinical trial and animal studies assessing the effects of glutamine on diabetes mellitus were eligible for inclusion. 19 studies of 1482 articles met the inclusion criteria. Of the 19 studies, nine studies reported a significant increase in serum GLP-1 levels. Also, eight studies showed reducing in serum levels of fasting blood sugar, four studies reducing in postprandial blood sugar, and triglyceride after glutamine supplementation. Although glutamine resulted in a significant increase in insulin production in seven studies, the findings on Hb-A1c levels were inconclusive. In addition to, despite of the results was promising for the effects of glutamine on weight changes, oxidative stress, and inflammation, more precise clinical trials are needed to obtain more accurate results. In conclusion, glutamine supplementation could improve glycemic control and levels of incretins (such as GLP-1 and GIP) in diabetes mellitus. However, more studies are needed for future studies.