Potential roles of ellagic acid on metabolic variables in diabetes mellitus: A systematic review.

Diabetes mellitus is a widespread endocrine disorder globally. Due to its antioxidant and anti-inflammatory properties, ellagic acid has the potential to improve the metabolic effects of chronic non-communicable diseases. This systematic review summarizes current evidence about the potential effects of ellagic acid on metabolic variables in diabetes mellitus. A comprehensive systematic literature search was conducted in databases such as PubMed, Scopus, EMBASE, ProQuest and Google Scholar from inception until March 2022. All animal studies and clinical trials were eligible for inclusion. Studies using in vitro models or published in a non-English language were excluded. Of 1320 articles, 23 were selected for assessment, including 21 animal studies and two randomized controlled trial studies. Following ellagic acid administration, findings reported improvement in FBS, HbA1c, insulin (20, 8 and 12 studies, respectively), TG, TC, HDL-C (13, 10 and 5 studies, respectively), MDA, GSH, CAT, SOD (11, 6, 3 and 4 studies, respectively), and TNF-α and IL-6 (6 and 3 studies, respectively). In conclusion, ellagic acid may improve glycaemic indicators, dyslipidaemia, oxidative stress and inflammation in diabetes mellitus. However, further clinical trials are needed to explore the mechanisms more precisely and to observe the applied consequences.

A comprehensive insight into effects of green tea extract in polycystic ovary syndrome: a systematic review.

BACKGROUND: Polycystic ovary syndrome (PCOS), as the most common endocrine disorder in reproductive-aged women, is characterized by oxidative stress and ovarian tissue inflammation. Green tea extract (GTE) potentially possesses therapeutic effects for PCOS because of the antioxidant and anti-inflammatory compounds. This systematic review evaluates the potential roles of GTE on metabolic variables, hormone levels, and ovarian function in PCOS. METHODS: A systematic review was conducted of published studies reporting the effects of GTE on PCOS. Several major databases, including PubMed, SCOPUS, and Google Scholar, were searched up from inception to April 2021. Clinical trials and animal studies that assessed the effects of GTE on PCOS were eligible for inclusion. RESULTS: Of 314 articles found in the search, four human studies and four animal studies were included. All studies in humans showed the effects of GTE on weight loss. GTE's effect on decreasing testosterone levels in humans and LH levels in animals were also reported. In addition, increases in FSH and progesterone levels in animal models were observed. Although GTE improved fasting blood sugar and insulin levels, the effect of GTE on inflammatory parameters, such as TNF-alpha and IL-6 and antioxidant status, was limited to animal studies. CONCLUSION: Therefore, this review suggests that GTE could be considered a potential agent to attenuate PCOS complications mainly due to its effect on weight loss and glycemic levels. However, more studies are needed to formulate conclusions about the effects and mechanisms of GTE in PCOS.

The effect of vitamin d-calcium co-supplementation on inflammatory biomarkers: A systematic review and meta-analysis of randomized controlled trials.

Data on the effect of vitamin d-calcium co-supplementation on inflammatory biomarkers, compared to placebo or intake of calcium and vitamin D supplements alone, are conflicting. The current systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to summarize available findings on the effect of vitamin d-calcium co-supplementation on inflammatory biomarkers in adults. Online databases including PubMed, Scopus, ISI Web of Science and Google Scholar were searched using relevant keywords up to June 2019. We included RCTs investigating the effect of vitamin d-calcium co-supplementation, compared to placebo or intake of calcium and vitamin D supplements alone, on inflammatory biomarkers. In total, 8 RCTs that enrolled 706 participants, aged ≥18 years, were included. Pooling 9 effect sizes from 8 RCTs on C-reactive protein (CRP) levels revealed a significant reducing effect of vitamin d-calcium co-supplementation on serum CRP concentrations compared to placebo intake (WMD: -0.82, 95% CI: -1.56, -0.07 mg/L, P = 0.03). However, this beneficial effect became non-significant when compared to the intake of calcium and vitamin D supplements alone. Also, we found that the associations of vitamin d-calcium dosages and duration of intervention with the reduction in CRP concentrations were in a non-linear fashion. Combining 5 effect sizes for IL-6 and 3 effect sizes for TNF-α, we found no significant effect of joint calcium and vitamin D supplementation on serum concentrations of IL-6 (WMD: -1.45, 95% CI: -5.31, 2.41 pg/mL, P = 0.46) and TNF-α (WMD: -0.79, 95% CI: -2.19, 0.61 pg/mL, P = 0.26). We found a beneficial effect of vitamin d-calcium co-supplementation on serum CRP concentrations. However, such a beneficial effect was not seen for IL-6 and TNF-α concentrations.

The effects of taurine supplementation on glycemic control and serum lipid profile in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled trial.

Previous studies have suggested that taurine has hypoglycemic and hypolipidemic effects on experimental diabetic models. Therefore, this clinical trial was designed to explore the impacts of taurine supplementation on glycemic control and lipid profile in the patients with T2DM. This study was conducted on 45 patients with T2DM in Tabriz Sheikhor-raees Polyclinic and Imam-Reza Hospital Endocrine Center. Subjects were randomly divided into taurine and placebo groups. Accordingly, the taurine group (n = 23) received taurine 3000 mg/daily and the placebo group (n = 22) took crystalline microcellulose/daily for the duration of 8 weeks. At baseline and after the trial completion, fasting blood samples were obtained from the patients to assess the glycemic indicators and lipid profile. Independent t test, paired t test, Pearson's correlation, and analysis of covariance was used for analysis. At the end of the study, levels of FBS (p = 0.01), insulin (p = 0.01), HOMA-IR (p = 0.003), TC (p = 0.013), and LDL-C (p = 0.041) significantly decreased in the taurine group compared to the placebo group. In addition, there was no significant changes in HbA1c, triglyceride, HDL-C, anthropometric indicators or dietary intakes by passing 8 weeks from the intervention. In conclusion, the findings of the current study indicated that taurine supplementation (3000 mg/day) for 8 weeks could improve the glycemic indexes and lipid profiles including TC and LDL-C in the patients with T2DM.

A comprehensive mechanistic review insight into the effects of micronutrients on toll-like receptors functions.

Toll-like receptors (TLRs) are the special proteins receptors for recognition of molecules related to the pathogens. In this way, TLRs and secreted cytokines as a result of TLRs activation are involved in the inflammation pathways. So far, in vivo and in vitro studies have demonstrated that micronutrients (vitamins & minerals) with a broad range of effects on body health, can regulate TLRs signaling pathways. Current review aimed at determining the possible mechanisms of micronutrient effects on TLRs functions. In the aspect of gene expression, micronutrients have inconsistent effects on mRNA level of TLRs which are dependent on time, dose and type of studied TLR. Also, some micronutrients affect gene expression of TLRs signaling mediators namely TLRs adaptors like Myeloid differentiation primary response 88 (MyD88). In the aspect of TLRs signaling pathways, nuclear factor-κB (NF-κB) is an important mediator which is regulated by micronutrients. Also, the regulatory effects of micronutrients on phosphorylation reactions may be effective in the activation/inactivation of TLRs signaling mediators. In addition, zinc can regulate TLRs signaling indirectly via the zinc finger proteins which have contradictory effects on TLRs cascade. In conclusion, the relationship between micronutrients and TLRs signaling is complicated and depends on some known internal, external and genetic factors like form of studied micronutrient, cell type, TLR agonist, dose and time of exposure, inflammation, apoptosis, cell cycle, and environmental factors. Some unknown factors may be effective in TLRs response and as a result additional mechanistic studies are needed to elucidate exact effect of micronutrients on TLRs signaling.

Metabolic endotoxemia and cardiovascular disease: A systematic review about potential roles of prebiotics and probiotics.

Translocation of microbiome-derived lipopolysaccharide (LPS) to the bloodstream (metabolic endotoxaemia) is associated with a significantly increased risk of cardiovascular diseases (CVD); however, the direction of this association is not fully understood. It has been revealed by some studies that alterations in the intestinal microbiota (dysbiosis) lead to increased intestinal permeability and translocation of LPS to the blood circulation. LPS may trigger toll-like receptor 4- (TLR-4) mediated inflammatory responses; this could lead to a chronic low-grade pro-inflammatory condition named metabolic endotoxaemia (ME), which is typically observed in CVD patients. ME is promoted by increased intestinal permeability. Moreover, dysbiosis leads to production of trimethylamine-N-oxide (TMAO), a gut bacterial metabolite suggested as a new risk factor in CVD development. Probiotics, extensively reviewed for decades, are live microorganisms which, when taken in adequate amounts, have beneficial effects on the host metabolism. Prebiotics are a type of dietary fibre that act as nourishment for the good bacteria in the gut and decrease the population of pathogen bacteria that produce greater amounts of endotoxins. Although an association has been postulated between ME and CVD, the results of studies investigating the role of antibiotic therapy in preventing the disease have been inconsistent. In this review, we discuss how prebiotics and probiotics modulate gut microbiota and consequently might help with prevention and/or treatment of CVD associated with ME.

Potential roles of Citrulline and watermelon extract on metabolic and inflammatory variables in diabetes mellitus, current evidence and future directions: A systematic review.

OBJECTIVE: Diabetes mellitus is a prevalent endocrine disorder worldwide. Citrulline is an α-amino acid, which is abundant in watermelon, and a precursor of arginine and nitric oxide. Decreased bioavailability of nitric oxide is associated with insulin resistance. The present systematic review focused on the existing evidence of citrulline and watermelon extract effects on metabolic and inflammatory parameters in diabetes mellitus. METHODS: A systematic search of the databases PubMed, Scopus, EMBASE, ProQuest and Google Scholar was conducted for relevant papers published from inception until October 2018. All clinical trials, animal and in vitro studies published in the English language that assessed the role of citrulline and watermelon extract on diabetes mellitus, were eligible. Studies providing inadequate information were excluded. RESULTS: Out of 1262 articles we found, only eight articles met the inclusion criteria for analysis. In three studies an increase in the synthesis of nitric oxide was reported with citrulline and watermelon extract supplementation. Four studies showed a significant reduction in blood glucose after supplementation with watermelon extract, and two studies reported a decrease in a number of inflammatory biomarkers following citrulline supplementation. Although citrulline intake caused a significant reduction in HOMA-IR in one study, inconsistent results were revealed on the effects of citrulline and watermelon extract on insulin levels and lipid profile. CONCLUSION: Citrulline and watermelon extract could improve nitric oxide synthesis, glycaemic status and inflammation in diabetes mellitus. However, further studies are required to shed light on the underlying mechanisms.

The effects of melatonin on neurohormonal regulation in cardiac cachexia: A mechanistic review.

Heart failure (HF) is one of the prominent health concerns and its morbidity is comparable to many malignancies. Cardiac cachexia (CC), characterized by significant weight loss and muscle wasting, frequently occurs in progressive stage of HF. The pathophysiology of CC is multifactorial including nutritional and gastrointestinal alterations, immunological and neurohormonal activation, and anabolic/catabolic imbalance. Neurohormones are critically involved in the development of both HF and CC. Melatonin is known as an anti-inflammatory and antioxidant hormone. It seems that melatonin possibly regulates the neurohormonal signaling pathway related to muscle wasting in CC, but limited comprehensive data is available on the mechanistic aspects of its activity. In this, we reviewed the reports regarding the role of neurohormones in CC occurrence and possible activity of melatonin in modulation of HF and subsequently CC via neurohormonal regulation. In addition, we have discussed proposed mechanisms of action for melatonin considering its possible interactions with neurohormones. In conclusion, melatonin likely regulates the signaling pathways related to muscle wasting in CC by reducing tumor necrosis factor α levels and activating the gene expression of insulin-like growth factor-1. Also, this hormone inhibits the proteolytic pathway by inhibiting nuclear factor-κB (NF-κB), renin-angiotensin system and forkhead box protein O1 pathways and could increase protein synthesis by activating Akt and mammalian target of rapamycin. To elucidate the positive role of melatonin in CC and exact mechanisms related to muscle wasting more cellular and clinical trial studies are needed.

Selenium and Polycystic Ovary Syndrome; Current Knowledge and Future Directions: A Systematic Review.

Polycystic ovary syndrome (PCOS), as the most common endocrine disorder in reproductive-aged women, is recognized by hyperandrogenism and insulin resistance. Selenium (Se) potentially possesses therapeutic effects on PCOS due to antioxidant and insulin-like properties. This systematic review evaluates the potential role of Se in the complications of PCOS. A systematic review was performed on published studies reporting the effects of Se on PCOS. Three major databases including PubMed, Scopus, and Google Scholar were searched until December 2018. A total of 7 human studies and two in vitro studies met the inclusion criteria. Two out of three case-control studies showed that serum Se levels tend to decrease in patients with PCOS. Of four studies that evaluated the impact of Se supplementation on insulin resistance, only one study showed protective effects of Se against insulin resistance. Two out of three studies reported the antioxidant effect of Se. Few studies investigating anti-androgenic effect of Se presented controversial results. There were three studies that evaluated the anti-hyperlipidemic effect of Se, of which two surveys indicated the lowering effects of Se on VLDL and LDL-cholesterol. The reviewed studies confirmed inverse relationships between serum Se levels and some androgenic hormones in PCOS. Se is able to attenuate insulin resistance and dyslipidemia. The available data are currently insufficient to support the protective effects of Se on PCOS.

Mechanistic insights into the effect of lutein on atherosclerosis, vascular dysfunction, and related risk factors: A systematic review of in vivo, ex vivo and in vitro studies.

Lutein is an essential carotenoid commonly consumed in the diet; however, its dietary intake does not usually reach the minimum recommended intake to decrease the incidence of chronic diseases. Experimental and epidemiological evidence suggests an anti-atherosclerotic effect for lutein-rich foods or lutein supplementation. This systematic review aimed to assess the mechanistic pathways of lutein in the prevention of atherosclerosis. Electronic databases, including PubMed, SCOPUS, ProQuest, Embase, and Google Scholar were searched to May 2019. Original studies published in English-language journals that investigated the effects of lutein on atherosclerosis and related risk factors, including lipid profile, hemodynamic, glycemic and inflammatory measurements, and endothelial function indices, were considered. Two reviewers independently extracted data on study characteristics, methods and outcomes. The review protocol has been registered at PROSPERO database of Systematic Reviews (registration number: CRD42019121381). A total of 5818 articles were found in the first phase of the search; from these, 19 met the inclusion criteria: 3 in vitro, 1 ex vivo, 11 animal, and 4 human studies. Nine of ten studies showed positive effects of lutein on endothelial function by reducing blood pressure, arterial thickness, monocyte migration, and vascular smooth muscle cell migration. Twelve studies examined the anti-inflammatory properties of lutein and found a significant decrease in proinflammatory cytokines. Although few studies investigated the anti-hyperlipidemic effects of lutein, three animal studies and one clinical trial found a beneficial effect of lutein on lipid profile. Evidence supports positive effects of lutein on atherosclerosis development and some common risk factors of atherosclerosis, including inflammation and endothelial dysfunction. Further studies focused on the effects of lutein on hyperglycemia, lipid profile, blood pressure and coagulation are required.

Dietary acid load and risk of hypertension: A systematic review and dose-response meta-analysis of observational studies.

BACKGROUND AND AIM: Previous studies have assessed diet-induced mild metabolic acidosis in relation to blood pressure, however, data are conflicting. Current systematic review and dose-response meta-analysis aimed to summarize earlier findings from observational studies on the association between dietary acid load and hypertension. METHODS AND RESULTS: We searched the online databases for relevant publications up to Feb 2019, using relevant keywords. Overall, 14 studies (3 prospective and 11 cross-sectional studies) that included 306,183 individuals and 62,264 cases of hypertension were included in the current meta-analysis. Combining effect sizes from both prospective and cross-sectional studies revealed no significant non-linear association between dietary acid load (based on net endogenous acid production (NEAP) method) and hypertension. However, stratified analysis based on study design showed a significant non-linear association between dietary acid load and hypertension in prospective studies (P = 0.006), but not cross-sectional ones. According to linear dose-response analysis, no significant association was found between dietary acid load (based on NEAP) and hypertension (combined effect size: 1.01, 95% CI: 0.97-1.06, P = 0.51). In terms of dietary acid load based on potential renal acid load (PRAL) method, no significant non-linear association was seen with hypertension (P = 0.52). However, in linear dose-response analysis, a-20 unit increase in PRAL values was associated with 3% increased risk of hypertension (combined effect size: 1.03, 95% CI: 1.00-1.06, P = 0.03). CONCLUSION: We found a significant positive association between dietary acid load and hypertension. Further studies, particularly those with prospective nature, are needed to confirm our findings.

Potential roles of chromium on inflammatory biomarkers in diabetes: A Systematic.

Diabetes, as a low-grade chronic inflammatory disease, causes disruption in proper function of immune and metabolic system. Chromium is an important element required for normal lipid and glucose metabolism. Chromium deficiency is correlated with elevation in cardiometabolic risk, which results from increased inflammation. This systematic review was conducted to discover the potential roles of chromium on inflammatory biomarkers. Eligible studies were all in vitro, animal and human studies published in English-language journals from inception until October 2018. PubMed, Scopus, Embase, ProQuest and Google Scholar databases were searched to fined interventional studies from the effects of chromium on inflammatory biomarkers such as tumour necrosis factor a (TNF-a), C-reactive protein (CRP), interleukins, monocyte chemoattractant protein-1 (MCP-1), intercellular adhesion molecule-1 (ICAM-1) and adipocytokines in hyperglycaemia and diabetes. Out of 647 articles found in the search, only 14 articles were eligible for analysis, three in vitro studies, eight animal studies and three human studies. Twelve of the 14 studies included in this review, chromium significantly decreased inflammatory factors. The findings of this review indicate, based on in vitro and in vivo studies, that chromium might have potential anti-inflammatory properties, but some of the studies did not show anti-inflammatory effects for chromium (two studies). There are only three studies in humans with controversial results. Therefore, more consistent randomized double-blind controlled trials are needed to reach relevant clinical recommendations, as well as to determine the precise mechanism, of chromium on inflammation in diabetes.

Potential roles of carnitine in patients with polycystic ovary syndrome: a systematic review.

Polycystic ovary syndrome (PCOS) is recognized as the most prevalent endocrinopathy in reproductive-aged women. This systematic review was performed with focus on the current knowledge on carnitine concerning metabolic variables in PCOS. PubMed, Scopus, Embase, ClinicalTrials.gov and Google Scholar databases were searched from inception until May 2018. All clinical trials and observational studies published in English-language journals were eligible. Studies that provided insufficient outcomes, animal and in vitro studies were excluded. Out of 451 articles identified in our search, only six articles were eligible for analysis. Two observational studies evaluated the association of serum carnitine levels with metabolic variables, and four clinical trials examined the effect of carnitine supplementation in patients with PCOS. Serum carnitine levels had inverse relationship with glycemic status, body mass index (BMI) and waist circumference. Also, carnitine supplementation resulted in improved weight loss, glycemic status, oxidative stress, follicles and size of ovarian cells; no significant effects were reported on sex hormones and lipid profile. According to the current evidence, carnitine might improve weight loss, glycemic status and oxidative stress. However, to explore the exact mechanisms of carnitine role in patients with PCOS, further studies are recommended.

Accessing free quality health care services and premature death.

BACKGROUND: The type of health insurance may affect the likelihood of mortality of insured people. We conducted this study to determine if accessing free quality health care services could decrease the premature mortality of people in a developing country. METHODS: In a multicenter cross sectional study, "years-life-lost" (YLL) due to premature death was evaluated in 202 671 insured people residing in six large regions in Iran. The participants had access to free quality health care services. The number of insured people that died in the six regions during March 20, 2014, to March 20, 2015, as well as their sex, age, and cause of the death, were collected, and the YLL was calculated based on assumptions made in Global Burden of Disease Study 2010 (GBD2010). RESULTS: The crude mortality rate was 2.3 per 1000, significantly lower than the overall rate of 4.6 per 1000 people in general population of Iran. The average YLL was 47 years per 1000 persons, significantly lower than that in general population of Iran and many industrialized countries. The most common causes of death (and YLL) were cardiovascular diseases and malignancies. CONCLUSION: Having access to free quality health care services is associated with a significant decrease in premature death.

Zinc against advanced glycation end products.

Advanced glycation end products (AGEs) are destructive compounds with pathogenic importance in age-related chronic diseases. Zinc has antioxidant, anti-inflammatory and anti-apoptotic potential. This study aimed to summarize effects of zinc on AGE formation and AGE-induced damaging agents. Pubmed, Google scholar, Web of Sciences, and Scopus databases were searched. There was no limitation for publication date. English language original articles (in vitro, experimental and human studies) which examined the effect of external zinc on AGE formation, AGE-induced apoptosis, or oxidative stress in mammals were included. To review the effect of zinc on AGE generation, the search keywords were as follows: "zinc" in title and "AGEs" or "methylglyoxal" or "pentosidine" or "carboxymethyllysine" or "glucosylation" or "carbonyl stress" or "AGEs-induced apoptosis or oxidative stress or inflammation" in title/abstract. In total, 90 titles and abstracts were identified. Fifty-two studies were screened after duplicates were removed. Six articles were chosen for review following analysis of both titles and summaries. Finally, based on intensive critical appraisal, 5 articles were included in the study. The evidence presented indicates that zinc has anti-glycation, anti-oxidative and anti-apoptotic effects. Zinc insufficiency may stimulate AGEs formation. Whereas, zinc supplementation could inhibit formation of AGEs, AGE-induced cell apoptosis and oxidative stress status, and protein carbonyl formation possibly through various signalling pathways.

The effect of resveratrol on advanced glycation end products in diabetes mellitus: a systematic review.

Advanced glycation end products (AGEs) lead to chronic oxidative stress and inflammation, which in turn augment diabetes complications. Resveratrol plays a potential role in relation to diabetes due to improving of hyperglycemia, oxidative stress, and inflammation. The aim of this review was to evaluate the scientific literature to identify the impacts of resveratrol on the accumulation of AGEs. The literature was searched in the online databases, viz. PubMed, SCOPUS, Embase, ProQuest, and Google Scholar until May 2019. From a total of 338 retrieved articles, 10 papers were eligible for the present analysis. Except one clinical trial, all studies were conducted on animals. All the included studies, except one, showed inhibitory effects of resveratrol on the accumulation of AGE or receptor for AGEs. The findings indicate that resveratrol is a potential protective agent against the accumulation of AGEs. There is, however, the need for future studies to investigate this effect on human.

A comprehensive insight into the potential roles of VDR gene polymorphism in obesity: a systematic review.

Vitamin D receptor (VDR) gene polymorphisms are believed to be involved in the obesity pathogenesis. This study summarises the results of research concerning the association between VDR polymorphisms and obesity. For this survey, the records of common databases were searched until November 2019. Four loci of the VDR gene in four case-controlled and 22 cross-sectional studies were assessed and evaluated. In the case-control studies, no significant association was observed between ApaI and FokI polymorphism with obesity risk. TaqI "T" allele in two studies was related to a higher risk of obesity. One investigation found no relationship between BsmI and obesity, while another article suggested that the "b" allele is more frequently found in obese subjects. The results of cross-sectional studies did not lead to consistent findings. Although the previous studies failed to arrive at conclusive findings, the effects of VDR polymorphism on obesity development cannot be ignored.

Effect of Nigella sativa supplementation on kidney function, glycemic control, oxidative stress, inflammation, quality of life, and depression in diabetic hemodialysis patients: study protocol for a double-blind, randomized controlled trial.

BACKGROUND AND OBJECTIVES: The kidney is probably the most crucial target of microvascular damage in diabetes, which can ultimately eventuate end-stage renal disease (ESRD). Hemodialysis is the most usual way of renal replacement therapy in ESRD. Patients receiving hemodialysis are susceptible to many complications like hyperglycemia, inflammation, depression, anxiety, and poor quality of life. So, they are constrained to consume many drugs. Medicinal herbs are used in different cultures as a reliable source of natural remedies. This study aims to determine the efficacy of Nigella sativa (NS) oil supplementation on blood glucose, kidney function tests, inflammation, oxidative stress, quality of life, and depression in hemodialysis patients. METHODS AND ANALYSIS: This double-blind, randomized controlled trial will enroll 46 patients with diabetes mellitus who give hemodialysis thrice a week. Patients who have an inflammatory or infectious disease and who are receiving nonsteroidal anti-inflammatory drugs will be excluded. Patients will be randomized to the treatment and control group, which will be recommended using two soft gels of NS and paraffin oil, respectively. Laboratory tests will be assessed at baseline and end of the study, including fasting blood sugar, glycated albumin, insulin, creatinine, blood urea nitrogen, urea, uric acid, superoxide dismutase, malondialdehyde, total antioxidant capacity, high sensitive C reactive protein, and 24-h urine volume. Also, the kidney disease and quality of life and hospital anxiety and depression scale questionnaires will be evaluated. DISCUSSION: Previous studies have reported a positive effect of Nigella sativa supplementation in chronic kidney disease, but there is no evidence that this plant is safe in hemodialysis patients. The results of this study can be helpful in better control of blood sugar and kidney function and reduce complications in diabetic hemodialysis patients. TRIAL REGISTRATION: Iranian Registry of Clinical Trials . Registered on 31 May 2020.

The Effects of Taurine Supplementation on Metabolic Profiles, Pentosidine, Soluble Receptor of Advanced Glycation End Products and Methylglyoxal in Adults With Type 2 Diabetes: A Randomized, Double-Blind, Placebo-Controlled Trial.

OBJECTIVES: Advanced glycation end products, along with methylglyoxal (MGO) as their precursor, play a major role in increased complications of type 2 diabetes mellitus (T2DM). Taurine (2-aminoethanesulphonic acid), a conditionally essential amino acid, is found in most mammalian tissues. Taurine is known as an antiglycation compound. This study was designed to investigate the effects of taurine supplementation on metabolic profiles, pentosidine, MGO and soluble receptors for advanced glycation end products in patients with T2DM. METHODS: In this double-blind randomized controlled trial, 46 patients with T2DM were randomly allocated into taurine and placebo groups. Participants received either 3,000 mg/day taurine or placebo for 8 weeks. Metabolic profiles, pentosidine, MGO and soluble receptors for advanced glycation end products levels were assessed after 12 h of fasting at baseline and completion of the clinical trial. Independent t test, paired t test, Pearson correlation and analysis of covariance were used for analysis. RESULTS: The mean serum levels of fasting blood sugar (p=0.01), glycated hemoglobin (p=0.04), insulin (p=0.03), homeostasis model assessment-insulin resistance (p=0.004), total cholesterol (p=0.01) and low-density lipoprotein cholesterol (p=0.03) significantly were reduced in the taurine group at completion compared with the placebo group. In addition, after completion of the study, pentosidine (p=0.004) and MGO (p=0.006) were significantly reduced in the taurine group compared with the placebo group. CONCLUSIONS: The results of this trial show that taurine supplementation may decrease diabetes complications through improving glycemic control and advanced glycation end products.