Assessment of heavy metal contamination in herbal medicinal products consumed in the Iranian market.

Herbal medicines have been reported to contain many contaminants that are potential harmful to health. These include heavy metals, such as lead (Pb), cadmium (Cd), arsenic (As), and mercury (Hg). Therefore, this study aimed to measure the levels of Pb, Cd, As, and Hg in several orally administered herbal products available in the Iranian market. Fifteen products labeled (A-O) of different brands from three different production batches (n = 45) were purchased from traditional herbal medicine factories in Iran. Each sample was digested with nitric acid by the wet digestion method, and the resultant solutions were used to determine the concentrations of Pb, Cd, As, and Hg. These measurements were performed using flame atomic absorption spectrometry, graphite furnace atomic absorption, or cold vapor atomic absorption. The lead, cadmium, arsenic, and mercury contents in the investigated samples did not show significant levels that may be associated with toxicity. All four metals were present at concentrations below the limits recommended by the WHO (World Health Organization), American Herbal Products Association (AHPA), and Canadian standard, but in several herbal products, the concentrations of these trace elements exceeded the Agency for Toxic Substances and Disease Registry (ATSDR). The concentrations of Pb, Cd, As, and Hg in commercially available herbal remedies were well below the acceptable intake recommended by global recommendations. Our findings revealed that at present, the amount of heavy metals in medicinal herbs processed at the level of supply by pharmacies licensed is favorable.

Enzymatic antioxidant system and endothelial function in patients with metabolic syndrome.

BACKGROUND: This study examined the relationship between serum glutathione peroxidase 1 (GPx-1) activity and endothelial dysfunction in the subjects with and without metabolic syndrome (MetS). METHODS: This case-control study was conducted on 76 subjects, 38 were patients with MetS and 38 were without MetS. The demographic, clinical, and laboratory features of the subjects were measured and then compared. The MetS was diagnosed according to the definitions of the National Cholesterol Education Program (NCEP) and International Diabetes Federation (IDF). Serum GPx-1 activity was measured by standard methods. Endothelial dysfunction was assessed with flow-mediated dilation (FMD) technique. RESULTS: In case-control study of 76 subjects, all of MetS risk factors including abdominal obesity, triglyceride (TG), low serum level of high-density lipoprotein cholesterol (HDL-C), hypertension (HTN), and fasting plasma glucose (FPG) were significantly higher than healthy individuals (P < 0.050). FMD was significantly lower than normal subjects (P < 0.050). Serum GP-1 activity was significantly lower in patients with MetS compared to normal subjects (21.7 ± 13.5 vs. 79.0 ± 38.6, respectively) (P = 0.001). The value of GPx-1 was significantly correlated with diastolic blood pressure (DBP) (r = -0.249, P = 0.040), C-reactive protein (CRP) (r = -0.409, P = 0.014), and FMD (r = 0.293, P = 0.050) in patients with MetS. The results of logistic regression showed that a unite increase in CRP (mg/dl), FMD (%), and endothelin-1 (ET-1) (pg/ml) and a unit decrease in GPx significantly increased the odds ratio (OR) of MetS; after adjusting for age and sex the results remained significant except for FMD (P < 0.050). CONCLUSION: Endothelial dysfunction is related to serum GPx-1 activity in patients with MetS. GPX-1 activity is associated with risk of cardiovascular diseases (CVDs) and peripheral vascular diseases (PVDs) in patients with MetS.

Effects of curcuminoids on inflammatory status in patients with non-alcoholic fatty liver disease: A randomized controlled trial.

BACKGROUND: Nonalcoholic fatty liver diseases (NAFLD) is a highly prevalent disease that is closely associated with several cardiometabolic complications. The potential anti-inflammatory role of curcuminoids that have already been reported to reduce hepatic steatosis, in patients with NAFLD was explored in this study. METHODS: This double-blind, randomized placebo-controlled trial was conducted for a period of 8 weeks in patients with NAFLD. Subjects (n = 55) were randomly allocated to receive either curcuminoids or placebo. The curcuminoids group received one capsule containing 500 mg curcuminoids (plus 5 mg piperine to increase intestinal absorption) per day for 8 weeks and the control group received matched placebo capsules for the same period. Liver ultrasonography was performed to assess the severity of hepatic steatosis at baseline and the study end. Serum levels of cytokines including interleukin-1α, interleukin-1ß, interleukin-2, interleukin-4, interleukin-6, interleukin-8, interleukin-10, tumor necrosis factor-α, monocyte chemoattractant protein-1, interferon γ, vascular endothelial growth factor and epidermal growth factor were measured before and after the intervention. RESULTS: The two groups were comparable in demographic features at baseline. The results showed that supplementation with curcuminoids could decrease weight compared to the placebo group (p = 0.016) in patients with NAFLD. Curcuminoids supplementation improved the severity of NAFLD according to the ultrasound results (p = 0.002). Moreover, serum concentrations of TNF-α (p = 0.024), MCP-1 (p = 0.008) and EGF (p = 0.0001) were improved by curcuminoids in NAFLD patients. CONCLUSIONS: The results of our study showed that curcumin supplementation can improve serum levels of inflammatory cytokines in subjects with NAFLD and this might be at least partly responsible for the anti-steatotic effects of curcuminoids.

Exploring the role of circadian clock gene and association with cancer pathophysiology.

Most of the processes that occur in the mind and body follow natural rhythms. Those with a cycle length of about one day are called circadian rhythms. These rhythms are driven by a system of self-sustained clocks and are entrained by environmental cues such as light-dark cycles as well as food intake. In mammals, the circadian clock system is hierarchically organized such that the master clock in the suprachiasmatic nuclei of the hypothalamus integrates environmental information and synchronizes the phase of oscillators in peripheral tissues.The circadian system is responsible for regulating a variety of physiological and behavioral processes, including feeding behavior and energy metabolism. Studies revealed that the circadian clock system consists primarily of a set of clock genes. Several genes control the biological clock, including BMAL1, CLOCK (positive regulators), CRY1, CRY2, PER1, PER2, and PER3 (negative regulators) as indicators of the peripheral clock.Circadian has increasingly become an important area of medical research, with hundreds of studies pointing to the body's internal clocks as a factor in both health and disease. Thousands of biochemical processes from sleep and wakefulness to DNA repair are scheduled and dictated by these internal clocks. Cancer is an example of health problems where chronotherapy can be used to improve outcomes and deliver a higher quality of care to patients.In this article, we will discuss knowledge about molecular mechanisms of the circadian clock and the role of clocks in physiology and pathophysiology of concerns.

Relationship between Resistin, Endothelin-1, and Flow-Mediated Dilation in Patient with and without Metabolic Syndrome.

BACKGROUND: Resistin is peptides that signal the functional status of adipose tissue to the brain and other target organs. It causes insulin resistance and affects the vascular endothelial dysfunction. However, the function and relation between resistin in endothelin-1 (ET-1), which leads to the endothelial dysfunction in humans are enigmatic. MATERIALS AND METHODS: In a cross-sectional study of 76 participants (38 metabolic syndrome patients and 38 healthy participants), biochemical and clinical parameters, including lipid profile, fasting glucose, resistin, ET-1, C-reactive protein (CRP), flow-mediated dilation (FMD), and hypertension were determined and compared between the two groups. RESULTS: Multiple linear regression analysis was performed with age- and sex-adjusted plasma resistin levels, FMD, and ET-1 as the dependent variables. Analysis showed that weight, body mass index, triglycerides (TGs), and ET-1 were statistically significant correlated with serum resistin. FMD has negative significantly correlated with weight (r = -0.491, P = 0.001), waist circumference (r = -0.491, P = 0.001), waist-to-hip ratio (r = -0.0444, P = 0.001), and ET-1 (r = -0.075, P = 0.050), but it has significantly correlated with systolic blood pressure (SBP) (r = 0.290, P = 0.016), diastolic blood pressure (DBP) (r = 0.275, P = 0.023), and high-density lipoprotein cholesterol (HDL-C) (r = -0.266, P = 0.050), and ET-1, but it has significantly correlated with SBP, DBP, and HDL-C. ET-1 is significantly correlated with TGs (r = -0.436, P = 0.006), total cholesterol (r = 0.452, P = 0.004), low-density lipoprotein cholesterol (r = 0.454, r = 0.004), and resistin (r = 0.282, P = 0.050), whereas it has negative significantly correlated with HDL-C (r = 0.346, P = 0.034), FMD (r = -0.075, P = 0.050. CONCLUSION: In this study, results shown plasma ET-1 and resistin are suggested as risk factors for the development of endothelial dysfunction and with further study, it is possible that can diagnose the risk of diabetes and cardiovascular disease in the early stages.

Proposal of a study protocol of a preliminary double-blind randomized controlled trial. Verifying effects of selenium supplementation on selenoprotein p and s genes expression in protein and mRNA levels in subjects with coronary artery disease: selenegene.

BACKGROUND: Selenium is the component of selenocystein amino acid, which itself is the building block of selenoproteins having diverse effects on various aspects of the human health. Among these proteins, selenoprotein P is the central to the distribution and homeostasis of selenium, and selenoprotein S as a transmembrane protein is associated with a range of inflammatory markers, particularly in the context of cardiovascular disease. It is known that selenium status outside of the normal range is considered to confer different benefits or adverse cardiovascular risk factors. Therefore, for the first time, we aimed to verify effects of Selenium supplementation on Selenoprotein P and S Genes Expression in Protein and mRNA Levels in Subjects with Coronary Artery Disease (CAD). METHODS: This is the study protocol of a double blinded randomized clinical trial on 130 subjects with angiographically documented stenosis of more than 75% in one or more coronary artery vessels. In this 60-day study, 65 patients in each group received either a 200mg selenium yeast or placebo tablets once daily. During the study, subjects were followed by phone calls and visited our clinic twice to repeat baseline measurements. We hypothesized that our finding would enable a more basic and confirmed understanding for the effect of selenium supplementation by investigating its effect on gene expression levels in people with CAD. DISCUSSION: Upon confirmation of this hypothesis, the beneficial effect of inflammation regulation by supplementation with micronutrients could be considered for subjects with CVD.

Effects of Pistacia atlantica on Oxidative Stress Markers and Antioxidant Enzymes Expression in Diabetic Rats.

INTRODUCTION: Diabetes mellitus (DM) affects many patients all over the world. It involves different parts of the body, such as brain, eyes, kidneys, vessels, and so on. The lack of balance between free radicals and antioxidants is a possible mechanism involved in the pathogenesis of diabetes. Antioxidant treatment, especially natural forms, can be a beneficial solution. Therefore, we evaluated the effects of Pistacia atlantica oleoresin (PAO) on oxidative stress markers and antioxidant enzymes expression in diabetic rats. METHOD: Fifty adult male Wistar rats were allotted randomly into five groups as follow: control group, diabetic control group, glibenclamide control group, diabetic glibenclamide group, diabetic treated group with 200 mg/kg PAO. Then PAO was prepared and analyzed by gas chromatography/mass spectroscopy (GC/MS). LD50 was also estimated for essential oil. Oxidative stress markers and antioxidant enzyme including malondialdehyde (MDA), glutathione (GSH), glutathione peroxidase (GPx), catalase (CAT), and superoxide dismutase (SOD) were also measured. The expression of GPx, CAT, and SOD genes was investigated using real-time polymerase chain reaction (PCR). RESULTS: The main constituents of essential oil gum were beta-pinene (29.38%), followed by alpha-pinene (18.15%), myrcene (7.36%), trans-pinocarveol (7.15%), and camphene (4.12%). Diabetes induced an increased level of MDA (69.92 ± 3.92 vs. 43.76 ± 3.73) and decreased levels of GSH (2.57 ± 0.40 vs. 7.05 ± 1.59), GPx (11.66 ± 2.2 vs. 16.38 ± 2.1), CAT (12.17 ± 3.38 vs. 18.7 ± 2.66), and SOD (0.78 ± 0.67 vs. 2.41 ± 0.46). In contrast, PAO treatment significantly decreased MDA (54.59 ± 12.54 vs. 69.92 ± 3.92) and increased GSH (4.5 ± 0.89 vs. 2.57 ± 0.40), GPx (25.86 ± 5.37 vs. 11.66 ± 2.2), CAT (22.69 ± 0.36 vs. 12.17 ± 3.38), and SOD (3.65 ± 1.08 vs. 0.78 ± 0.67) (p < 0.05). Moreover, our results indicated that both GPx and CAT mRNA levels significantly increased approximately 4.46 and 6.23 times in rats fed with 200 mg/kg of PAO, more than that of the healthy control group, respectively (p < 0.01 and p < 0.001, respectively). Also, the average expression level of SOD was also significantly 1.57 higher in rats fed with 200 mg/kg of PAO in comparison to the diabetic control group (p < 0.05). CONCLUSION: The results indicated that PAO could be propose as an agent that protects the body against diseases that are associated with oxidative stress.

Paraoxonase 1 activities and its gene promoter single nucleotide polymorphisms (-108, -126, and -162) in diabetes mellitus.

BACKGROUND: Paraoxonase 1 (PON1) enzyme is known enzyme with, aryl esterase, phosphatase, peroxidase, and lactonase activities. According to some studies, the activity of PON1 enzyme is decreased in type 2 diabetic patients. We analyzed the enzyme activity and its single nucleotide polymorphisms (SNPs) distribution on promoter regions (-108, -126, and -162) in type 2 diabetic patients compared with non-diabetic individuals to reveal the likely relationship between PON1 activity and its gene promoter polymorphisms. METHODS: On the whole, 98 diabetic and 104 non-diabetic individuals were examined in this study. The enzyme activity and the genotypes were studied using spectrophotometry, real-time PCR-HRM, and sequencing techniques, respectively. RESULTS: There was no meaningful difference in enzyme activity between two under-studied groups (P.V = 0.671). Moreover, no meaningful difference was also seen between two groups in terms of the frequency of polymorphism -108 (P.V = 0.277). The frequencies of SNPs -126 and -162, however, showed a meaningful difference between two groups (P.V = 0.000 and P.V = 0.017, respectively). CONCLUSIONS: We indicated PON1 activity could be similar in DM-2 patients and non-DM-2 individuals. The significant role of SNP -108 in PON1 activity in DM-2 patients compared with non-DM-2 individuals was confirmed in the study too. On the other hand, the role of -162 and -126 SNPs in causing diabetes cannot be easily overlook because of a meaningful difference of their distribution in understudied groups. However, they may be attributed to DM-2-associated genes.

Correlation Between Resistin Level and Metabolic Syndrome Component: A Review.

Metabolic syndrome (MetS) has a collection of some abnormal and pathological conditions that cause many critical diseases. Resistin is one of the possible candidates for these pathologies but there are not enough data to prove if resistin has positive, neutral, or negative effects on one or some components of MetS. This review summarizes data about comparing the effects and contribution of resistin in initiation and progression of MetS components and also its different actions between human and other mammalians. This summarized data about the relationship of resistin and MetS components have been obtained from clinical researches and in some cases even animal studies. To find the relevant studies, the search in PubMed, Science Direct, and Scopus were performed. Human and animal studies on relationships between resistin and MetS (initiation and progression of components) were included in our search. In experiments reported among different human genetic groups as well as the patients with various disease such as diabetes, no significant correlation is shown between FBG and resistin level. Furthermore, this review shows that the results of correlation between resistin and TG, HDL, and central or abdominal obesity were inconsistent. These inconsistencies can arise from different sample size or genetic groups, gender, and also from experimental studies. Therefore, to obtain precise results systematic review and meta-analyses are required.

Parent-child relationships and self­control in male university students' desire to play video games.

AIM: To determine the relationship between the parent-child relationship, self-control and demographic characteristics and the desire to play video games among male university students at one university in Iran. METHOD: This was a correlational, descriptive, applied study. A total of 103 male students were selected randomly as a study sample from the population of male students at Isfahan University in Iran. Data collection tools used were the Video Games Questionnaire, Tanji's Self-Control Scale, Parent-Child Relationship Questionnaire, and Demographic Questionnaire. Data were analysed using stepwise regression analysis. RESULTS: This study found several factors increased male students' desire to play video games. Demographic characteristics associated with increased tendency to play video games among male students in Iran are older age, larger number of family members, lower parental level of education and higher socio-economic class, while other significant factors are a lower level of self­control and a poorer parent-child relationship. PARTICIPANTS': higher socio-economic class, lower level of self-control and older age explained 8.2%, 5.2% and 5.9% of their desire to play video games, respectively. These three variables together accounted for significantly 16.9% of a male student's desire to play video games in this study ( P <0.05). CONCLUSION: These results suggest that the family's socio-economic status plays a significant role in young men's desire to play video games in Iran. Moreover, lower levels of self-control and a poorer parent-child relationship were found to be accompanied by a greater desire to play video games among male university students.

Weight Loss Associated With Consumption of Apples: A Review.

Apples are known as a major source of polyphenols, dietary fiber, carotenoids, and other nutrients. There are many documents and studies that show fruit polyphenols likely promote anti-obesity effects and exert their beneficial effects via scavenging free radicals, regulating gene expression, and altering signal transduction in target cells and tissues, especially fat tissues.The goal of this review is to presenti the major components of apple and the evidence that indicates its potential to diminution weight gain risk from in vitro, animal, and epidemiological and clinical studies. This review summarizes data about the apple and apple products that been have reported to reduce weight gain by various mechanisms, including antioxidant, antiproliferative, and cell signaling pathways. An extensive search was performed in PubMed, Science Direct, Scopus, and Google Scholar to identify human, animal, and cell culture studies on the association between weight loss and apple consumption, published from inception up to journey 15, 2017. The feeding of apples rats (7-10 mg/kg/d) in different forms in 8 experiments have shown that this caused weight loss during 3 to 28 weeks. In agreement with this, the obtained results from 5 experiments on humans have revealed that consumption of the whole apple or apple juice (240-720 mg/d) in 4-12 weeks by fat people can cause weight loss. Experiments on animals and humans have shown that the consumption of apples in different forms can cause weight loss in overweight ones. However, the main questions are which kind of apple, which part of it, how much, and how long overweight persons should consume them to reduce their body fat and body mass index (BMI). Then, it is necessary to do a meta-analysis to show how these factors affect the body fat percentage and whether this weight-lowering effect is statistically significant or not.

Functional Food and Cardiovascular Disease Prevention and Treatment: A Review.

Cardiovascular disease (CVD) is now the leading cause of death globally and is a growing health concern. Lifestyle factors, including nutrition, play an important role in the etiology and treatment of CVD. Functional foods based on their basic nutritional functions can decrease the risk of many chronic diseases and have some physiological benefits. They contain physiologically active components either from plant or animal sources, marketed with the claim of their ability to reduce heart disease risk, focusing primarily on established risk factors, which are hyperlipidemia, diabetes, metabolic syndrome, obesity/overweight, elevated lipoprotein A level, small dense low-density lipoprotein cholesterol (LDL-C), and elevated inflammatory marker levels. Functional foods are suspected to exert their cardioprotective effects mainly through blood lipid profile level and improve hypertension control, endothelial function, platelet aggregation, and antioxidant actions. Clinical and epidemiological observations indicate that vegetable and fruit fiber, nuts and seeds, sea foods, coffee, tea, and dark chocolate have cardioprotective potential in humans, as well whole-grain products containing intact grain kernels rich in fiber and trace nutrients. They are nutritionally more important because they contain phytoprotective substances that might work synergistically to reduce cardiovascular risk. This review will focus on the reciprocal interaction between functional foods and the potential link to cardiovascular health and the possible mechanisms of action.

Potential Cardioprotective Effects of Sumac Capsule in Patients With Hyperlipidemia: A Triple-Blind Randomized, Placebo-Controlled Crossover Trial.

OBJECTIVE: Alternative medicine and herbal drugs have been taken into account for managing cardiovascular risk factors. Sumac (Rhus coriaria L.) is rich in biologically active ingredients known to improve cardiovascular health. We investigated the effect of sumac on systolic (SBP) and diastolic (DBP) blood pressure, flow-mediated dilation (FMD), body mass index (BMI), and serum concentrations of lipids and fasting blood sugar (FBS) in participants with hyperlipidemia in a triple-blind randomized placebo- controlled crossover trial. METHODS: Thirty adults with dyslipidemia (mild to moderate elevation of plasma total cholesterol and/or triglycerides [TG; total cholesterol ≥ 6.0 mmol/L or TG ≥ 1.7 mmol/L and TG ≤ 5.0 mmol/L]) were assigned randomly to a sumac or a placebo group. Participants in the sumac group received sumac capsules (500 mg/twice daily) for the first 4 weeks, followed by 2 weeks' washout period; the patients were then switched to a 4-week interval and received placebo for 4 weeks in the second period. The placebo group received these treatments in reverse order. FMD, BMI, SBP, DBP, lipids, and FBS were measured at baseline and after each period. RESULTS: Differences between placebo group and sumac group (placebo-sumac) were significantly decreased for BMI (0.21 ± 0.075 kg/m2), SBP (1.87 ± 0.83 mm Hg), DBP (1.32 ± 0.46 mm Hg), and total cholesterol (14.42 ± 4.95 mmol/L) and significantly increased for FMD (-0.23% ± 0.065%). Plasma level of TG did not change significantly across the treatment. CONCLUSION: Sumac consumption may decrease cardiovascular risk factors in persons with mild to moderate hyperlipidemia.

Serum levels of lead, mercury and cadmium in relation to coronary artery disease in the elderly: A cross-sectional study.

BACKGROUND: There is a continuing attempt to identify novel factors that can predict the risk of cardiovascular disease beyond the established coronary risk factors. It has been suggested that serum levels of lead, mercury and cadmium are associated with the risk of coronary artery disease (CAD). In the present study, we aimed to evaluate serum concentrations of lead (s-Pb), mercury (s-Hg) and cadmium (s-Cd) in patients with CAD in comparison with those of healthy individuals. The correlation between serum levels of these heavy metals and lipid profile parameters was also investigated. METHODS: In this case-control study, we included 65 patients (35 females) aged 50-70 years with angiographically-documented CAD and 65 healthy controls (43 female) matched for sex, age and place of residence. Serum concentrations of heavy metals were determined using graphite furnace atomic absorption (GFAA). Serum lipids were measured using routine enzymatic methods. RESULTS: It was observed that the mean concentration of s-Pb (12.54 ± 8.41 vs. 5.89 ± 4.44 µg/L, p < 0.05) and s-Cd (0.938 ± 0.72 vs. 0.448 ± 0.30, p < 0.05; CI: 95%) and s-Hg (10.14 ± 5.06 vs. 6.11 ± 5.66, p < 0.05) were significantly higher in CAD patients compared with control subjects. The same result was also obtained after adjustment for cardiovascular risk factors including age, dyslipidemia, diabetes mellitus and hypertension (p < 0.05). The mean concentration of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and TC:HDL-C ratio were significantly higher in CAD patients (p < 0.05). There was no significant association between serum metal concentrations with TC, HDL-C and TC:HDL-C ratio (p > 0.05). CONCLUSIONS: The present results showed that serum levels of heavy metals are associated with the presence of CAD. Long-term exposure to trace levels of Pb, Cd and Hg may play a role in the development of coronary atherosclerotic plaques.

Pomegranate Consumption and Blood Pressure: A Review.

BACKGROUND: Pomegranate (Punica granatum L.) is a polyphenol-rich fruit with diverse medicinal properties. Several lines of experimental and clinical evidence have shown that pomegranate intake helps lowering blood pressure (BP) through different mechanisms. AIMS: This study aimed to present a narrative review on the anti-hypertensive properties of different parts of pomegranate such as pomegranate juice (PJ), pomegranate peels (PP), pomegranate seed oil (PSO), pomegranate fruit extract (PFE) and the mechanisms and phytochemicals responsible for these effects. METHODS: A review on the efficacy of consuming different parts of pomegranate (juice, peels, fruit extract and seed oil) in lowering BP has been performed. To find relevant studies, a search in PubMed, Science Direct and Scopus up from inception to May 4, 2015 was performed. Human, animals and in vitro studies investigating the anti-hypertensive effects of pomegranate were included in the search. RESULTS: Findings arising from animal and clinical studies have shown pomegranate juice can reduce BP in both short-term and long-term course. These effects are accompanied by antioxidant and anti-atherosclerotic actions that collectively improve cardiovascular health. The anti-hypertensive effects have been reported for both pomegranate juice and seed oil. Both systolic and diastolic pressures are affected. CONCLUSION: Pomegranate juice possesses antioxidant, anti-hypertensive and anti-atherosclerotic properties.

Treatment of Non-alcoholic Fatty Liver Disease with Curcumin: A Randomized Placebo-controlled Trial.

Non-alcoholic fatty liver disease (NAFLD) is a global health problem. Although many aspects of NAFLD pathogenesis have been understood, there is a paucity of effective treatments to be used as the second line when lifestyle modification is insufficient. Curcumin, a natural polyphenol from turmeric, has been shown to be effective against development of hepatic steatosis and its progression to steatohepatitis, yet these beneficial effects have not been explored in clinical practice. The aim of this study is to investigate the effects of curcumin on hepatic fat content as well as biochemical and anthropometric features of patients with NAFLD. In this randomized double-blind placebo-controlled trial, patients with ultrasonographic evidence of NAFLD were randomly assigned to receive an amorphous dispersion curcumin formulation (500 mg/day equivalent to 70-mg curcumin) or matched placebo for a period of 8 weeks. Liver fat content (assessed through ultrasonography), glycemic and lipid profile, transaminase levels, and anthropometric indices were evaluated at baseline and at the end of follow-up period. The clinical trial protocol was registered under the Iranian Registry of Clinical Trials ID: IRCT2014110511763N18. Compared with placebo, curcumin was associated with a significant reduction in liver fat content (78.9% improvement in the curcumin vs 27.5% improvement in the placebo group). There were also significant reductions in body mass index and serum levels of total cholesterol, low-density lipoprotein cholesterol, triglycerides, aspartate aminotransferase, alanine aminotransferase, glucose, and glycated hemoglobin compared with the placebo group. Curcumin was safe and well tolerated during the course of trial. Findings of the present proof-of-concept trial suggested improvement of different features of NAFLD after a short-term supplementation with curcumin. Copyright © 2016 John Wiley & Sons, Ltd.

Evaluation of the effects of roselle (Hibiscus sabdariffa L.) on oxidative stress and serum levels of lipids, insulin and hs-CRP in adult patients with metabolic syndrome: a double-blind placebo-controlled clinical trial.

BACKGROUND: Roselle (Hibiscus sabdariffa L.) is a plant with antihyperlipidemic and antihypertensive effects. This study aimed to evaluate the effects of roselle calyces on the serum levels of lipids and insulin, inflammation, and oxidative stress in patients with metabolic syndrome (MetS). METHODS: Forty adult patients with MetS were randomly assigned to receive either 500 mg of H. sabdariffa calyx powder or placebo once daily for 4 weeks. Systolic and diastolic blood pressures (SBP and DBP) and BMI (body mass index) as well as fasting serum levels of glucose (FPG; fasting plasma glucose), insulin, lipoproteins, triglycerides (TG), high-sensitivity C-reactive protein (hs-CRP), and malondialdehyde (MDA) were determined pre- and post-intervention and compared. RESULTS: H. sabdariffa significantly reduced serum TG (p=0.044) and SBP (p=0.049) compared to placebo. All other variables were not significantly affected by the interventions. CONCLUSIONS: Daily consumption of 500 mg of H. sabdariffa L. calyx powder can decrease SBP and serum TG in MetS patients.

Effects of aqueous extract of alfalfa on hyperglycemia and dyslipidemia in alloxan-induced diabetic Wistar rats.

BACKGROUND: The aim of this study was to investigate the effects of aqueous extract of alfalfa on blood glucose and serum lipids in alloxan-induced diabetic rats. MATERIALS AND METHODS: Thirty-two adult male Wistar rats weighing 210-250 g were selected and divided randomly into four groups of eight animals each for 21 days as follows: (1) control group, (2) diabetic control group, (3) diabetic group plus aqueous extract of alfalfa (250 mg/l), and (4) diabetic group plus aqueous extract of alfalfa (500 mg/l). Serum concentrations of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), very low-density lipoprotein (VLDL), glucose, and the liver enzymes such as aspartate transaminase (AST) and alanine transaminase (ALT) were measured at the end of period in all studied groups. RESULTS: Administration of 250 and 500 mg/l aqueous alfalfa extract resulted in a significantly decreased glucose, TC, TG, LDL-C, VLDL, ALT, and AST levels and increased HDL levels as compared with the control group and diabetic control group (p < 0.05). Histological examination showed that the aqueous alfalfa extract caused reconstruction of damaged liver and pancreas. CONCLUSION: These results suggest that aqueous alfalfa extract revealed significant effects on blood lipids and glucose levels in diabetic rats and might be useful in prevention and treatment of diabetes. However, further studies are needed to determine the exact impacts of those effects.

Relationship between serum resistin concentrations with metabolic syndrome and its components in an Iranian population.

BACKGROUND: The aim of the study is to determine the association of resistin with each MetS component. METHODS: This study had a case-control design, and its data was retrieved from the Isfahan Healthy Heart Program (IHHP), Serum samples from 44 subjects with MetS (diagnosed according to the NCEP-ATPIII criteria) and 46 healthy controls were analyzed for resistin using enzyme-linked immunosorbent assay. Association between serum resistin and levels of total (TC), low- (LDL-C) and high-density (HDL-C) lipoprotein cholesterol, triglycerides (TG), fasting blood sugar (FBS), waist circumference, body mass index, and systolic and diastolic blood pressures was determined. RESULTS: Serum resistin levels were significantly higher in the MetS compared with control group (3.64 ± 1.63, P=0.040). Serum levels of resistin were found to be significantly correlated with levels of TC (r=-0.347; P=0.027) and LDL-C (r=-0.311; P=0.050), but not other components of MetS including systolic and diastolic blood pressure, TG, HDL-C and FBS (P>0.05) in the MetS group, after adjustment for age, gender and BMI. No significant correlation between resistin and MetS components was observed in the control group (P>0.05). CONCLUSION: Serum resistin levels are elevated in subjects with MetS and may be associated with the severity of this syndrome.

Long-term results of pleurodesis in malignant pleural effusions: Doxycycline vs Bleomycin.

BACKGROUND: The aim of this study was to compare the response of doxycycline and bleomycin in pleurodesis of malignant pleural effusions. MATERIALS AND METHODS: The radiologic and clinical responses of doxycycline and bleomycin in pleurodesis of malignant pleural effusions were compared in this randomized clinical trial. Forty-two patients were randomized to receive either bleomycin 45 mg or doxycycline 600 mg as the sclerotherapy agent. Chest X-rays were taken before and after intervention, 10 days and 2 months later to compare the radiologic response. Dyspnea and other side effects, before and after intervention, 10 days and 2 months later were recorded and compared. Chi-square test was applied to analyze the data. RESULTS: The prevalence of dyspnea and its different severities, 10 days and 2 months after intervention were significantly different (P < 0.05) between the two groups. Analysis of pleural effusions revealed a significant difference (P < 0.05) between Doxycycline vs. Bleomycin 2 months after the intervention. Three months after pleurodesis, only one patient in bleomycin group needed pleural fluid drainage. CONCLUSION: Pleural effusions did not change with use of doxycycline and bleomycin in short time but long-term results of doxycycline sclerotherapy was better than bleomycin sclerotherapy in malignant pleural effusions that was supported by this study. However, additional studies with larger sample size are necessary to confirm the results.