Effects of ellagic acid supplementation on glycemic index and insulin resistance in type 2 diabetics: A double blind randomized clinical trial

authors:

avatar Mahnaz Ghadimi Yari , avatar Farshad Foroughi , avatar Sima Hashemipour , avatar Mohamadreza Rashidi Nooshabadi , avatar Mohammad Hossein Ahmadi , avatar Bahman Ahadi Nezhad , avatar Hossein Khadem , *

Koomesh: Vol.23, issue 5; 582-590
article type: issue_documents_importer
received: April 01, 2020
accepted: April 02, 2021

how to cite: Ghadimi Yari M, Foroughi F, Hashemipour S, Rashidi Nooshabadi M, Ahmadi M H, et al. Effects of ellagic acid supplementation on glycemic index and insulin resistance in type 2 diabetics: A double blind randomized clinical trial. koomesh. 2021;23(5):e153290. 

Abstract

Introduction: The beneficial effects of polyphenols to improve glycemic status in patients with type 2 diabetes have been reported in scientific studies. The aim of this study was to investigate the effect of oral ellagic acid (EA) supplement on glycemic index and insulin resistance in type 2 diabetic patients. Materials and Methods: In this double blind randomized clinical trial, 44 diabetic patients were selected, and were randomly assigned to the intervention group (22 subjects) and placebo (22 subjects) and received a capsule containing 180 mg of EA per day or placebo for 8 weeks, respectively. At the beginning and end of the study, demographic information, anthropometric indices, food intake and physical activity, biochemical factors of fasting and two-hour blood sugar, plasma insulin level, glycosylated hemoglobin percentage (HbA1c) and insulin resistance (IR) were measured. Results: At the beginning and end of the study, there was no significant difference between the two groups in terms of anthropometric indices, food intake and physical activity (P>0.05). At the end of the study, receiving EA in the intervention group significantly reduced fasting and two-hour blood sugar means, plasma insulin levels, HbA1c percentage, and IR levels compared with placebo group (P

References

  • 1.

    Jadhav R, Puchchakayala G. Hypoglycemic and antidiabetic activity of flavonoids: boswellic acid, ellagic acid, quercetin, rutin on streptozotocin-nicotinamide induced type 2 diabetic rats. Group 2012; 1: 100g.

  • 2.

    Rubino F, Nathan DM, Eckel RH, Schauer PR, Alberti KG, Zimmet PZ, et al. Metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by international diabetes organizations. Surg Obes Relat Dis 2016; 12: 1144-1162.

  • 3.

    Whiting DR, Guariguata L, Weil C, Shaw J. (2011) IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabet Res Clin Pract 2011; 94: 311-321.

  • 4.

    Fowler MJ. Microvascular and macrovascular complications of diabetes. Clin Diabet 2008; 26: 77-82.

  • 5.

    Li Y, Schoufour J, Wang DD, Dhana K, Pan A, Liu X, et al. Healthy lifestyle and life expectancy free of cancer, cardiovascular disease, and type 2 diabetes: prospective cohort study. BMJ 2020; 368: 6669.

  • 6.

    Abudawood M, Tabassum H, Almaarik B, Aljohi A. Interrelationship between oxidative stress, DNA damage and cancer risk in diabetes (Type 2) in Riyadh, KSA. Saudi J Biol Sci 2020; 7: 177-183.

  • 7.

    Ramos Ibarra ML, Gonzlez CM, Gmez Meda BC, Zamora Prez AL. Diabetes, oxidative stress and antioxidants. Invest Salud 2006; 8: 7-15.

  • 8.

    Evans JL, Goldfine ID, Maddux BA, Grodsky GM. Oxidative stress and stress-activated signaling pathways: a unifying hypothesis of type 2 diabetes. Endoc Rev 2002; 23: 599-622.

  • 9.

    Szkudelska K, Okulicz M, Hertig I, Szkudelski T. Resveratrol ameliorates inflammatory and oxidative stress in type 2 diabetic Goto-Kakizaki rats. Biomed Pharmacother 2020; 125: 110026.

  • 10.

    Kang I, Buckner T, Shay NF, Gu L, Chung S. Improvements in metabolic health with consumption of ellagic acid and subsequent conversion into urolithins: evidence and mechanisms. Adv Nutr 2016; 7: 961-972.

  • 11.

    Long J, Guo Y, Yang J, Henning SM, Lee RP, Rasmussen A, et al. Bioavailability and bioactivity of free ellagic acid compared to pomegranate juice. Food Funct 2019; 10: 6582-6588.

  • 12.

    Chao CY, Mong MC, Chan KC, Yin MC. Antiglycative and antiinflammatory effects of caffeic acid and ellagic acid in kidney of diabetic mice. Mol Nutr Food Res 2010; 54: 388-395.

  • 13.

    Fatima N, Hafizur RM, Hameed A, Ahmed S, Nisar M, Kabir N. Ellagic acid in Emblica officinalis exerts anti-diabetic activity through the action on -cells of pancreas. Eur J Nutr 2017; 56: 591-601.

  • 14.

    Babaeian amini S, Ebrahimi Mameghani M, Niafar M. The effect of pomegranate juice (no added sugar) consumption on fast blood sugar, lipid profile, antioxidant factors in Type 2 diabetes. Sci Magazine Yafte 2016; 18: 95-103. (Persian).

  • 15.

    Falsaperla M, Morgia G, Tartarone A, Ardito R, Romano G. Support ellagic acid therapy in patients with hormone refractory prostate cancer (HRPC) on standard chemotherapy using vinorelbine and estramustine phosphate. Eur Urol 2005; 47: 449-455.

  • 16.

    Moghaddam MB, Aghdam FB, Jafarabadi MA, Allahverdipour H, Nikookheslat SD, Safarpour S. The Iranian version of international physical activity questionnaire (IPAQ) in Iran: content and construct validity, factor structure, internal consistency and stability. World Appl Sci J 2012; 18: 1073-1080.

  • 17.

    Craig C, Marshall A, Sjostrom M, Bauman A, Lee P, Macfarlane D, Lam T, Stewart S. International Physical Activity Questionnaire-Short Form. J Am Coll Health. 2017; 65: 492-501.

  • 18.

    Gutch M, Kumar S, Razi SM, Gupta KK, Gupta A. Assessment of insulin sensitivity/resistance. Indian J Endoc Metab 2015; 19: 160.

  • 19.

    Hosseini B, Saedisomeolia A, Wood LG, Yaseri M, Tavasoli S. Effects of pomegranate extract supplementation on inflammation in overweight and obese individuals: A randomized controlled clinical trial. Complement Ther Clin Pract 2016; 22: 44-50.

  • 20.

    Babaeian S, Ebrahimi-Mameghani M, Niafar M, Sanaii S. The effect of unsweetened pomegranate Juice on insulin resistance, high sensitivity C-reactive protein and obesity among Type 2 diabetes patients. J Ardabil Univ Med Sci 2013; 13: 7-15. (Persian).

  • 21.

    Huang TH, Peng G, Kota BP, Li GQ, Yamahara J, Roufogalis BD, Li Y. Anti-diabetic action of Punica granatum flower extract: activation of PPAR- and identification of an active component. Toxicol Appl Pharmacol 2005; 207: 160-169.

  • 22.

    Amin MM, Arbid MS. Estimation of ellagic acid and/or repaglinide effects on insulin signaling, oxidative stress, and inflammatory mediators of liver, pancreas, adipose tissue, and brain in insulin resistant/type 2 diabetic rats. Appl Physiol Nutr Metab 2017; 42: 181-192.

  • 23.

    Malini P, Kanchana G, Rajadurai M. Antibiabetic efficacy of ellagic acid in streptozotocin-induced diabetes mellitus in albino wistar rats. Asian J Pharm Clin Res 2011; 4: 124-128.

  • 24.

    Najafzadeh H, Aghel N, Hemmati A, Oulapour S. Effect of hydro alcoholic extract of peel of Punica granatum on experimental diabetes mellitus by streptozotocin in rats. Pharmace Sci 2011; 16: 239-248.

  • 25.

    Rosenblat M, Hayek T, Aviram M. Anti-oxidative effects of pomegranate juice (PJ) consumption by diabetic patients on serum and on macrophages. Atherosclerosis 2006; 187: 363-371.

  • 26.

    Khajebishak Y, Payahoo L, Alivand M, Hamishehkar H, Mobasseri M, Ebrahimzadeh V, et al. Effect of pomegranate seed oil supplementation on the GLUT4 gene expression and glycemic control in obese people with type 2 diabetes: A randomized controlled clinical trial. J Cell Physiol 2019; 234: 19621-19628.##.