Effect of bulk bread formulated with portulaca oleracea on liver enzymes, and oxidative stress in patients with type 2 diabetes and hyperlipidemia: A parallel randomized controlled trial

authors:

avatar Aisa Bahar , avatar Hossein Ebrahimi , avatar Abdorreza Mohammadi Nafchi , avatar Behzad Valizade , avatar delvarianzadeh delvarianzadeh , *


how to cite: Bahar A, Ebrahimi H, Mohammadi Nafchi A, Valizade B , delvarianzadeh D. Effect of bulk bread formulated with portulaca oleracea on liver enzymes, and oxidative stress in patients with type 2 diabetes and hyperlipidemia: A parallel randomized controlled trial. koomesh. 2022;24(1):e154095. 

Abstract

Introduction: Elevated liver enzymes and decreased total antioxidant capacity increase the risk of liver disease. Bread can be a good carrier for adding nutrients and effective herbs. This study aimed to evaluate the effect of bread enriched with Portulaca Oleracea on liver enzymes, and some oxidative stress parameters in patients with type 2 diabetes and dyslipidemia. Materials and Methods: This parallel randomized controlled clinical trial was conducted on 104 patients with type 2 diabetes and dyslipidemia. Participants received bulk bread containing 10% Portulaca powder for 8 weeks (intervention group) the control group used bread without fortification. At baseline and end of the study for 4 weeks fasting blood sample were collected to quantify plasma serum level of liver enzymes include AST (aspartate aminotransferase), ALT (alanine aminotransferase), GTT (γ-glutamyltransferase), ALP (alkaline phosphatase) and total antioxidant capacity (TAC), malondialdehyde (MDA). Results: The results showed that before the intervention, there was no significant mean between the two groups in terms of mean of the studied variables. Comparison of the mean change scores of predictor variables showed that except for malondialdehyde, there was a significant difference between the other variables in the two groups with a significance level of P

References

  • 1.

    Cho N, Shaw J, Karuranga S, Huang Y, da Rocha Fernandes J, Ohlrogge A, Malanda B. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract 2018; 138: 271-281. https://doi.org/10.1016/j.diabres.2018.02.023 PMid:29496507.

  • 2.

    Guariguata L, Linnenkamp U, Makaroff LE, Ogurtsova K, Colagiuri S. Global estimates of hyperglycaemia in pregnancy: determinants and trends. Nutr Diet Matern Diabetes 2018; p: 3-15. https://doi.org/10.1007/978-3-319-56440-1_1.

  • 3.

    World Health Organization - Diabetes country profiles. Iran (Islamic Republic of) 2016.##.

  • 4.

    Moradi Y, Baradaran HR, Djalalinia S, Chinekesh A, Khamseh ME, Dastoorpoor M, et al. Complications of type 2 diabetes in Iranian population: An updated systematic review and meta-analysis. Diabetes Metab Syndr 2019; 13: 2300-2312. https://doi.org/10.1016/j.dsx.2019.05.018 PMid:31235172.

  • 5.

    Doustmohamadian S, Kia NS, Fatahi SJK. Associated factors of poor glycemic control in Iranian diabetic patients. 2021; 23: 372-378. (Persian). https://doi.org/10.52547/koomesh.23.3.372.

  • 6.

    Marseglia L, Manti S, D'Angelo G, Nicotera A, Parisi E, Di Rosa G, et al. Oxidative stress in obesity: a critical component in human diseases. Int J Mol Sci 2015; 16: 378-400. https://doi.org/10.3390/ijms16010378 PMid:25548896 PMCid:PMC4307252.

  • 7.

    Unuofin JO, Lebelo SLJOM, Longevity C. Antioxidant Effects and Mechanisms of Medicinal Plants and Their Bioactive Compounds for the Prevention and Treatment of Type 2 Diabetes: An Updated Review. Oxid Med Cell Longev 2020; 2020: 1356893. https://doi.org/10.1155/2020/1356893 PMid:32148647 PMCid:PMC7042557.

  • 8.

    Hossein-Panah F, Sadeghi L, Rambod M, Foroutan M, Naseri MJ. Assessing predicting factors in non-alcoholic fatty liver disease (NAFLD) in type 2 diabetes. 2006; 30: 9-15. (Persian).

  • 9.

    Leite NC, Salles GF, Araujo AL, VillelaNogueira CA, Cardoso CR. Prevalence and associated factors of nonalcoholic fatty liver disease in patients with type2 diabetes mellitus. Liver Int 2009; 29: 113-119. https://doi.org/10.1111/j.1478-3231.2008.01718.x PMid:18384521.

  • 10.

    Abbasian M, Delvarianzadeh M, Ebrahimi H, Khosravi F, Nourozi PJD, Research MSC, Reviews. Relationship between serum levels of oxidative stress and metabolic syndrome components. Diabetes Metab Syndr 2018; 12: 497-500. https://doi.org/10.1016/j.dsx.2018.03.015 PMid:29576521.

  • 11.

    Deng R. A review of the hypoglycemic effects of five commonly used herbal food supplements. Recent Pat Food Nutr Agric 2012; 4: 50-60. https://doi.org/10.2174/1876142911204010050 https://doi.org/10.2174/2212798411204010050 PMid:22329631 PMCid:PMC3626401.

  • 12.

    Rezaei A, Farzadfard A, Amirahmadi A, Alemi M, Khademi MJ. Diabetes mellitus and its management with medicinal plants: A perspective based on Iranian research. J Ethnopharmacol 2015; 175: 567-616. https://doi.org/10.1016/j.jep.2015.08.010 PMid:26283471.

  • 13.

    Bai Y, Zang X, Ma J, Xu GJ. Anti-diabetic effect of Portulaca oleracea L. Polysaccharideandits mechanism in diabetic rats. Int J Mol Sci 2016; 17: 1201. https://doi.org/10.3390/ijms17081201 PMid:27463713 PMCid:PMC5000599.

  • 14.

    Zhao R1 ZT, Zhao H, Cai Y. Effects of portulaca oleracea L. Polysaccharides on phenotypic and functional maturation of murine bone marrow derived dendritic cells. Nutr Cancer 201; 67: 986-993. https://doi.org/10.1080/01635581.2015.1060352 PMid:26219397.

  • 15.

    Movahedian Ataar A, Eshraghi A, Asgari S, Naderi G, Badiee A. Antioxidant Effect of Ziziphus vulgaris, Portulaca oleracea, Berberis integerima and gundelia tournefortti on lipid peroxidation, Hb glycosylation and Red Blood Cell Hemolysis. Journal of Medicinal Plants. 2011;10(40):80-8.

  • 16.

    Niharika S, Sukumar D. Hypolipidemic effect of purslane (Portulaca oleracea L.) in rats fed on high cholesterol diet. J Nutr Food Sci 2016; 6: 1-8.

  • 17.

    Qiao JY, Li HW, Liu FG, Li YC, Tian S, Cao LH, Hu K, Wu XX, Miao MS. Effects of portulaca oleracea extract on acute alcoholic liver injury of rats. Molecules 2019; 24: 2887. https://doi.org/10.3390/molecules24162887 PMid:31398934 PMCid:PMC6720614.

  • 18.

    Hadi A, Pourmasoumi M, Najafgholizadeh A, Kafeshani M, Sahebkar A. Effect of purslane on blood lipids and glucose: A systematic review and metaanalysis of randomized controlled trials. Phytother Res 2019; 33: 3-12. https://doi.org/10.1002/ptr.6203 PMid:30281177.

  • 19.

    Gheflati A, Adelnia E, Nadjarzadeh AJ. The clinical effects of purslane (Portulaca oleracea) seeds on metabolic profiles in patients with nonalcoholic fatty liver disease: A randomized controlled clinical trial. Phytother Res 2019; 33: 1501-1509. https://doi.org/10.1002/ptr.6342 PMid:30895694.

  • 20.

    Esmaillzadeh A, Zakizadeh E, Faghihimani E, Gohari M, Jazayeri S. The effect of purslane seeds on glycemic status and lipid profiles of persons with type 2 diabetes: A randomized controlled cross-over clinical trial. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences 2015; 20: 47. (Persian).

  • 21.

    Wainstein J, Landau Z, Dayan YB, Jakubowicz D, Grothe T, Perrinjaquet-Moccetti T, Boaz M. Purslane extract and glucose homeostasis in adults with type 2 diabetes: A double-blind, placebo-controlled clinical trial of efficacy and safety. J Med Food 2016; 19: 133-140. https://doi.org/10.1089/jmf.2015.0090 PMid:26854844.

  • 22.

    Guyot JP. Cerealbased fermented foods in developing countries: ancient foods for modern research. Int J Food Sci Technol 2012; 47: 1109-1114. https://doi.org/10.1111/j.1365-2621.2012.02969.x.

  • 23.

    Hussain S, Anjum F, Alamri M. Fortification of pan bread with healthy flaxseed. Aust J Basic Appl Sci 2011; 5: e983.

  • 24.

    Kaur A, Ramneet K, Suresh B. Baking and sensory quality of flaxseed meal cookies prepared from refined wheat flour (maida) and whole wheat flour (atta). Agricultural Research Journal. 2019;56(2):295-307. https://doi.org/10.5958/2395-146X.2019.00046.2.

  • 25.

    Bhardwaj K, Verma N, Trivedi R, Bhardwaj S. Flaxseed oil and diabetes: a systemic review. J Med Sci 2015; 15: 135.##https://doi.org/10.3923/jms.2015.135.138.

  • 26.

    Geberemeskel GA, Debebe YG, Nguse NA. Antidiabetic effect of fenugreek seed powder solution (Trigonella foenum-graecum L.) on hyperlipidemia in diabetic patients. J Diabet Res 2019; 2019. https://doi.org/10.1155/2019/8507453 PMid:31583253 MCid:PMC6748210.

  • 27.

    Maktouf S, Jeddou KB, Moulis C, Hajji H, Remaud-Simeon M, Ellouz-Ghorbel R. Evaluation of dough rheological properties and bread texture of pearl millet-wheat flour mix. J Food Sci Technol 2016; 53: 2061-2066. https://doi.org/10.1007/s13197-015-2065-z PMid:27413235 PMCid:PMC4926890.

  • 28.

    Mastud S, Mote G, Sahoo A. Development of value added products by using purslane (Portulaca oleracea). J Pharmac Phytochem 2018; 7: 1761.

  • 29.

    Lai H, Lin T. Bakery products: science and technology. Bakery products: Sci Technol 2006; 3-65. https://doi.org/10.1002/9780470277553.ch1.

  • 30.

    Dewettinck K, Van Bockstaele F, Khne B, Van de Walle D, Courtens T, Gellynck X. Nutritional value of bread: Influence of processing, food interaction and consumer perception. J Cereal Sci 2008; 48: 243-257. https://doi.org/10.1016/j.jcs.2008.01.003.

  • 31.

    Ishida PMG, Steel CJ. Physicochemical and sensory characteristics of pan bread samples available in the Brazilian market. Food Sci Technol 2014; 34: 746-754. https://doi.org/10.1590/1678-457X.6453.

  • 32.

    Sabzghabaee AM, Kelishadi R, Jelokhanian H, Asgary S, Ghannadi A, Badri S. Clinical effects of portulaca oleracea seeds on dyslipidemia in obese adolescents: a triple-blinded randomized controlled trial. Med Arch 2014; 68: 195. https://doi.org/10.5455/medarh.2014.68.195-199 https://doi.org/10.5455/medarh.2014.68.308-312.

  • 33.

    Dhole J, Dhole N, Lone K, Bodke S, Dhole JJ. Preliminary phytochemical analysis and antimicrobial activity of some weeds collected from Marathwada region. J Res Biol 2011; 1: 19-23.

  • 34.

    Ghanbari M, Farmani J. Influence of hydrocolloids on dough properties and quality of barbari: an Iranian leavened flat bread. J Agricul Sci Technol 2013; 15: 545-555.

  • 35.

    Delvarianzadeh M, Nouri L, Nafchi AM, Ebrahimi HJ. Physicochemical, rheological, and sensory evaluation of voluminous breads enriched by purslane (Portulaca oleracea L.). Italian J Food Sci 2020; 32.

  • 36.

    Huang D, Ou B, Prior RL. The chemistry behind antioxidant capacity assays. J Agricul Food Chem 2005; 53: 1841-56. https://doi.org/10.1021/jf030723c PMid:15769103.

  • 37.

    Prior RL, Wu X, Schaich K. Standardized methods for the determination of antioxidant capacity and phenolics in foods and dietary supplements. J Agricul Food Chem 2005; 53: 4290-4302. https://doi.org/10.1021/jf0502698 PMid:15884874.

  • 38.

    Rao B, Soufir J, Martin M, David GJ. Lipid peroxidation in human spermatozoa as relatd to midpiece abnormalities and motility. Gamete Res 1989; 24: 127-134. https://doi.org/10.1002/mrd.1120240202 PMid:2793053.

  • 39.

    Mirmiran P, Esfahani FH, Mehrabi Y, Hedayati M, Azizi FJ. Reliability and relative validity of an FFQ for nutrients in the Tehran lipid and glucose study. Public Health Nutr 2010; 13: 654-662. https://doi.org/10.1017/S1368980009991698 PMid:19807937.

  • 40.

    Delvarianzadeh M, Nouri L, Nafchi AM, Ebrahimi H, Khosravi A. Is the Staple Food Consumed Changes in Diabetics Can Affect the Quality of Life? A Parallel Randomized Controlled Trial. International Journal of Health Studies. 2020;6 (4):9-15.

  • 41.

    Rafie R, Hosseini SA, Hajiani E, Malehi AS, Mard SA. Effect of ginger powder supplementation in patients with non-alcoholic fatty liver disease: A randomized clinical trial. Clinical and experimental gastroenterology. 2020;13: 35.

  • 42.

    Fukumitsu S, Aida K, Shimizu H, Toyoda KJ. Flaxseed lignan lowers blood cholesterol and decreases liver disease risk factors in moderately hypercholesterolemic men. Nutr Res 2010; 30: 441-446. https://doi.org/10.1016/j.nutres.2010.06.004 PMid:20797475.

  • 43.

    Yari Z, Rahimlou M, Eslamparast T, Ebrahimi-Daryani N, Poustchi H, Hekmatdoost AJ. Flaxseed supplementation in non-alcoholic fatty liver disease: a pilot randomized, open labeled, controlled study. 2016; 67: 461-469. (Persian). https://doi.org/10.3109/09637486.2016.1161011 PMid:26983396.

  • 44.

    El-Sayed M-IK. Effects of Portulaca oleracea L. seeds in treatment of type-2 diabetes mellitus patients as adjunctive and alternative therapy. J Ethnopharmacology 2011; 137: 643-651. https://doi.org/10.1016/j.jep.2011.06.020 PMid:21718775.

  • 45.

    Zarei A, Ashtiyani SC, Taheri S. The effect of the extract of portulaca oleracea on physiological. Qom Univ Med Sci J 2015; 8. (Persian).

  • 46.

    Adelnia Najafabadi E, Dehghani A, Behradmanesh S, Najarzadeh AJ. The effect of purslane seeds on fasting blood glucose and serum liver enzymes in patients with nonalcoholic fatty livers. Iran J Diabet Obest 2015; 7: 163-171.

  • 47.

    Dkhil MA, Moniem AE, Al-Quraishy S, Saleh RA. Antioxidant effect of purslane (Portulaca oleracea) and its mechanism of action. J Med Plants Res 2011; 5: 1589-1593.

  • 48.

    Andr P, Balkau B, Born C, Royer B, Wilpart E, Charles MA, et al. Hepatic markers and development of type 2 diabetes in middle aged men and women: a three-year follow-up study: the DESIR Study (Data from an Epidemiological Study on the Insulin Resistance syndrome). Diabetes Metab 2005; 31: 542-550. https://doi.org/10.1016/S1262-3636(07)70229-X.

  • 49.

    Nakanishi N, Suzuki K, Tatara K. Serum -glutamyltransferase and risk of metabolic syndrome and type 2 diabetes in middle-aged Japanese men. Diabetes Care 2004; 27: 1427-1432. https://doi.org/10.2337/diacare.27.6.1427 PMid:15161799.

  • 50.

    Jump DB. N-3 polyunsaturated fatty acid regulation of hepatic gene transcription. Curr Opin Lipidol 2008; 19: 242. https://doi.org/10.1097/MOL.0b013e3282ffaf6a PMid:18460914 PMCid:PMC2764370.

  • 51.

    Vozarova B, Stefan N, Lindsay RS, Saremi A, Pratley RE, Bogardus C, Tataranni PA. High alanine aminotransferase is associated with decreased hepatic insulin sensitivity and predicts the development of type 2 diabetes. Diabetes 2002; 51: 1889-1895. https://doi.org/10.2337/diabetes.51.6.1889 https://doi.org/10.2337/diabetes.51.2.455.

  • 52.

    Hu Q, Niu Q, Song H, Wei S, Wang S, Yao L, Li YP. Polysaccharides from Portulaca oleracea L. regulated insulin secretion in INS-1 cells through voltage-gated Na+ channel. Biomed Pharmacother 2019; 109: 876-85. https://doi.org/10.1016/j.biopha.2018.10.113 PMid:30551541.

  • 53.

    MacDonald PE. Signal integration at the level of ion channel and exocytotic function in pancreatic -cells. Am J Physiol Endocrinol Metab 2011; 301: E1065-E1069. https://doi.org/10.1152/ajpendo.00426.2011 PMid:21934040.

  • 54.

    Ghorbanian B, Saberi Y, Azali Alamdari K, Shokrollahi F, Mohammadi H. The effects of portulaca supplementation on antioxidant biomarkers and oxidative stress in non-active girls. J Medicin Plants 2019; 18: 255-263. https://doi.org/10.29252/jmp.4.72.255.

  • 55.

    Zakizadeh E, Faghihimani E, Saneei P, Esmaillzadeh A. The effect of purslane seeds on biomarkers of oxidative stress in diabetic patients: A randomized controlled cross-over clinical trial. Int J Prevent Med 2015; 6. https://doi.org/10.4103/2008-7802.166505 PMid:26605016 PMCid:PMC4629294.

  • 56.

    Gatreh-Samani K, Farrokhi E, Khalili B, Rafieian M, Moradi M. Purslane (Portulaca oleracea) effects on serum paraoxanase-1 activity. J Shahrekord Univ Med Sci 2011; 13: 9-14. (Persian).

  • 57.

    Lee AS, Lee YJ, Lee SM, Yoon JJ, Kim JS, Kang DG, Lee HS. Portulaca oleracea ameliorates diabetic vascular inflammation and endothelial dysfunction in db/db mice. Evid Based Complement Alternat Med 2012; 2012: 741824. https://doi.org/10.1155/2012/741824 PMid:22474522 PMCid:PMC3303738.

  • 58.

    Oliveira I, Valento P, Lopes R, Andrade PB, Bento A, Pereira JA. Phytochemical characterization and radical scavenging activity of Portulaca oleraceae L. leaves and stems. Microchemical J 2009; 92: 129-134. https://doi.org/10.1016/j.microc.2009.02.006.

  • 59.

    Carrier A. Metabolic syndrome and oxidative stress: a complex relationship. Mary Ann Liebert, Inc. 140 Huguenot Street, 3rd Floor New Rochelle, NY 10801 USA; 2017.