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МРНТИ 76.31.29
УДК: 615.272.4:616.153.455-008.64
EFFECTS OF LADYFINGERS ON BLOOD LIPIDS AND BLOOD GLUCOSE AZMAT ALI1, SHAH MURAD2, HINA ASLAM2, KHALID NIAZ2
'Alnafees Medical College, Islamabad-Pakistan Islamabad Medical College, Islamabad-Pakistan
Azmat Ali, - AP, Pharmacology, Alnafees Medical College, Islamabad-Pakistan.
Shah Murad, - Professor of Pharmacology, Islamabad Medical College, Islamabad-Pakistan.
Tel: +923142243415. Email: shahhmurad65@gmail.com.
Hina Aslam, - AP, Pharmacology, Islamabad Medical College, Islamabad-Pakistan.
Khalid Niaz, - AP, Pharmacology, Islamabad Medical College, Islamabad-Pakistan.
Metabolic syndrome is cluster of pathological states, which start from hyperglycemia and hyperlipidemia, eventually cause obesity, hypertension, heart diseases and stroke. Hypolipidemic and hypoglycemic agents used in allopathy cause adverse effects, so researchers are trying to investigate on medicinal herbs to solve the problem. Abelmoschus esculentus or ladyfinger has hypolipidemic and hypoglycemic potential. In this study Bhindi or ladyfinger was used along with placebo to see exact potential of the herb to normalize increased blood glucose and lipids levels. The study was conducted in National hospital Lahore from June 2017 to October 2017. 60 patients suffering from diabetes mellitus and secondary hyperlipidemia were selected from medical OPD of the hospital and were divided in two groups. Group-I was on placebo and group-II was advised to take 200 grams raw ladyfinger in divided doses for three months. Baseline fasting blood sugar (FBS) and lipid profile was determined at day-0, day-30, day-60, and at the end of research period ie; day-90. For statistical analysis SPSS version 2010 was used. Paired 't' test was applied to see p-value of the tested parameters. It was observed that lady finger reduced blood LDL-cholesterol 26.04 mg/dl (p-value <0.001) and FBS 16.63 mg/dl (p-value <0.01). It was then concluded from the trial that ladyfinger has significant hypolipidemic and hypoglycemic potential and may be used in diabetic, and hyperlipidemic patients safely.
Keywords: ladyfinger, hypolipidemic and hypoglycemic potential, diabetes mellitus.
INTRODUCTION
Hyperglycemia and dyslipidemia, sedentary life, age, gender, smoking alcohol use can cause metabolic syndrome which ultimately do effect heath of vital organs of body like heart, liver, kidney and lungs. Because the syndrome is complicated, its cure is also complicated like that. Generally hypoglycemic, hypolipidemic drugs are used to solve symptoms. Apart from hypoglycemic and hypolipidemic allopathic medications, varous herbs have been used to prevent and cure of the disease2. Abelmoschus esculentus (lady finger or okra) is a non-leafy, green, fruit vegetable that is widely consumed in Pakistan and abroad. Popularly called bhindi in Pakistani households, this vegetable is tender, mucilaginous and dense in nutritional content. It can be eaten raw and cooked3. Bhindi helps control diabetes. Okra is packed with dietary fibre that helps stabilisation of blood sugar levels by regulation of the rate of absorption of sugar from the digestive tract. The anti-diabetic property of okra is also attributed to its ability of inhibition of enzymes metabolising carbohydrates, enhancement of production of insulin, regeneration of beta cell of the pancreas and increased secretion of insulin4. It prevents heart disease5. People are often affected with heart disease due to high
levels of cholesterol in their blood6. Pectin, a soluble fibre present in lady's finger helps lower this cholesterol and thus is helpful in preventing heart disease. Bhindi is also fairly rich in antioxidant compounds like polyphenols7. Polyphenol compounds, especially quercetin, helps prevent oxidation of cholesterol and blocking of arteries, preventing heart disease development8. Okra or ladyfinger is not the herb which normalize the blood glucose and fat in human body but these also decrease formation of foamy cells which ultimately deposit to walls of cardiac vessels leading to cause coronary artery disease9.
MATERIAL AND METHOD
The research study was placebo controlled, and was conducted at National hospital Lahore from June 2017 to October 2017. 60 patients suffering from diabetes mellitus type-II and secondary hyperlipidemia were selected from medical OPD of the hospital. Written consent was taken from all patients. This consent was already approved by ETHICS COMMITTEE of the hospital. These patients were divided in two groups. Group-I (n=30) was on placebo (capsules containing grinded wheat shell only) and group-II (n=30) was advised to take 200 grams raw ladyfinger in divided doses for three months. Baseline fasting blood sugar
TABLE: SHOWING PRE AND POST-TREATMENT VALUES IN DIABETES MELLITUS AND HYPERLIPIDEMIC PATIENTS WHO TOOK 200 GRAMS LADYFINGERS FOR 90 DAYS
Groups & Parameters At day-0 At day-90 Difference p-value
Placebo n=30
LDL-C 190.01±1.11 187.00±2.05 3.01 >0.05
FBS 151.17±2.98 147.76±1.98 3.41 >0.05
Lady finger n=27
LDL-C 209.13±2.22 183.09±1.58 26.04 <0.001
FBS 166.61±3.09 149.98±1.76 16.63 <0.01
KEY: All parameters and difference in pre and post treatment values are measured in mg/dl, LDL-C stands for low density lipoprotein cholesterol, FBS stands for fasting blood sugar, n= sample size, p-value >0.05 is non-significant, <0.01 is significant and p-value <0.001 is highly significant change in mentioned parameters.
(FBS) and lipid profile was determined at day-0, day-30, day-60, and at the end of research period ie; day-90. Serum LDL-cholesterol was calculated by Friedwald formula10 (LDL-Cholesterol = Total Cholesterol-(Triglycerides/5 +HDL-Cholesterol). Glucometer made by Roch pharma serial No: CE 0123 was used for estimation of FBS. For statistical analysis SPSS version 2010 was used. SD and ±SEM was determined from mean of the pre and post treatment values. Paired 't' test was applied to see p-value of the tested parameters. P-value >0.05 was considered as non significant change, <0.01 as significant and <0.001 as highly significant change in the tested parameter.
RESULTS
After three months it was observed that lady finger reduced blood LDL-cholesterol from 209.13±2.22 mg/dl to 183.09±1.58 mg/dl. Difference in pre and post treatment was 26.04 mg/dl (p-value <0.001). FBS in 27 diabetic patients suffering from DM type-II was reduced from 166.61±3.09 mg/dl to 149.98±1.76 mg/dl. Difference in pre and post treatment values was 16.63 mg/dl (p-value <0.01).
DISCUSSION
Sedentary life style, age, smoking, alcohol use, abuse of allopathic or medicinal herbs can cause metabolic syndrome. Hyperglycemia and hyperlipidemia are classical problems concerned with metabolic syndrome. Antidiabetic and hypolipidemic drugs have side effects so physicians are going to research on alternative therapies in these conditions. Medicinal herbs can work as allopathic agents in therapeutic discipline of medicine. Ladyfingers or Abelmoschus esculentus are one of those medicinal herbs. We tried to get hypolipidemic and hypoglycemic effects of ladyfingers as compared with placebo therapies. In our results 90 days tretment with use of 200 grams raw lady finger reduced LDL-cholesterol in 27 patients 26.04 mg/dl. In these patients fasting blood sugar reduced 16.63 mg/dl. These results match with results obtained in trial
conducted by Misghat TR et al11 who observed 30.89 mg/dl reduction in LDL cholesterol in 56 hyperlipidemic patients when they used 150 grams raw ladyfingers for two months. Fekuj RE et al12 proved 19.99 mg/dl decrease in total cholesterol when raw Bhindi (ladyfinger) was used in 18 hyperlipidemic patients for two months. Semnv D et al13, saw 18.14 mg/dl change in low density lipoprotein cholesterol in 33 hyperlipidemic patients. All of these results support our results. Soghaat RE et al14 stated that the herb reduces enterohepatic circulation of bile salts so VLDL are not synthesized, and so the LDL. Milkiyat RE et al15 mentioned the antioxident effects of ladyfingers. Polyphenolic compound like quercetin present in ladyfingers prevent oxidation of cholesterol. Tehj GH et al16 observed lesser hypolipidemic effects of ladyfingers as their results proved 16.98 mg/dl reduction in LDL-cholesterol in 19 hyperlipidemic patients. This contrast may be due to lesser amount of herb used as they used 100 grams raw ladyfinger in 25 hyperlipidemic patients for 75 days. Our results proved 16.63 mg/dl reduction in fasting blood glucose (FBS) level when lady finger was used by 27 diabetic patients suffering from diabetes mellitus type-II. These results match with results of study conducted by Wilker R et al17-20 who proved 18.76 mg/dl reduction in FBS level when this herb was used (150 grams per day for two months) by 56 patients suffering from diabetes mellitus type-II.Okra being rich in fibres helps to normalize the blood sugar; it absorbs the excessive glucose from blood and balances the level. Menrob QW et al21 mentioned other uses of ladyfingers like cystitis, leucorrhea, impotence. Quovis B et al22 proved that ladyfingers can reduce high blood glucose and lipid levels but these herbs do not cause hypoglycemia, so these can be used without any hypoglycemic danger like observed in allopathic agents. The only demerit of ladyfingers they warned about is acidity.
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ТYЙIН
ABELMOSCHUS ESCULENTUS-тыц ГИПОЛИПИДЕМИЯЛЬЩ ЖЭНЕ ГИПОГЛИКЕМИЯЛЬЩ ЭСЕРЛЕР1
AZMAT ALI1, SHAH MURAD2, HINA ASLAM2, KHALID NIAZ2
1Alnafees медицинский колледж^ Исламабад, Пэкiстан 2Исламабад медицина колледж^ Исламабад, Пэкiстан
Азмат Али - доцент, Фармакология, Alnafees медицинский колледж!, Исламабад-Пэкютан.
Шах Мурад - фармакология профессоры, Исламабад медицина колледж^ Исламабад-Пэкiстан, тeл: +923i422434i5, е-mail: shahhmurad65@gmail.com;
Хина Аслам - доцент, Фармакология, Исламабад медицина колледж^ Исламабад-Пэкютан.
Халид Ниаз - доцент, Фармакология, Исламабад медицина колледж^ Исламабад-Пэкютан.
Метаболикалык синдром гипергликемиядан жэне гиперлипидемиядан басталып, нэтижесiнде семiрy, гипертония, жYрек аyрyлары мен инсyльтка экеп согатын патологиялык жагдайлар тобын камтиды. Аллопатия кезшде колданылатын гиполипидемиялык жэне гипогликемиялык дэрiлер жанама эсер бередi, сондыктан зерт-теyшiлер мэселенi шешy Yшiн дэршк швптердi зерттеyге тырысады. Abelmoschus esculentus немесе ladyfinger гиполипидемиялык жэне гипогликемиялык шамага ие. Б^л зерттеyде Bhindi немесе ladyfinger швптiн накты шамасын аныктаy жэне кандагы глюкозаньщ денгейi мен липидтер денгейiн калыпка келтiрy Yшiн плацебомен бiрге колданылды. Зерттеy Лахордын ^лттык аyрyханасында 2017 жылдыц маyсым-казан айлары аралыгында жYргiзiлдi. ОПД аyрyханасынын кант диабетiмен жэне ешншшк гиперлипидемиямен ауыратын 60 пациент тавдалып ек1 топка бвлiндi. I топ плацебода болса, ал II топка Ym ай бойына бвлгне дозада 200 грамнан шик1 дамфингер кабылдау ^сынылды. Аш карындагы кандагы канттыц базалык денгейiн (FBS) жэне липидл бейiнiн 0-кYнi, 30-кYнi, 60-^ш жэне зерттеyдiн соты кезенiнде, ягни 90-кYнi аныктады. Статистикалык талдаy Yrnrn SPSS 20i0 н^скасы колданылды. Тесттелетш параметрлердiн p-белгiсiн тексерy Yшiн «t» тестi колданылды. Ladyfinger-дiн кандагы ТТЛП-холестерин денгейiн 26,04 мг / дл ^-белла <0,00i) жэне FBS 16,63 мг/дл (p-бел-riri <0,0i) твмендеткеш аныкталды. Ladyfinger-дiн едэyiр гиполипидемиялык жэне гипогликемиялык шамасы бар жэне оны диабетi жэне гиперлипидемиясы бар пациенттерде каyiпсiз колданyFа болады.
Нег1зг1 свздер: ladyfinger, гиперлипидемия, гипогликемиялык шама, диабет.
РЕЗЮМЕ
ГИПОЛИПИДЕМИЧЕСКИЙ И ГИПОГЛИКЕМИЧЕСКИЙ ЭФФЕКТЫ
ABELMOSCHUS ESCULENTUS AZMAT ALI1, SHAH MURAD2, HINA ASLAM, KHALID NIAZ2
1Медицинский колледж Alnafees , Исламабад, Пакистан 2Исламабадский медицинский колледж, Исламабад, Пакистан
Азмат Али - доцент, Фармакология, Медицинский колледж Alnafees, Исламабад-Пакистан.
Шах Мурад - профессор фармакологии, Медицинский колледж Исламабада, Исламабад-Пакистан, тeл: +923142243415, е-mail: shahhmurad65@gmail.com;
Хина Аслам - доцент, Фармакология, Медицинский колледж Исламабада, Исламабад-Пакистан;
Халид Ниаз - доцент, Фармакология, Медицинский колледж Исламабада, Исламабад-Пакистан.
Метаболический синдром представляет собой группу патологических состояний, которые начинаются с гипергликемии и гиперлипидемии, в конечном итоге вызывают ожирение, гипертонию, сердечные заболевания и инсульт. Гиполипидемические и гипогликемические средства, использyемые при аллопатии, вызывают побочные эффекты, поэтому исследователи пытаются исследовать лекарственные травы, чтобы решить проблему. Abelmoschus esculentus или ladyfinger обладает гиполипидемическим и гипогликемическим потенциалом. В этом
исследовании Bhindi или ladyfinger использовались вместе с плацебо для выявления точного потенциала травы и нормализации уровеня глюкозы в крови и уровень липидов. Исследование проводилось в Национальной больнице Лахор с июня 2017 года по октябрь 2017 года. 60 пациентов, страдающих сахарным диабетом и вторичной гиперлипидемией, были отобраны из медицинского ОПД больницы и были разделены на две группы. Группа I была на плацебо, а группе II было рекомендовано принимать 200 граммов сырого дамфингера в разделенных дозах в течение трех месяцев. Базовый уровень сахара в крови натощак (FBS) и липидный профиль определяли в день-0, день-30, день-60 и в конце периода исследования, т.е. день-90. Для статистического анализа использовалась SPSS версия 2010. Для проверки p-значения тестируемых параметров применялся тест «t». Было отмечено, что ladyfinger уменьшали уровень ЛПНП-холестерина в крови 26,04 мг / дл (p-значение <0,001) и FBS 16,63 мг/дл (p-значение <0,01). У ladyfinger имеется значительный гиполипидемический и гипогликемический потенциал и он может безопасно использоваться у пациентов с диабетом и гиперлипидемией.
Ключевые слова: ladyfinger, гиперлипидемия, гипогликемический потенциал, диабет.
