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Endocrine, Metabolic & Immune Disorders - Drug Targets


ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

Clinical Trial

Effect of Capparis spinosa Extract on Metabolic Parameters in Patients with Type-2 Diabetes: A Randomized Controlled Trial

Author(s): Hamideh Vahid, Shokoufeh Bonakdaran, Zahra Mazloum Khorasani, Lida Jarahi, Hassan Rakhshandeh, Ahmad Ghorbani, Nazila Zarghi and Mahdi Yousefi*

Volume 19, Issue 1, 2019

Page: [100 - 107] Pages: 8

DOI: 10.2174/1871530318666180821131201

Price: $65


Background: Experimental studies have reported beneficial effects of Capparis spinosa L., a perennial shrub from the Capparidaceae family, on the glycemic status and serum lipids in diabetic animals.

Objective: The aim of the present randomized triple-blind placebo-controlled clinical trial was to investigate the safety and efficacy of C. spinosa oxymel on blood glucose, lipid profile, and other diagnostic indexes of metabolic syndrome in patients with poorly controlled type 2 diabetes.

Method: The C. spinosa oxymel was prepared by adding hydroalcoholic extract of C. spinosa fruit to simple oxymel (a mixture of grape vinegar and lactulose). Thirty diabetic patients with metabolic syndrome whose glycemic status was not controlled despite receiving full doses of oral hypoglycemic agents did not want to start insulin therapy and were randomly allocated to three groups to receive placebo, simple oxymel, or C. spinosa oxymel (10 mL/thrice daily for 3 months). All patients continued conventional therapy with hypolipidemic, antihyperlipidemic, and antihypertensive drugs during the study.

Results: C. spinosa oxymel significantly decreased the body weight and body mass index at the end of the study compared to the baseline. While the patients in the placebo and simple oxymel groups displayed further increase in the level of FBG or PPBG, administration of C. spinosa oxymel inhibited the progression of hyperglycemia. Nevertheless, there was not a significant difference between placebo and intervention groups regarding HbA1c at the end of the study. C. spinosa oxymel had no significant effect on the serum cholesterol but inhibited the progression of hypertriglyceridemia during the study. There were no significant changes in creatinine, microalbuminuria, AST, ALT, and ALP values following C. spinosa treatment, suggesting that it had no unwanted effects on kidney and liver function.

Conclusion: The results suggest that although C. spinosa oxymel cannot enhance the effects of hypoglycemic and hypolipidemic drugs, it can prevent further increase of blood glucose and triglycerides in patients with poorly controlled diabetes.

Keywords: Caper, Capparis spinosa, diabetes, metabolic syndrome, rutin, hyperglycemia.

Graphical Abstract
Chatterjee, S.; Khunti, K.; Davies, M.J. Type 2 diabetes. The Lancet, 2017, 389(10085), 2239-2251.
Gregg, E.W.; Williams, D.E.; Geiss, L. Changes in diabetes-related complications in the United States. N. Engl. J. Med., 2014, 371(3), 286.
Tzoulaki, I.; Molokhia, M.; Curcin, V.; Little, M.P.; Millett, C.J.; Ng, A.; Hughes, R.I.; Khunti, K.; Wilkins, M.R.; Majeed, A. Risk of cardiovascular disease and all cause mortality among patients with type 2 diabetes prescribed oral antidiabetes drugs: Retrospective cohort study using UK general practice research database. BMJ, 2009, 339, b4731.
Ghorbani, A. Phytotherapy for diabetic dyslipidemia: Evidence from clinical trials. Clin. Lipidol., 2013, 8(3), 311-319.
Ghorbani, A. Best herbs for managing diabetes: A review of clinical studies. Braz. J. Pharm. Sci., 2013, 49(3), 413-422.
Yu, L.; Yang, J.; Wang, X.; Jiang, B.; Sun, Y.; Ji, Y. Antioxidant and antitumor activities of Capparis spinosa L. And the related mechanisms. Oncol. Rep., 2017, 37(1), 357-367.
El Azhary, K.; Jouti, N.T.; El Khachibi, M.; Moutia, M.; Tabyaoui, I.; El Hou, A.; Achtak, H.; Nadifi, S.; Habti, N.; Badou, A. Anti-inflammatory potential of Capparis spinosa L. in vivo in mice through inhibition of cell infiltration and cytokine gene expression. BMC Complement. Altern. Med., 2017, 17(1), 81.
Arena, A.; Bisignano, G.; Pavone, B.; Tomaino, A.; Bonina, F.; Saija, A.; Cristani, M.; D’arrigo, M.; Trombetta, D. Antiviral and immunomodulatory effect of a lyophilized extract of Capparis spinosa L. buds. Phytother. Res., 2008, 22(3), 313-317.
Bilen, S.; Altunoglu, Y.C.; Ulu, F.; Biswas, G. Innate immune and growth promoting responses to caper (Capparis spinosa) extract in rainbow trout (Oncorhynchus mykiss). Fish Shellfish Immunol., 2016, 57, 206-212.
Oudah, S.K.; Al-Salih, R.M.; Gusar, S.H. Study the role of polyphenolic extract of Capparis spinosa l. leaves as a hypoglycemic agent. Int. J. Sci. Eng. Res., 2014, 5(5), 1561-1575.
Tlili, N.; Feriani, A.; Saadoui, E.; Nasri, N.; Khaldi, A. Capparis spinosa leaves extract: Source of bioantioxidants with nephroprotective and hepatoprotective effects. Biomed. Pharmacother., 2017, 87, 171-179.
Mohebali, N.; Shahzadeh Fazeli, S.A.; Ghafoori, H.; Farahmand, Z. MohammadKhani, E.; Vakhshiteh, F.; Ghamarian, A.; Farhangniya, M.; Sanati, M.H. Effect of flavonoids rich extract of Capparis spinosa on inflammatory involved genes in amyloid-beta peptide injected rat model of Alzheimer’s disease. Nutr. Neurosci., 2018, 21(2), 143-150.
Vahid, H.; Rakhshandeh, H.; Ghorbani, A. Antidiabetic properties of Capparis spinosa L. and its components. Biomed. Pharmacother., 2017, 92, 293-302.
Zargaran, A.; Zarshenas, M.; Mehdizadeh, A.; Mohagheghzadeh, A. Oxymel in medieval Persia. Pharm. Hist. (Lond.), 2012, 42(1), 11-13.
Ashok, P.K.; Saini, B. HPLC analysis and isolation of rutin from stem bark of Ginkgo biloba l. J. Pharmacogn. Phytochem., 2013, 2(4)
Huseini, H.F.; Hasani-Rnjbar, P.S.; Nayebi, N.; Heshmat, R.; Sigaroodi, F.K. M.; Ahvazi, B.A.; Alaei, S.; Kianbakht; Capparis spinosa, L.(Caper) fruit extract in treatment of type 2 diabetic patients: a randomized double-blind placebo-controlled clinical trial. Complement. Ther. Med., 2013, 21(5), 447-452.
Hosseini, A.; Shafiee-Nick, R.; Ghorbani, A. Pancreatic beta cell protection/regeneration with phytotherapy. Braz. J. Pharm. Sci., 2015, 51(1), 1-16.
Loizzo, M.R.; Bonesi, M.; Nabavi, S.M.; Sobarzo‐Sánchez, E.; Rastrelli, L.; Tundis, R. Hypoglycaemic effects of plants food constituents via inhibition of carbohydrate‐hydrolysing enzymes: From chemistry to future applications; Nat. Products Targeting Clin. Relevant Enzymes, 2017, pp. 135-161.
Sayem, A.S.M.; Arya, A.; Karimian, H.; Krishnasamy, N.; Ashok, A.H.; Hossain, C.F. Action of phytochemicals on insulin signaling pathways accelerating glucose transporter (glut4) protein translocation. Molecules (Basel, Switzerland), , 2018, 23(2)
Ghorbani, A. Mechanisms of antidiabetic effects of flavonoid rutin. Biomed. Pharmacother., 2017, 96, 305-312.
Viljoen, A.; Joshi, S.; Wierzbicki, A.S. Diabetic dyslipidemia and risk of cardiovascular disease. Textbook of Diabetes, 2017, 643-652.
Rahmani, R.; Mahmoodi, M.; Karimi, M.; Hoseini, F.; Heydari, R.; Salehi, M.; Yousefi, A. Effect of hydroalcoholic extract of Capparis spinosa fruit on blood sugar and lipid profile of diabetic and normal rats. Zahedan J. Res. Med. Sci., 2013, 15(11), 34-38.
Negahdarizadeh, M.; Mokhtari, M.; Malekzadeh, J.; Mohammadi, J. The effects of Capparis Spinosa hydroalcoholic extract on blood glucose and lipids serum in diabetic and normal male rats. Armaghane danesh, 2011, 16 (2) 181-190.
Nazari, P.; Ebrahimi, S.; Cheraqi, J.; Rangin, A. Comparison of Capparis spinosa l. seeds and morus alba l. leaves extracts with glibenclamide on blood glucose and lipids in diabetic rats. J. Babol Uni. Med. Sci., 2014, 16(12), 39-47.
Jalali, M.T.; Mohammadtaghvaei, N.; Larky, D.A. Investigating the effects of Capparis spinosa on hepatic gluconeogenesis and lipid content in streptozotocin-induced diabetic rats. Biomed. Pharmacother., 2016, 84, 1243-1248.
Kazemian, M.; Abad, M. reza Haeri, M.; Ebrahimi, M.; Heidari, R. Anti-diabetic effect of Capparis spinosa L. root extract in diabetic rats. Avicenna J. Phytomed., 2015, 5(4), 325-332.
Lemhadri, A.; Eddouks, M.; Sulpice, T.; Burcelin, R. Anti-hyperglycaemic and anti-obesity effects of Capparis spinosa and Chamaemelum nobile aqueous extracts in hfd mice. Am. J. Pharmacol. Toxicol., 2007, 2(3), 106-110.
Seo, K.I.; Lee, J.; Choi, R.Y.; Lee, H.I.; Lee, J.H.; Jeong, Y.K.; Kim, M-J.; Lee, M.K. Anti-obesity and anti-insulin resistance effects of tomato vinegar beverage in diet-induced obese mice. Food Funct., 2014, 5(7), 1579-1586.
Kondo, T.; Kishi, M.; Fushimi, T.; Ugajin, S.; Kaga, T. Vinegar intake reduces body weight, body fat mass, and serum triglyceride levels in obese Japanese subjects. Biosci. Biotechnol. Biochem., 2009, 73(8), 1837-1843.
Mitrou, P.; Petsiou, E.; Papakonstantinou, E.; Maratou, E.; Lambadiari, V.; Dimitriadis, P.; Spanoudi, F.; Raptis, S.A.; Dimitriadis, G. Vinegar consumption increases insulin-stimulated glucose uptake by the forearm muscle in humans with type 2 diabetes. J. Diabetes Res., 2015, 2015, 175204.
Kahraman, N.K.; Mesci, B.; Oguz, A.; Tamer, G.; Kahraman, C.; Sagun, G.; Kilic, D.C.; Akalin, A. The effect of vinegar on postprandial glycemia: Does the amount matter? Acta Endocrinol., 2011, 7(4), 1841-0987.
van Dijk, J.W.; Tummers, K.; Hamer, H.M.; van Loon, L.J. Vinegar co-ingestion does not improve oral glucose tolerance in patients with type 2 diabetes. J. Diabetes Complications, 2012, 26(5), 460-461.
Panetta, C.J.; Jonk, Y.C.; Shapiro, A.C. Prospective randomized clinical trial evaluating the impact of vinegar on lipids in non-diabetics. World J. Cardiovasc. Dis., 2013, 3(02), 191-196.
Derakhshandeh, R.S.M.; Heidari-Beni, M.; Feizi, A.; Askari, G.R.; Entezari, M.H. Effect of honey vinegar syrup on blood sugar and lipid profile in healthy subjects. Int. J. Prev. Med., 2014, 5(12), 1608-1615.
Liatis, S.; Grammatikou, S.; Poulia, K.A.; Perrea, D.; Makrilakis, K.; Diakoumopoulou, E.; Katsilambros, N. Vinegar reduces postprandial hyperglycaemia in patients with type II diabetes when added to a high, but not to a low, glycaemic index meal. Eur. J. Clin. Nutr., 2010, 64(7), 727-732.

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