Lycium barbarum Reduces Abdominal Fat and Improves Lipid Profile and Antioxidant Status in Patients with Metabolic Syndrome

Lycium barbarum Reduces Abdominal Fat and Improves Lipid Profile and Antioxidant Status in Patients with Metabolic Syndrome

Abstract
Natural antioxidants present in fruits have attracted considerable interest due to their presumed safety and potential nutritional value. Even though antioxidant activities of many fruits have been reported, the effects of phytochemicals of goji berry (GB) in patients with metabolic syndrome have not been investigated. In this study, we examined anthropometric and biochemical parameters in patients with metabolic syndrome after the consumption of GB. The patients were divided into two groups, control (C) and supplemented (S), and followed up for 45 days. Participants were individually instructed to carry out a healthy diet, but additionally, an inclusion of 14 g of the natural form of goji berry in the diet during 45 days for the S group was proposed. After 45 days of study, a significant reduction in transaminases as well as an improvement in lipid profile in the S group was observed. Likewise, a significant reduction in the waist circumference of the S group was observed when compared with that of the C group, and increased glutathione and catalase levels associated with a reduction of lipid peroxidation. These results suggest that this is an effective dietary supplement for the prevention of cardiovascular diseases in individuals with metabolic syndrome.

 Introduction
Metabolic syndrome (MS) consists of different risk factors for cardiovascular disease (CVD) and diabetes mellitus type 2 (DM2) , and it includes a cluster of metabolic abnormalities such as abdominal obesity, dyslipidemia, hyperglycemia, and hypertension, leading to an increase in the levels of oxidative stress, concomitantly reducing antioxidant defenses . It is one of the main clinical challenges in public health, being considered a group of risk factors for cardiovascular disease, due to the accumulation of abdominal fat and the increase in inflammatory mediators and oxidative stress .
 
Oxidative stress has been implicated in the development and progression of many diseases such as atherosclerosis, inflammation, cancer, neurodegenerative diseases, and diabetes . Redox homeostasis, being a metabolic equilibrium between reduction and oxidation, is important in maintaining normal metabolism by ensuring proper response from the cells to either endogenous or exogenous stimuli. Energy harvesting through cellular redox process releases by-products as reactive species: oxygen (ROS) and nitrogen (RNS). These reactive species are crucial for cell signaling. Overwhelming levels and dysregulation of the reactive species, however, disrupt the delicate balance . The shift towards the oxidized state leads to oxidative stress which can be defined as an imbalance between endogenous antioxidant defense mechanisms and the production of ROS, which at high levels can cause cell injury and damage through modifications of proteins, lipids, and DNA.
 
In order to reduce the deleterious effects of oxidative stress, several antioxidant protective networks and signaling pathways are operative in cells. The most important enzymatic antioxidant system is composed of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx), which protect the cells against damage caused by the radical superoxide and hydrogen peroxide. In addition to the enzymatic system, the cells have a nonenzymatic system, especially glutathione .
 
Previous studies have demonstrated a close relationship between the complications associated with MS and subcutaneous adipose tissue, as well as the characteristics of the visceral adipose tissue. When the adipocyte homeostasis is altered due to excessive calorie intake, sedentarism, or genetic variants, among others, several inflammatory adipose tissue-derived cytokines are released, such as interleukin 1 beta (IL-1β), interleukin 18 (IL-18), interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-α), as well as induction of mononuclear leukocytes (lymphocytes and monocytes). Such cytokines constitute a well-stablished link between insulin resistance and endothelial dysfunction, a precursor of atherosclerosis, another hallmark of MS.
 
Epidemiological studies have found that consumption of fruits and vegetables has attracted growing interest because of their significant role in reducing the risk of cardiovascular diseases and other chronic diseases . Several studies demonstrated that medicinal plants and fruits are a rich source of antioxidant compounds such as phenolics, flavonoids, quinones, vitamins, and alkaloids, which can decrease the incidence of oxidative stress and associated diseases . Recent studies have demonstrated the effects of polyphenolic compounds in improving clinical factors associated with MS. Epidemiological evidence shows that the consumption of food rich in polyphenolic compounds in Asian populations reduces cardiovascular risk factors. However, there are limited studies associating the consumption of polyphenolic compounds in western populations.
 
A negative correlation has been shown between MS and polyphenolic compound ingestion and vitamins A, C, and E . The addition of flavonoids on a diet could be an effective strategy for MS prevention with possible improvements in blood pressure, systemic inflammation, and oxidative stress .
 
Natural antioxidants that are presented in fruits have attracted considerable interest because of their presumed safety and potential nutritional and therapeutic value. The increased interest in natural antioxidants has led to the antioxidant evaluation of many species of fruits .
 
Among the fruits with the highest amount of antioxidant substances is the Lycium barbarum also named goji berry (GB). Lycium barbarum, a traditional Chinese medicine plant, is a small red fruit widely consumed in China due to its benefits to vision, kidney, liver, and diseases such as diabetes mellitus and obesity. It is considered the richest natural source of antioxidants vitamin C, flavonoids, and carotenoids especially zeaxanthin, quercetin, and rutin .
 
A number of preclinical studies and a few clinical studies on the pharmacological activities and possible mechanisms of GB have been reported in the literature. GB exhibits a wide array of therapeutic/medicinal effects on aging, fatigue, cancer, colitis, stroke, diabetes, Alzheimer's disease, hepatoprotection, immunomodulation, and glaucoma in different animal models .
 
Although the antioxidant benefits of GB have already been highlighted in several in vitro and in vivo studies, no previous study has shown the effect of GB supplementation in natura on MS patients. In this study, we hypothesize that the administration of GB in patients with MS could positively influence glucose homeostasis, lipid profile, hepatic markers, and biomarkers of inflammation and oxidative stress.

Author information
1  Programa de Pós Graduação em Biociências e Saúde, Universidade do Oeste de Santa Catarina (UNOESC), Joaçaba, SC, Brazil.
2  Curso de Medicina, Instituto de Ciências Exatas e Naturais (ICEN), Universidade Federal de Mato Grosso (UFMT), Rondonópolis, MT, Brazil.
3  Departamento de Análises Clínicas, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil.
4  Laboratório de Bioquimica Experimental, Universidade do Oeste de Santa Catarina (UNOESC), Joaçaba, SC, Brazil.

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