Flavonoids, Mucilage, and Ethanol Extracts of Medicinal Herbs Improve Overall Lipid Metabolism and Regulate Proper Enzyme Function on a Cellular Level in Humans

Research Article

Austin J Pharmacol Ther. 2019; 7(1).1113.

Flavonoids, Mucilage, and Ethanol Extracts of Medicinal Herbs Improve Overall Lipid Metabolism and Regulate Proper Enzyme Function on a Cellular Level in Humans

Murad S1*, Khokhar AQ2, Rahman IU3, Ghaffar A4, Shafique A5 and Moeen-ud-Din H6

1Professor of Pharmacology and Therapeutics at Dr. Akbar Niazi Teaching Hospital- IMDC, Islamabad, Pakistan

2AP Community Medicine at KIMS, Malir Cantt Karachi, Pakistan

3Urologist at DHQ Hospital, Dera Ismail Khan, Pakistan

4CWO at Community Medicine Department at DANTHIMDC Islamabad, Pakistan

5Consultant Pharmacist at MCC Pharmacy, Islamabad, Pakistan

6AP Anatomy at AIMC, Lahore, Pakistan

*Corresponding author: Shah Murad, Pharmacology Department of Akbar Niazi Teaching Hospital and IM&DC, affiliated with SZABMU, Islamabad, Pakistan

Received: June 14, 2019; Accepted: July 24, 2019; Published: July 31, 2019

Abstract

The cholesterol may is secreted by the liver whenever the requirement of cholesterol is needed by the body. Cholesterol is not present in the food, which is derived from the plants. We in this study have compared hypolipidemic effects of Fenugreek, Curcuma longa, and Lemon. Study was conducted at Jinnah Hospital Lahore-Pakistan from August to December 2018. Ninety hyperlipidemic patients of age group 19 to 70 were included in the study. Exclusion criteria were diabetic, alcoholic additives, hypertensive patients and those whose kidney or liver functions were impaired. Consent was taken from all participants. Their base line lipid profile was taken in biochemistry laboratory of the hospital. They were divided in three groups i.e. 30 patients in each group. Group-I was advised to take 500mg of Curcuma longa (haldi) mixed in fresh milk without cream, thrice daily for two months. Group-II patients were advised to take 100 grams of Fenugreek leaves mixed with salad in each meal (thrice daily) for the period of two months. Group-III patients were advised to take 40ml of fresh lemon juice mixed with 40ml mineral water thrice daily for two months. They all were advised not to take heavy meal rich with any type of fat like junk food etc. One-hour daily brisk walk was advised to all participants. 15 days follow up visit was scheduled for them. After two months, their lipid profile was re-determined. When results were compiled and statistically analyzed by applying paired ‘t’ test, it revealed that Curcuma longa decreased total cholesterol, TG, LDL cholesterol 16.10, 20.01, and 17.59 mg/dl respectively. Fenugreek decreased total cholesterol, TGs, and LDL cholesterol 14.70, 17.33, and 17.06 mg/dl respectively. Lemon in two months therapy decreased total cholesterol, TGs, and LDL cholesterol 15.45, 10.13, and 11.97 mg/dl respectively. None of the above-mentioned herbs raised HDL cholesterol significantly. It was concluded from this research work that Curcuma longa, Fenugreek leaves and Lemon are mild to moderately effective hypolipidemic herbs to lower total plasma cholesterol, triglycerides, and LDL cholesterol but have no potential to raise HDL cholesterol when analyzed bio statistically.

Keywords: Lemon; Methi; Haldi; Plants; Hyperlipidemia; CAD; Prevention; Cure

Introduction

Uptake of plasma Low Density Lipoprotein in liver is mediated via specific LDL receptors, but a scavenger receptor system is employed by macrophages. Plasma LDL must be modified prior to uptake by macrophages. Analysis of the lipid content in the oxidatively modified LDL from hyper lipidemic patients revealed that the level of lysophosphatidylcholine was greatly elevated, and the high level of the lysolipid was shown to impair the endotheliumdependent relaxation of the blood vessels [1-7]. In alllopathy blood, lipid levels are normalized by statins, fibrates, niacin and Bile Acid Binding Resins (BABRs). All of these allopathy related drugs have low compliance ranges from mild compliance due to metalic taste of BABRs to severe side effects like rhabdomyolysis by fibrates and statins [8]. Due to low compliance and adverse effects of conventionally used hypolipidemic agents, herbal medicines are going to be famous among Physicians, and Cardiologists [9]. Medicinal herbs like Curcuma Longa, Fenugreek, and Lemon contents are being used as mild to moderate hypolipidemic agents. Curcuma Longa commonly known as Haldi in India and Pakistan is used to lower plasma lipids, in view of their contents. It contains Curcuminoids (curcumin, demethoxycurcumin, and bisdemethoxycurcumin), turmerone, atlantone, zingiberene, proteins, and resins [10]. Curcumin reduces both the oxidation and circulation of oxidized levels of LDL cholesterol which leads to reduction in the occurrence or treatment of already present atherosclerosis in the subjects [11]. Research has revealed that curcumin from turmeric is an extremely efficient agent in increasing cholesterol uptake by the liver cells [12]. Several independent studies have shown that curcumin increases the expression of cholesterol and lipoprotein receptors on the liver cells [13]. Curcumin also increases cholesterol and bile acids excretion in feces [14]. Additionally, curcumin also increases the amount of ABC (ATP-binding cassette) transporters. These transporters are basically involved in flushing out excess cholesterol from the inside of the macrophages. When the numbers of ABC transporters are increased on the surface of a macrophage, the deposited cholesterol is effluxes out through these channels again into the blood. Through the blood, it reaches liver where it is metabolized efficiently [15]. The composition of fenugreek includes a large number of chemical components. They include proteins and amino acids, flavonoids, saponins and steroidal saponins, coumarin, lipids, vitamins, minerals, galactomannan fiber and alkaloids, such as trigonelline. Extracts are available standardized to contain 50 percent saponins or 20 percent of the amino acid 4-hydroxyisoleucine [16]. Treatment with fenugreek. Seed powder normalized the enhanced lipid peroxidation and increased susceptibility to oxidative stress associated with depletion of antioxidants [17]. The steroidal saponins (diosgenin, yamogenin, tigogenin and neotigogenin) are thought to inhibit cholesterol absorption and synthesis and hence its potential role in arteriosclerosis [18]. Phenolics in Curcuma Longa have potential health benefits mainly due to their antioxidant properties such as Reactive Oxygen Species (ROS) scavenging and inhibition, electrophile scavenging and metal chelation [19]. Epidemiological studies support a relationship between the consumption of phenolic rich food products and a low incidence of coronary heart disease, atherosclerosis, certain forms of cancer and stroke [20]. Lipid peroxidation is inhibited by flavonoids and flavanones present in Lemon [21].

Patients and Methods

Three main areas of medical research can be distinguished by study type: basic (experimental), clinical, and epidemiological research. Furthermore, clinical and epidemiological studies can be further sub-classified as either interventional or non-interventional. The research work was conducted at Jinnah Hospital, Lahore from August to December 2018 with approval of Research ethics committee of the Hospital.

Sample size: Ninety hyperlipidemic patients were selected for research work.

Consent: Written consent was taken from all patients. Specific Performa was designed for the research work. Hyperlipidemic patients were selected with age range from 19 to 70 years.

Exclusion criteria: Exclusion criteria were hypertension, hypothyroidism, diabetes mellitus, alcohol addictive patients, peptic ulcer, any gastrointestinal upset, renal impairment, and any hepatic or cardiac problem.

Grouping: All patients were divided in three groups (group-I, group-II, group-III), 30 patients in each group. Their baseline lipid profile data were taken and filed in specifically designed Performa, at start of taking medicine, like lipid profile, blood pressure and pulse rate.

Lipid profile: Serum lipid profile (total cholesterol, HDLcholesterol, triglyceride) parameters were determined after a 12 hour overnight fast by standard methods. LDL-cholesterol level was calculated according to the Friedewald’s formula. Thirty patients of group-I were advised to take 500mg of Curcuma longa (haldi) mixed in fresh milk without cream, thrice daily for two months. Group-II patients were advised to take 100 grams of Fenugreek leaves mixed with salad in each meal (thrice daily) for the period of two months. Group-III patients were advised to take 40ml of fresh lemon juice mixed with 40ml mineral water thrice daily for two months. They all were advised not to take heavy meal rich with any type of fat like junk food etc. One-hour daily brisk walk was advised to all participants. 15 days follow up visit was scheduled for them. After two months, their lipid profile was re-determined.

Statistical analysis: Mean values of the day-0 and day-60 of tested parameters (total cholesterol, LDL cholesterol, triglycerides, and HDL cholesterol) ± SD were taken to be analyzed statistically. SPSS 10 version 2.00.01.10 was used to analyze pretreatment and post treatment values of all parameters. Paired ‘t’ test was applied to determine changes in pre and post treatment values. P-value >0.05 was considered as non-significant changes in tested parameters, and p-values ‹0.01 were considered as significant changes. Paired t-test for mean difference from one group of samples. Paired sample t-test compares means where the two groups are correlated, such as data from the same participants before-and-after, or repeated measures, matched-pairs, or case-control studies.

Results

Hyperlipidemia is abnormally elevated levels of any or all lipids or lipoproteins in the blood. It is the most common form of dyslipidemia (which includes any abnormal lipid levels). When results were compiled and statistically analyzed by using SPSS 10 version 02.00.01.10, it revealed that curcuma longa decreased Triglycerides (TG), Total Cholesterol (TC), and LDL cholesterol of 29 hyperlipidemic patients 20.01, 16.10, and 17.59 mg/dl respectively. Raise in HDL cholesterol in this group was 03.70mg/dl. Fenugreek leaves reduced TG, TC, LDL cholesterol of 28 hyperlipidemic patients 17.33, 14.70, and 17.06 mg/dl respectively. Lemon juice reduced TC, TG, and LDL cholesterol 15.45, 10.13, and 11.97 mg/ dl respectively. HDL raised 03.55mg/dl in this group. Changes in all tested parameters, and their statistical significance are shown in following tables (Table 1-3).