نوع مقاله : مقاله پژوهشی Released under CC BY-NC 4.0 license I Open Access I

نویسندگان

1 گروه فیزیولوژی ورزشی، دانشکدة علوم تربیتی و روانشناسی، دانشگاه محقق اردبیلی، اردبیل، ایران.

2 نویسنده مسؤول، گروه فیزیولوژی ورزشی، دانشکدة علوم تربیتی و روانشناسی، دانشگاه محقق اردبیلی، اردبیل، ایران.

3 گروه تربیت بدنی و علوم ورزشی، دانشکدة علوم انسانی، دانشگاه کاشان، کاشان، ایران.

4 گروه اطفال، دانشکدة پزشکی، بیمارستان بوعلی، دانشگاه علوم پزشکی اردبیل، اردبیل، ایران.

چکیده

مقدمه: شواهد زیادی مبنی بر اثر مکمل‌یاری عصارۀ شاتوت و تمرینات ورزشی بر شاخص‌های التهابی مؤثر در پاتوژنز دیابت در سالمندان وجود ندارد. هدف از تحقیق حاضر، بررسی اثر 8 هفته تمرینات ترکیبی (هوازی + مقاومتی) و مصرف عصارۀ برگ شاتوت بر سطوح سرمی لیپوکالین 2، اینترلوکین 1 بتا و شاخص‌های متابولیکی مرتبط با دیابت در بیماران سالمند مبتلا به دیابت نوع دو بود.
روش پژوهش: در این پژوهش نیمه‌تجربی و یک‌سوکور، 40 نفر از مردان سالمند با محدودۀ سنی 67.07±7.48 سال به‌صورت هدفمند به‌عنوان نمونه انتخاب شدند و به‌طور تصادفی، در پنج گروه مساوی (تمرین، مکمل، مکمل+تمرین، دارونما و کنترل)، قرار گرفتند. دوز روزانه 1000 میلی‌گرم (دو عدد کپسول 500 میلی‌گرمی) عصارۀ برگ شاتوت در 3 نوبت، به مدت 2 ماه استفاده شد. گروه‌ها به مدت 8 هفته و هر هفته 3 جلسه به مدت 90 دقیقه به تمرین پرداختند. متغیرهای مورد بررسی 24 ساعت پیش و 48 ساعت پس از دورۀ مداخلـه اندازه‌گیری شدند.
یافته‌ها: مقدار لیپوکالین 2، اینترلوکین 1 بتا و مقاومت به انسولین در پس‌آزمون گروه تمرین، تمرین+مکمل و مکمل نسبت به پیش‌آزمون کاهش معناداری داشت (P<0.05). در تغییرات بین‌گروهی، مقدار لیپوکالین 2، اینترلوکین 1 بتا و مقاومت به انسولین در گروه تمرین، تمرین+مکمل و مکمل نسبت به گروه دارونما و کنترل کاهش معناداری داشت (P<0.05).
نتیجه‌گیری: به‌نظر می‌رسد مصرف عصارۀ شاتوت می‌تواند تأثیرگذاری تمرین ورزشی را در کاهش نشانگرهای التهابی مؤثر در دیابت افزایش دهد و به‌همراه تمرین ترکیبی تأثیر هم‌افزایی داشته باشد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The Effect of Mulberry leaf Extract Supplementation and Combined Exercises on Lipocalin-2, Interleukin 1 beta Levels and Diabetes-Related Metabolic Parameters in Elderly Patients With Type 2 Diabetes

نویسندگان [English]

  • Mohammad Ebrahim Bahram 1
  • Roghayeh Afroundeh 2
  • MohammadJavad Pourvaghar 3
  • Farnaz Seify 1
  • Leila Katebi 4

1 Department of Sports Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.

2 Corresponding Author, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.

3 Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran.

4 Department of Pediatrics, School of Medicine Bu'ali Hospital, Ardabil University of Medical Sciences, Ardabil, Iran.

چکیده [English]

Introduction: There is not much evidence about the complementary effect of Mulberry extract and exercise on the inflammatory indicators that are effective in the pathogenesis of diabetes in the elderly. This study aimed to investigate the effect of 8 weeks of combined exercise (aerobic+ resistance) and consumption of Mulberry leaf extract on serum levels of lipocalin-2, interleukin-1 beta, and metabolic parameters related to diabetes in elderly patients with type 2 diabetes.
Methods: In this quasi-experimental and single-blind study, 40 elderly with an age range of 67.07±7.48 years were purposefully selected as a sample and randomly assigned into five equal groups (Exercise, Supplement, Supplement + Exercise, Placebo, and Control). A daily dose of 1000 mg (two 500 mg capsules) of Mulberry leaf extract was used three times weekly for two months. The groups practiced three 90 minutes sessions per week for eight weeks. The studied variables were measured 24 hours before and 48 hours after the intervention period.
Results: The levels of lipocalin-2, interleukin-1 beta, and insulin resistance in the post-test of Exercise, Supplement + Exercise, and Supplement groups were significantly reduced compared to the pre-test (P<0.05). In the inter-group changes, the level of lipocalin-2, interleukin-1 beta, and insulin resistance in the Exercise, Supplement + Exercise, and Supplement groups had a significant decrease compared to the Placebo and Control groups (P<0.05).
Conclusion: It seems that the consumption of Mulberry extract can increase the effectiveness of exercise in reducing the inflammatory markers effective in diabetes and have a synergistic effect along with combined exercise.

کلیدواژه‌ها [English]

  • Combined Exercises
  • Lipocalin 2
  • Interleukin 1 Beta
  • Mulberry Leaf Extract
  1. Stewart C, Rittweger J. Adaptive processes in skeletal muscle: molecular regulators and genetic influences. Journal of Musculoskeletal and Neuronal Interactions. 2006;6(1): 73.
  2. Ghalavand A, Shakerian S, Zakerkish M, Shahbazian H, Monazam Nejad A. The effect of resistance training on anthropometric characteristics and lipid profile in men with type 2 diabetes referred to Golestan Hospital. Jundishapur Scientific Medical Journal. 2017;13(6): 709-20.
  3. Al-Saeed AH, Constantino MI, Molyneaux L, D’Souza M, Limacher-Gisler F, Luo C, et al. An inverse relationship between age of type 2 diabetes onset and complication risk and mortality: the impact of youth-onset type 2 diabetes. Diabetes care. 2016;39(5):823-9.
  4. Ghasemi M, Hosseini H, Sabouhi F. The effect of peer group training on self-care of elderly with diabetes mellitus. Journal of Clinical Nursing and Midwifery. 2017;6(3): 33-43.
  5. Bahram ME, Afrondeh R, Pourvaghar MJ, Ghiyami Taklimi H, Hemmati S. The effect of resistance training on visfatin serum level, insulin resistance, glucose and some body composition indicators in obese teenagers. Physiology and management researches in sports, 2021; 14(1): 147-159.
  6. Belotto M, Magdalon J, Rodrigues HG, Vinolo MAR, Curi R, Pithon-Curi T, et al. Moderate exercise improves leucocyte function and decreases inflammation in diabetes. Clinical & Experimental Immunology. 2010;162(2):237-43.
  7. Esteve E, Ricart W, Fernández-Real JM. Adipocytokines and insulin resistance: the possible role of lipocalin-2, retinol binding protein-4, and adiponectin. Diabetes care. 2009;32(suppl 2):S362-S7.
  8. Kralisch S, Weise S, Sommer G, Lipfert J, Lossner U, Bluher M, et al. Interleukin-1ß induces the novel adipokine chemerin in adipocytes in vitro. Regulatory peptides. 2009;154(1-3):102-6.
  9. Stensvold D, Slørdahl SA, Wisløff U. Effect of exercise training on inflammation status among people with metabolic syndrome. Metabolic syndrome and related disorders. 2012;10(4):267-72.
  10. Yan Q-W, Yang Q, Mody N, Graham TE, Hsu C-H, Xu Z, et al. The adipokine lipocalin 2 is regulated by obesity and promotes insulin resistance. Diabetes. 2007;56(10):2533-40.
  11. Wang Y, Lam KS, Kraegen EW, Sweeney G, Zhang J, Tso AW, et al. Lipocalin-2 is an inflammatory marker closely associated with obesity, insulin resistance, and hyperglycemia in humans. Clinical chemistry. 2007;53(1):34-41.
  12. Sommer G, Weise S, Kralisch S, Lossner U, Bluher M, Stumvoll M, et al. Lipocalin‐2 is induced by interleukin‐1β in murine adipocytes in vitro. Journal of cellular biochemistry. 2009;106(1):103-8.
  13. Bijeh N, Abbasian S. The Effect of aerobic training and change in dietary pattern on IL-1β and insulin resistance in dexes in inactive obese subjects. Journal of Arak Medical Sciences University. 2013;16(76):1-10.
  14. Riyahi Malayeri S, Abdolhay S, Behdari R, Hoseini M. The combined effect of resveratrol supplement and endurance training on IL-10 and TNF-α in type 2 diabetic rats. Razi Journal of Medical Sciences. 2019;25(12):140-9.
  15. Kim JY, Chung HI, Jung K-O, Wee J-H, Kwon O. Chemical profiles and hypoglycemic activities of mulberry leaf extracts vary with ethanol concentration. Food Science and Biotechnology. 2013;22(5):1-5.
  16. Kimura T, Nakagawa K, Kubota H, Kojima Y, Goto Y, Yamagishi K, et al. Food-grade mulberry powder enriched with 1-deoxynojirimycin suppresses the elevation of postprandial blood glucose in humans. Journal of agricultural and food chemistry. 2007;55(14):5869-74.
  17. Tian S, Wang M, Liu C, Zhao H, Zhao B. Mulberry leaf reduces inflammation and insulin resistance in type 2 diabetic mice by TLRs and insulin Signalling pathway. BMC complementary and alternative medicine. 2019;19(1):1-12.
  18. Derdemezis CS, Kiortsis DN, Tsimihodimos V, Petraki MP, Vezyraki P, Elisaf MS, et al. Effect of plant polyphenols on adipokine secretion from human SGBS adipocytes. Biochemistry research international. 2011;2011.
  19. Dehghani K, Mogharnasi M, Sarir H, Malekaneh M. Changes in lipocalin-2 levels after resistance training (RT) and consumption of spirulina microalgae in overweight and obese men. KAUMS Journal (FEYZ). 2021; 25 (5) :1184-1193.
  20. Amini M, Abdi A, Abbassi Daloii A. Synergistic Effects of Aerobic Training and Momordica Charantia L. on Serum Lipocalins in Men with Type 2 Diabetes. Journal of Ardabil University of Medical Sciences. 2020;20(1):7-19.
  21. Hassani A, Ebrahimi M, Ramezanpoor M. The effect of eight period of aerobic exercise with nettle plant consumption on blood glucose index and insulin resistance in patients with type II diabeti. Journal of Knowledge & Health. 2016;10(4):57-64.
  22. Hosseini M, Shemshaki A, Saghebjoo M, Gharari Arefi R. Effect of aerobic training and Pistacia atlantica extract consumption on plasma levels of lipocalin-2 and insulin resistance index in Streptozotocin-induced diabetic rats. The Horizon of Medical Sciences. 2016;22(1):27-33.
  23. Hasanvand B, Soori R, Abbasian S, Rastegar M. The effect of three-week intensive interval training on lipocalin-2 and interleukin1-β in healthy and adult Rat hippocampus. Arak Medical University Journal (AMUJ). 2017;20(118):24-34.
  24. Mohammadi Domiyeh A, Khajehlandi A. The effects of 8 eight weeks resistance versus endurance training on lipocalin-2 level in non-athlete male students. Armaghane danesh. 2012;17(5):460-8.
  25. Mehrabani J, Damirchi A, Rahmaninia F. Effect of two aerobic exercise intensities on lipocalin-2, interleukin-1ß levels, and insulin resistance index in sedentary obese men. Sport Physiology. 2014;6(21):95-108.
  26. Hassani A, Ebrahimi M, Ramezanpoor MR. The effect of eight period of aerobic exercise with nettle plant consumption on blood glucose index and insulin resistance in patients with type II diabeti. Journal of Knowledge & Health 2016;10(4):57-64.
  27. Shemshaki A, Hosseini M, Saghebjoo M, Arefi R. The effect of 6 weeks of aerobic training on plasma levels of lipocalin-2, insulin and insulin resistance in streptozotocin-induced diabetic male rats. Sport Physiology & Management Investigations. 2016;8(1):51-61.
  28. Touvra A-M, Volaklis KA, Spassis AT, Zois CE, Douda HT, Kotsa K, et al. Combined strength and aerobic training increases transforming growth factor-β1 in patients with type 2 diabetes. Hormones. 2011;10(2):125-30.
  29. Shenoy S, Guglani R, Sandhu JS. Effectiveness of an aerobic walking program using heart rate monitor and pedometer on the parameters of diabetes control in Asian Indians with type 2 diabetes. Primary Care Diabetes. 2010;4(1):41-5.
  30. Seyedizadeh SH, Cheragh-Birjandi S, Hamedi Nia MR. The effects of combined exercise training (resistance-aerobic) on serum kinesin and physical function in type 2 diabetes patients with diabetic peripheral neuropathy (randomized controlled trials). Journal of diabetes research. 2020;2020.
  31. Riche DM, Riche KD, East HE, Barrett EK, May WL. Impact of mulberry leaf extract on type 2 diabetes (Mul-DM): a randomized, placebo-controlled pilot study. Complementary therapies in medicine. 2017;32:105-8.
  32. Aliniya N, Elmieh A, Fadaei Chafy MR. Interaction effect of combined exercise and supplementation with portulaca oleracea on liver enzymes in obese postmenopausal women with non-alcoholic fatty liver disease. Complementary Medicine Journal. 2020;10(1):68-79.
  33. Ghaffarpour M, Houshiar A, Kianfar H. Household of Scales Guide, Conversion coefficients and Percent of Edible food. Tehran, Publication of Agricultural Sciences. 2000;25:24-9.
  34. Jackson AS, Pollock ML. Generalized equations for predicting body density of men. British journal of nutrition. 1978;40(3):497-504.
  35. Li W, Zheng H, Bukuru J, De Kimpe N. Natural medicines used in the traditional Chinese medical system for therapy of diabetes mellitus. Journal of ethnopharmacology. 2004;92(1):1-21.
  36. Conde J, Otero M, Scotece M, Abella V, López V, Pino J, et al. E74‐like factor 3 and nuclear factor‐κB regulate lipocalin‐2 expression in chondrocytes. The Journal of physiology. 2016;594(21):6133-46.
  37. Lázaro I, Ferré R, Plana N, Aragonès G, Girona J, Merino J, et al. Lifestyle changes lower FABP4 plasma concentration in patients with cardiovascular risk. Revista Española de Cardiología (English Edition). 2012;65(2):152-7.
  38. Ghorbanian B, Esmaelzadeh D. Effect of progressive resistance training on serum lipocalin-2 and lipid profiles in in-active men. Iranian Journal of Endocrinology and Metabolism. 2017;18(5).
  39. Cowland JB, Sørensen OE, Sehested M, Borregaard N. Neutrophil gelatinase-associated lipocalin is up-regulated in human epithelial cells by IL-1β, but not by TNF-α. The Journal of Immunology. 2003;171(12):6630-9.
  40. Wrann CD, White JP, Salogiannnis J, Laznik-Bogoslavski D, Wu J, Ma D, et al. Exercise induces hippocampal BDNF through a PGC-1α/FNDC5 pathway. Cell metabolism. 2013;18(5):649-59.
  41. Polyzos SA, Kountouras J, Anastasilakis AD, Geladari EV, Mantzoros CS. Irisin in patients with nonalcoholic fatty liver disease. Metabolism. 2014;63(2):207-17.
  42. Choi K, Kim T, Yoo H, Lee K, Cho G, Hwang T, et al. Effect of exercise training on A‐FABP, lipocalin‐2 and RBP4 levels in obese women. Clinical endocrinology. 2009;70(4):569-74.
  43. Silva Jr SD, Zampieri TT, Ruggeri A, Ceroni A, Aragão DS, Fernandes FB, et al. Downregulation of the Vascular Renin-Angiotensin System by Aerobic Training–Focus on the Balance Between Vasoconstrictor and Vasodilator Axes–. Circulation Journal. 2015;79(6):1372-80.
  44. Goldhammer E, Tanchilevitch A, Maor I, Beniamini Y, Rosenschein U, Sagiv M. Exercise training modulates cytokines activity in coronary heart disease patients. International journal of cardiology. 2005;100(1):93-9.
  45. Lovatel GA, Elsner VR, Bertoldi K, Vanzella C, dos Santos Moysés F, Vizuete A, et al. Treadmill exercise induces age-related changes in aversive memory, neuroinflammatory and epigenetic processes in the rat hippocampus. Neurobiology of learning and memory. 2013;101:94-102.
  46. Petersen AMW, Pedersen BK. The anti-inflammatory effect of exercise. Journal of applied physiology. 2005;98(4):1154-62.
  47. Khatami SL, Abdi A, BARARI A. Protective effect of aerobic training along with garlic on lipocalin-2 and IL-1β in obese women with high blood pressure. 2020, 15(1): 25-34.
  48. Peternelj T-T, Coombes JS. Antioxidant supplementation during exercise training. Sports medicine. 2011;41(12):1043-69.
  49. Rani P, Unni KM, Karthikeyan J. Evaluation of antioxidant properties of berries. Indian journal of clinical biochemistry. 2004;19(2):103-10.
  50. Zhishen J, Mengcheng T, Jianming W. The determination of flavonoid contents in mulberry and their scavenging effects on superoxide radicals. Food chemistry. 1999;64(4):555-9.
  51. Tolouei Azar J, Shabkhiz F, Khalafi M. The effects of eight weeks of resistance training on serum levels IL-15, IL-6, TNF-α and insulin resistance in older type 2 diabetic men. Journal of Sport Biosciences. 2021;12(4):391-406.
  52. Ahmadizad S, Haghighi AH, Hamedinia MR. Effects of resistance versus endurance training on serum adiponectin and insulin resistance index. European journal of Endocrinology. 2007;157(5):625-32.
  53. Nikseresht H, Tadibi V, Behpoor N. The Effects of 8 Weeks of Aerobic and Resistance Exercises on Salusins Levels and Inflammatory Indices in Type 2 Diabetic Women. Sport Physiology. 2020;12(47):73-92.
  54. Zhu X, Zhou Y, Cai W, Sun H, Qiu L. Salusin-β mediates high glucose-induced endothelial injury via disruption of AMPK signaling pathway. Biochemical and Biophysical Research Communications. 2017;491(2):515-21.
  55. Miyazaki A, Sakashita N, Lee O, Takahashi K, Horiuchi S, Hakamata H, et al. Expression of ACAT-1 protein in human atherosclerotic lesions and cultured human monocytes-macrophages. Arteriosclerosis, thrombosis, and vascular biology. 1998;18(10):1568-74.
  56. Hori M, Miyazaki A, Tamagawa H, Satoh M, Furukawa K, Hakamata H, et al. Up-regulation of acyl-coenzyme A: cholesterol acyltransferase-1 by transforming growth factor-β1 during differentiation of human monocytes into macrophages. Biochemical and biophysical research communications. 2004;320(2):501-5.
  57. Kim YS, Nam JS, Yeo DW, Kim KR, Suh SH, Ahn CW. The effects of aerobic exercise training on serum osteocalcin, adipocytokines and insulin resistance on obese young males. Clinical endocrinology. 2015;82(5):686-94.
  58. Aryaeian N, Arablou T, Sharifi F, Hosseini A, Valizadeh M. Effect of ginger consumption on glycemic status, insulin resistance, and inflammatory markers in patients with type 2 diabetes mellitus. Iranian Journal of Nutrition Sciences & Food Technology. 2014;9(1):1-10.
  59. Zhang X, Zhang Y, Zhao D, Wu J, Zhao J, Jiao X, et al. Relationship between blood glucose fluctuation and macrovascular endothelial dysfunction in type 2 diabetic patients with coronary heart disease. Eur Rev Med Pharmacol Sci. 2014;18(23):3593-600.
  60. Feinman RD, Pogozelski WK, Astrup A, Bernstein RK, Fine EJ, Westman EC, et al. Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition. 2015;31(1):1-13.
  61. Budiman A, Sulastri A, Alfauziah T. Chemical compounds and pharmacological activity of Morus nigra as a potential product of drug: A review. Int Res J Pharm. 2018;9:76-81.
  62. Leiherer A, Mündlein A, Drexel H. Phytochemicals and their impact on adipose tissue inflammation and diabetes. Vascular pharmacology. 2013;58(1-2):3-20.
  63. Coskun O, Kanter M, Korkmaz A, Oter S. Quercetin, a flavonoid antioxidant, prevents and protects streptozotocin-induced oxidative stress and β-cell damage in rat pancreas. Pharmacological research. 2005;51(2):117-23.
  64. Poehlman ET, Dvorak RV, DeNino WF, Brochu M, Ades PA. Effects of resistance training and endurance training on insulin sensitivity in nonobese, young women: a controlled randomized trial. The Journal of Clinical Endocrinology & Metabolism. 2000;85(7):2463-8.
  65. Jan N, Fatima T, Qadri T, Gani G, Naseer B, Hussain SZ. Pharmacological effects & quality parameters of Morus species: A review. International Journal of Pharmaceutical Science and Research. 2018;3(2):01-4.