The effect of Spirulina platensis versus soybean on insulin resistance in HIV-infected patients: a randomized pilot study

Azabji-Kenfack Marcel, Loni G Ekali, Sobngwi Eugene, Onana E Arnold, Edie D Sandrine, Denis von der Weid, Emmanuel Gbaguidi, Jeanne Ngogang, Jean C Mbanya, Azabji-Kenfack Marcel, Loni G Ekali, Sobngwi Eugene, Onana E Arnold, Edie D Sandrine, Denis von der Weid, Emmanuel Gbaguidi, Jeanne Ngogang, Jean C Mbanya

Abstract

HIV-infected patients develop abnormalities of glucose metabolism due to the virus and antiretroviral drugs. Spirulina and soybean are nutritional supplements that are cheap, accessible in our community and affect glucose metabolism. We carried out a randomized study to assess the effect of Spirulina platensis versus soybean as a food supplement on HIV/HAART-associated insulin resistance (IR) in 33 insulin-resistant HIV-infected patients. The study lasted for two months at the National Obesity Centre of Cameroon. Insulin resistance was measured using the short insulin tolerance test. Physical activity and diet did not change over the study duration. On-treatment analysis was used to analyze data. The Mann-Whitney U test, the Students T test and the Chi square test were used as appropriate. Curve gradients were analyzed using ANCOVA. Seventeen subjects were randomized to spirulina and 16 to soybean. Each received 19 g of supplement daily. The follow up rate was 65% vs. 100% for spirulina and soybean groups, respectively, and both groups were comparable at baseline. After eight weeks, insulin sensitivity (IS) increased by 224.7% vs. 60% in the spirulina and soybean groups respectively (p < 0.001). One hundred per cent vs. 69% of subjects on spirulina versus soybean, respectively, improved their IS (p = 0.049) with a 1.45 (1.05-2.02) chance of improving insulin sensitivity on spirulina. This pilot study suggests that insulin sensitivity in HIV patients improves more when spirulina rather than soybean is used as a nutritional supplement.

Trial registration: ClinicalTrials.gov identifier NCT01141777.

Keywords: HAART; HIV; insulin resistance; soybean; spirulina.

Figures

Figure 1
Figure 1
Participant flow in the course of the study.
Figure 2
Figure 2
Insulin sensitivity at baseline compared between the two groups.
Figure 3
Figure 3
Insulin sensitivity compared between the two groups after eight weeks.
Figure 4
Figure 4
Variation of insulin sensitivity during the trial.
Figure 5
Figure 5
Improvement of insulin sensitivity by treatment group at the end of the trial.

References

    1. Nolan D. Metabolic complications associated with HIV protease inhibitor therapy. Drugs. 2003;63:2556–2574.
    1. Vigouroux C., Gharakhanian S., Salhi Y., Nguyen T.H., Adda N., Rozenbaum W., Capeau J. Adverse metabolic disorders during highly active antiretroviral treatments (HAART) of HIV disease. Diabetes Metab. 1999;25:383–392.
    1. Martinez E., Mocroft A., García-Viejo M.A., Pérez-Cuevas J.B., Blanco J.L., Mallolas J., Bianchi L., Conget I., Blanch J., Phillips A., Gatell J.M. Risk of lipodystrophy in HIV-1 patients treated with protease inhibitors: a prospective cohort study. Lancet. 2001;357:592–598.
    1. Carr A., Samaras K., Burton S., Freund J., Chisholm D.J., Cooper D.A. A syndrome of peripheral lipodystrophy and insulin resistance due to HIV protease inhibitors. Aids. 1998;12(Suppl.):F51–F58. doi: 10.1097/00002030-199807000-00003.
    1. Brown T.T., Cofrancesco J. Metabolic Abnormalities in HIV-infected Patients: An Update. Curr. Infect. Dis. Rep. 2006;8:497–504.
    1. Behrens G., Dejam A., Schmidt H., Balks H., Brabant G., Korner T., Stoll M., Schimdt R.E. Impaired glucose tolerance, beta cell function and lipid metabolism in HIV patients under treatment with protease inhibitors. Aids. 1999;13:F63–F70.
    1. Arendt B.M., Aghdassi E., Mohammed S.S., Fung L.Y., Jalali P., Salit I.E., Allard J.P. Dietary intake and physical activity in a Canadian population sample of male patients with HIV infection and metabolic abnormalities. Curr. HIV Res. 2008;6:82–90.
    1. Dube M. Defects of glucose metabolism in patients with human immunodeficiency virus. Clin. Infect. Dis. 2000;31:1467–1475.
    1. Laws A., Reavens G. Evidence for an independent relationship between insulin resistance and fasting plasma HDL-cholesterol, triglyceride and insulin concentrations. J. Intern. Med. 1992;231:25–30.
    1. Murata H., Hruz P.W., Mueckler M. The mechanism of insulin resistance caused by HIV protease inhibitor therapy. J. Biol. Chem. 2000;275:20251–20254.
    1. Jensen M.D., Miles J.M. The roles of diet and exercise in the management of patients with insulin-dependent diabetes mellitus. Mayo Clin. Proc. 1986;61:813–819.
    1. Paquot N. Diet and nutrition principles in type 2 diabetes. Rev. Med. Liege. 2005;60:391–394. (in French).
    1. Wolever T.M. Carbohydrate and the regulation of blood glucose and metabolism. Nutr. Rev. 2003;61:S40–S48.
    1. Malita F.M., Karelis A.D., Toma E., Rabasa-Lhoret R. Effects of different types of exercise on body composition and fat distribution in HIV-infected patients: a brief review. Can. J. Appl. Physiol. 2005;30:233–245.
    1. Hasler C. Functional foods: benefits, concerns and challenges—a position paper from the American Council on Science and Health. J. Nutr. 2002;132:3772–3781.
    1. Annapuna V., Shah N., Bhaskaram P. Bioavailability of Spirulina carotenes in pre-school children. J. Clin. Biochem. Nutr. 1991;10:145–151.
    1. Parikh P., Mani U., Iyer U. Role of Spirulina in the Control of Glycemia and Lipidemia in Type 2 Diabetes Mellitus. J. Med. Food. 2001;4:193–199.
    1. Torres-Duran P.V., Ferreira-Hermosillo A., Juarez-Oropeza M.A. Antihyperlipemic and antihypertensive effects of Spirulina maxima in an open sample of Mexican population: a preliminary report. Lipids Health Dis. 2007;6:33.
    1. Maranesi M., Barzanti V., Carenini G., Gentili P. Nutritional studies on Spirulina maxima. Acta Vitaminol. Enzymol. 1984;6:295–304.
    1. Oliva M.E., Chicco A.G., Lombardo Y.B. Soya protein reverses dyslipidaemia and the altered capacity of insulin-stimulated glucose utilization in the skeletal muscle of sucrose-rich diet-fed rats. Br. J. Nutr. 2009;102:60–68.
    1. Gobert C.P., Pipe E.A., Capes S.E., Darlington G.A., Lampe J.W., Duncan A.M. Soya protein does not affect glycaemic control in adults with type 2 diabetes. Br. J. Nutr. 2010;103:412–421.
    1. Chen S.W., Zhang H.M., Zhang L.S., Feng X.F. Effects of soy isoflavone on gene expression of resistin in insulin-resistance rats. Sichuan Da Xue Xue Bao Yi Xue Ban. 2006;37:717–720. (in Chinese).
    1. The Helsinki Declaration on human experimentation. [(accessed on 31 October 2009)]. Available online: .
    1. Chumlea W.C., Guo S.S., Kuczmarski R.J., Flegal K.M., Johnson C.L., Heymsfield S.B., Lukaski H.C., Friedl K. Body composition estimates from NHANES III bioelectric impedance data. Int. J. Obes. Relat. Metab. Disord. 2002;26:1596–1609.
    1. Lundbaek K. Intravenous glucose tolerance as a tool in definition and diagnosis of diabetes mellitus. Br. Med. J. 1962;5291:1507–1513.
    1. Sobngwi E., Effoe V., Boudou P., Njamen D., Gautier J.F., Mbanya J.C. Waist circumference does not predict circulating adiponectin levels in sub-Saharan women. Cardiovasc. Diabetol. 2007;6:31.
    1. Elise J.W. Statistics review 4: Sample size calculations. Crit. Care. 2002;6:335–341.
    1. Park H.J., Lee Y.J., Ryu H.K., Kim M.H., Chung H.W., Kim Y.W. A randomized double-blind, placebo-controlled study to establish the effects of spirulina in elderly Koreans. Ann. Nutr. MeTable. 2008;52:322–328.
    1. Sutinen J., Hakkinen A.M., Westerbacka J., Seppala-Lindroos A., Vehkavaara S., Halavaara J., Jarvinen A., Ristola M., Yki-Jarvinen H. Increased fat accumulation in the liver in HIV-infected patients with antiretroviral therapy-associated lipodystrophy. Aids. 2002;16:2183–2193.
    1. George P., Ludvik B. Lipids and diabetes. J. Clin. Basic Cardiol. 2000;3:159–162.
    1. Nordentoft I., Jeppesen P.B., Hong J., Abudula R., Hermansen K. Increased insulin sensitivity and changes in the expression profile of key insulin regulatory genes and beta cell transcription factors in diabetic KKAy-mice after feeding with a soy bean protein rich diet high in isoflavone content. J. Agric. Food Chem. 2008;56:4377–4385.
    1. Chen S.W., Zhang H.M., Zhang L.S., Feng X.F., Peng X. Effects of soy isoflavone on gene expression of adiponectin in insulin-resistance rats induced by high-fat and high-sugar diet. Wei Sheng Yan Jiu. 2006;35:46–49. (in Chinese).
    1. Nagasawa A., Fukui K., Funahashi T., Maeda N., Shimomura I., Kihara S., Waki M., Takamatsu K., Matsuzawa Y. Effects of soy protein diet on the expression of adipose genes and plasma adiponectin. Horm. Metab. Res. 2002;34:635–639.
    1. Iritani N., Sugimoto T., Fukuda H., Komiya M., Ikeda H. Dietary soybean protein increases insulin receptor gene expression in Wistar fatty rats when dietary polyunsaturated fatty acid level is low. J. Nutr. 1997;127:1077–1083.
    1. Feres N.H., Reis S.R., Veloso R.V., Arantes V.C., Souza L.M., Carneiro E.M., Boschero A.C., Reis M.A., Latorraca M.Q. Soybean diet alters the insulin-signaling pathway in the liver of rats recovering from early-life malnutrition. Nutrition. 2010;26:441–448.
    1. Tsai A.C., Mott E.L., Owen G.M., Bennick M.R., Lo G.S., Steinke F.S. Effects of soy polysaccharide on gastrointestinal function, nutrient balance, steroid excretion, glucose tolerance, serum lipids and other parameters in humans. Am. J. Clin. Nutr. 1983;38:504–511.
    1. Liu Z.M., Chen Y.M., Ho S.C., Ho Y.P., Woo J. Effects of soy protein and isoflavones on glycemic control and insulin sensitivity: a 6-month double-blind, randomized, placebo-controlled trial in postmenopausal Chinese women with prediabetes or untreated early diabetes. Am. J. Clin. Nutr. 2010;91:1394–1401. doi: 10.3945/ajcn.2009.28813.

Source: PubMed

Sponsorzy i współpracownicy

Warunki medyczne

Interwencje lekowe

3
Subskrybuj