The cholesterol-lowering effect of unripe Rubus coreanus is associated with decreased oxidized LDL and apolipoprotein B levels in subjects with borderline-high cholesterol levels: a randomized controlled trial

Jung Min Cho, Jisuk Chae, Sa Rang Jeong, Min Jung Moon, Ki-Chan Ha, Sunoh Kim, Jong Ho Lee, Jung Min Cho, Jisuk Chae, Sa Rang Jeong, Min Jung Moon, Ki-Chan Ha, Sunoh Kim, Jong Ho Lee

Abstract

Background: Rubus coreanus (R. coreanus) possesses properties that may decrease cholesterol levels.

Methods: The effects of unripe R. coreanus (uRC) consumption on low-density lipoprotein (LDL) and total cholesterol levels related to decreased circulating apolipoprotein (Apo) B and oxidized LDL levels were evaluated. This randomized, double-blind, placebo-controlled study included subjects with borderline-high cholesterol levels (between 200 and 239 mg/dL) who consumed one capsule daily containing 600 mg of freeze-dried uRC extract (n = 39) or the placebo (n = 38).

Results: After 12 weeks, the uRC group showed reductions of 21.23 ± 4.36 mg/dL in total cholesterol levels (P = 0.007) and 15.61 ± 4.16 mg/dL in LDL cholesterol levels (P = 0.032). In addition, significantly greater reductions in Apo B levels were observed in the uRC group (- 3.48 ± 3.40 mg/dL), but Apo B levels were increased in the placebo group (6.21 ± 2.84 mg/dL; P = 0.032). Furthermore, a remarkably lower oxidized LDL level was detected in the uRC group (57.76 ± 2.07 U/L) than in the placebo group (66.09 ± 3.47 U/L) after 12 weeks of consumption (P = 0.044).

Conclusions: Because of its cholesterol-lowering effect, uRC shows great promise as a therapeutic agent for subjects with borderline-high total blood cholesterol levels.

Trial registration: ClinicalTrials.gov Identifier: NCT03649620 (8/28/2018, retrospectively registered).

Keywords: Apolipoprotein B; Cholesterol-lowering; Low-density lipoprotein; Oxidized LDL; Rubus coreanus; Rubus coreanus Miquel; Unripe Rubus coreanus.

Conflict of interest statement

The author declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of participants
Fig. 2
Fig. 2
Comparison of the change values of total cholesterol, LDL-cholesterol, non-HDL-cholesterol and apolipoprotein B levels between the placebo (■) group and the uRC (□) group before and after supplementation of uRC. *P < 0.05 and **P < 0.01 derived from independent t-test. A two-tailed P-value of less than 0.05 was considered statistically significant. Δ (delta, change) values were calculated as the difference from the baseline (0-week). Data are presented as means Mean ± SE

References

    1. Frostegård J. Immunity, atherosclerosis and cardiovascular disease. BMC Med. 2013;11:117.
    1. Klop B, Elte JWF, Cabezas MC. Dyslipidemia in obesity: mechanisms and potential targets. Nutrients. 2013;5:1218–1240.
    1. Nelson RH. Hyperlipidemia as a risk factor for cardiovascular disease. Prim Care. 2013;40:195–211.
    1. Stone NJ, Robinson JG, Lichtenstein AH, Merz CNB, Blum CB, Eckel RH, Goldberg AC, Gordon D, Levy D, Lloyd-Jones DM. ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. J Am Coll Cardiol. 2013, 2014;(63):2889–934.
    1. Ray KK, Kastelein JJ, Matthijs Boekholdt S, Nicholls SJ, Khaw K-T, Ballantyne CM, Catapano AL, Reiner Ž, Lüscher TF. The ACC/AHA 2013 guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: the good the bad and the uncertain: a comparison with ESC/EAS guidelines for the management of dyslipidaemias 2011. Eur Heart J. 2014;35:960–968.
    1. Jacobson TA, Ito MK, Maki KC, Orringer CE, Bays HE, Jones PH, McKenney JM, Grundy SM, Gill EA, Wild RA. National Lipid Association recommendations for patient-centered management of dyslipidemia: part 1—full report. J Clin Lipidol. 2015;9:129–169.
    1. Grundy SM, Arai H, Barter P, Bersot TP, Betteridge DJ, Carmena R, Cuevas A, Davidson MH, Genest J, Kesäniemi YA. An international atherosclerosis society position paper: global recommendations for the management of dyslipidemia-full report. J Clin Lipidol. 2014;8:29–60.
    1. Steptoe A, Kivimäki M. Stress and cardiovascular disease: an update on current knowledge. Annu Rev Public Health. 2013;34:337–354.
    1. Levit RD, Reynolds HR, Hochman JS. Cardiovascular disease in young women: a population at risk. Cardiol Rev. 2011;19(2):60–5.
    1. Chapman MJ, Ginsberg HN, Amarenco P, Andreotti F, Borén J, Catapano AL, Descamps OS, Fisher E, Kovanen PT, Kuivenhoven JA. Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management. Eur Heart J. 2011;32:1345–1361.
    1. Khera AV, Cuchel M, de la Llera-Moya M, Rodrigues A, Burke MF, Jafri K, French BC, Phillips JA, Mucksavage ML, Wilensky RL. Cholesterol efflux capacity, high-density lipoprotein function, and atherosclerosis. N Engl J Med. 2011;364:127–135.
    1. Akbari-Fakhrabadi M, Heshmati J, Sepidarkish M, Shidfar F. Effect of sumac (Rhus coriaria) on blood lipids: A systematic review and meta-analysis. Complement Ther Med. 2018;40:8–12.
    1. Damavandi RD, Mousavi SN, Shidfar F, Mohammadi V, Rajab A, Hosseini S, Heshmati J. Effects of Daily Consumption of Cashews on Oxidative Stress and Atherogenic Indices in Patients with Type 2 Diabetes: A Randomized, Controlled-Feeding Trial. Int J Endocrinol Metab. 2019;17(1):e70744. 10.5812/ijem.70744.
    1. Morvaridzadeh M, Sepidarkish M, Farsi F, Akbari A, Mostafai R, Omidi A, Potter E, Heshmati J. Effect of Cashew Nut on Lipid Profile: A Systematic Review and Meta-Analysis. Complement Med Res. 2020:1–9.
    1. Brown L, Rosner B, Willett WW, Sacks FM. Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr. 1999;69:30–42.
    1. Pereira MA, O’Reilly E, Augustsson K, Fraser GE, Goldbourt U, Heitmann BL, Hallmans G, Knekt P, Liu S, Spiegelman D. Dietary fiber and risk of coronary heart disease: a pooled analysis of cohort studies. Arch Intern Med. 2004;164:370–6.
    1. Panahi Y, Kianpour P, Mohtashami R, Jafari R, Simental-Mendía LE, Sahebkar A. Curcumin lowers serum lipids and uric acid in subjects with nonalcoholic fatty liver disease: a randomized controlled trial. J Cardiovasc Pharmacol. 2016;68:223–9.
    1. Lee KH, Kim S. Comparison of ellagic acid contents in Korean and Chinese cultivated species of unripe black raspberries. Korean J Food Preserv. 2018;25:549–556.
    1. Wang SY, Lin H-S. Antioxidant activity in fruits and leaves of blackberry, raspberry, and strawberry varies with cultivar and developmental stage. J Agric Food Chem. 2000;48:140–146.
    1. Choi HR, Lee SJ, Lee J-H, Kwon JW, Lee HK, Jeong JT, Lee T-B. Cholesterol-lowering effects of unripe black raspberry water extract. J Korean Soc Food Sci Nutr. 2013;42:1899–1907.
    1. Lim JW, Hwang HJ, Shin CS. Polyphenol compounds and anti-inflammatory activities of Korean black raspberry (Rubus coreanus Miquel) wines produced from juice supplemented with pulp and seed. J Agric Food Chem. 2012;60:5121–5127.
    1. Wallerath T, Deckert G, Ternes T, Anderson H, Li H, Witte K, Förstermann U. Resveratrol, a polyphenolic phytoalexin present in red wine, enhances expression and activity of endothelial nitric oxide synthase. Circulation. 2002;106:1652–1658.
    1. Yang HM, Oh SM, Lim SS, Shin HK, Oh YS, Kim JK. Antiinflammatory activities of Rubus coreanus depend on the degree of fruit ripening. Phytother Res. 2008;22:102–107.
    1. Zhao C, Kim HK, Kim SZ, Chae HJ, Cui WS, Lee SW, Jeon JH, Park JK. What is the role of unripe Rubus coreanus extract on penile erection? Phytother Res. 2011;25:1046–1053.
    1. Myung HJ, Jeong HS, Hwang TY, Go KH, Kim J, Cho W, Choi YK, Park J, Hong SJ. Black raspberry improved lipid profiles and vascular endothelial function in patients with metabolic syndrome: a subgroup analysis of statin Naïve participants. J Lipid Atherosclerosis. 2016;5:49–59.
    1. Reiner Ž, Tedeschi-Reiner E, Romić Ž. Effects of rice policosanol on serum lipoproteins, homocysteine, fibrinogen and C-reactive protein in hypercholesterolaemic patients. Clin Drug Investig. 2005;25:701–7.
    1. National Cholesterol Education Program (US). Expert Panel on Detection, & Treatment of High Blood Cholesterol in Adults. Third report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) (No. 2). National Cholesterol Education Program, National Heart, Lung, and Blood Institute, National Institutes of Health; 2002.
    1. Functional Food Evaluation Guideline (Administration KFaD ed. pp. 1–54: Korea Food and Drug Administration; 2012:1–54.
    1. Kim J, Kim JY, Won HS, Kwon HJ, Kwon HY, Jeong HI, Kwon O. Human studies on functional foods: how they are regulated. Korean J Nutr. 2010;43:653–60.
    1. Mohanan P, Hurh J, Kim SO, Na J-R, Kim YJ, Lee HA, Kim MK, Yang DC. Chloroplast DNA-derived markers for the authentication of oriental medicinal Rubus species and mistaken identity of bokbunja in the local markets of Korea. Plant Biotechnol Rep. 2019;13:305–14.
    1. Jung M-A, Cho S-H, Lee SY, Kim JH, Kim Y-S, Oh K, Yoo G, Lee D-W, Kim S. Anti-obesity effects on unripe rubus coreanus miquel extract in high fat diet-induced obese mice. Int J Biochem Res Rev. 2015;5:20–26.
    1. Oh D-R, Kim Y, Choi E-J, Jung M-A, Bae D, Jo A, Kim YR, Kim S. Antiobesity effects of unripe Rubus coreanus Miquel and Its Constituents: An in vitro and in vivo characterization of the underlying mechanism. Evid-Based Complement Alter Med. 2016;2016.
    1. Jung M-A, Cho S-H, Lee SY, Kim JH, Oh K, Kim Y-S, Yoo G, Lee D-W, Kim S. Effects of unripe Rubus coreanus miquel extract on improvement of lipid metabolism in C57BL/6 mice fed a high-cholesterol diet. J Korean Soc Food Sci Nutr. 2014;43:650–655.
    1. Hoon K, Lee SK. Comparison of ellagic acid contents in Korean and Chinese cultivated species of unripe black raspberries. Korean J Food Preserv. 2018;25:8.
    1. O’Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P, Rangarajan S, Islam S, Pais P, McQueen MJ. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet. 2010;376:112–123.
    1. Heshmati J, Sepidarkish M, Namazi N, Shokri F, Yavari M, Fazelian S, Khorshidi M, Shidfar, F. Impact of Dietary Calcium Supplement on Circulating Lipoprotein Concentrations and Atherogenic Indices in Overweight and Obese Individuals: A Systematic Review. J Diet Suppl. 2019;16:357–67.
    1. Sepidarkish M, Morvaridzadeh M, Akbari-Fakhrabadi M, Almasi-Hashiani A, Rezaeinejad M, Heshmati JJD, Research MSC, Reviews: effect of omega-3 fatty acid plus vitamin E co-supplementation on lipid profile: a systematic review and meta-analysis. 2019.
    1. Yang X, Yang L, Zheng H. Hypolipidemic and antioxidant effects of mulberry (Morus alba L.) fruit in hyperlipidaemia rats. Food Chem Toxicol. 2010;48:2374–9.
    1. Duthie SJ, Jenkinson AM, Crozier A, Mullen W, Pirie L, Kyle J, Yap LS, Christen P, Duthie GG. The effects of cranberry juice consumption on antioxidant status and biomarkers relating to heart disease and cancer in healthy human volunteers. Eur J Nutr. 2006;45:113–22.
    1. Nemes-Nagy E, Szocs-Molnar T, Dunca I. Effect of a dietary supplement containing blueberry and sea buckthorn concentrate on antioxidant capacity in type I diabetic children. Altern Med Rev. 2009;14:86–7.
    1. Yu Y-M, Chang W-C, Wu C-H, Chiang S-Y. Reduction of oxidative stress and apoptosis in hyperlipidemic rabbits by ellagic acid. J Nutr Biochem. 2005;16:675–81.
    1. Alarcon De La Lastra C, Villegas I. Resveratrol as an anti-inflammatory and anti-aging agent: Mechanisms and clinical implications. Mol Nutr Food Res. 2005;49:405–30.
    1. Basu A, Wilkinson M, Penugonda K, Simmons B, Betts NM, Lyons TJ. Freeze-dried strawberry powder improves lipid profile and lipid peroxidation in women with metabolic syndrome: baseline and post intervention effects. Nutr J. 2009;8:43.
    1. Basu A, Fu DX, Wilkinson M, Simmons B, Wu M, Betts NM, Du M, Lyons TJ. Strawberries decrease atherosclerotic markers in subjects with metabolic syndrome. Nutr Res. 2010;30:462–9.
    1. Wu X, Kang J, Xie C, Burris R, Ferguson ME, Badger TM, Nagarajan S. Dietary blueberries attenuate atherosclerosis in apolipoprotein E-deficient mice by upregulating antioxidant enzyme expression. J Nutr. 2010;140:1628–32.
    1. Lee JE, Park E, Auh JH, Choi H-K, Lee J, Cho S, Kim JH. Effects of a Rubus coreanus Miquel supplement on plasma antioxidant capacity in healthy Korean men. Nutr Res Pract. 2011;5:429–34.
    1. Lee W-J, Ou H-C, Hsu W-C, Chou M-M, Tseng J-J, Hsu S-L, Tsai K-L, Sheu WH-H. Ellagic acid inhibits oxidized LDL-mediated LOX-1 expression, ROS generation, and inflammation in human endothelial cells. J Vasc Surg. 2010;52:1290–1300.
    1. Park S-H, Kim J-L, Lee E-S, Han S-Y, Gong J-H, Kang M-K, Kang Y-H. Dietary Ellagic acid attenuates oxidized LDL uptake and stimulates cholesterol efflux in murine macrophages–3. J Nutr. 2011;141:1931–1937.
    1. Kannan MM, Quine SD. Ellagic acid inhibits cardiac arrhythmias, hypertrophy and hyperlipidaemia during myocardial infarction in rats. Metabolism. 2013;62:52–61.
    1. Kwon J-W, Lee H-K, Park H-J, Kwon T-O, Choi H-R, Song J-Y. Screening of biological activities to different ethanol extracts of Rubus coreanus Miq. Korean J Med Crop Sci. 2011;19:325–333.
    1. Lee KH, Jeong E-S, Jang G, Na J-R, Park S, Kang WS, Kim E, Choi H, Kim JS, Kim SJN. Unripe Rubus coreanus Miquel extract containing Ellagic acid regulates AMPK, SREBP-2, HMGCR, and INSIG-1 signaling and cholesterol metabolism in vitro and. Vivo. 2020;12:610.
    1. Wang SY, Jiao H. Scavenging capacity of berry crops on superoxide radicals, hydrogen peroxide, hydroxyl radicals, and singlet oxygen. J Agric Food Chem. 2000;48:5677–5684.
    1. Seeram NP, Nair MG. Inhibition of lipid peroxidation and structure− activity-related studies of the dietary constituents anthocyanins, anthocyanidins, and catechins. J Agric Food Chem. 2002;50:5308–5312.
    1. Bhandary B, Lee G-H, So B-O, Kim S-Y, Kim M-G, Kwon J-W, Song J-Y, Lee H-K, Kim H-R, Chae S-W. Rubus coreanus inhibits oxidized-LDL uptake by macrophages through regulation of JNK activation. Am J Chin Med. 2012;40:967–978.
    1. Vivancos M, Moreno JJ. Effect of resveratrol, tyrosol and β-sitosterol on oxidised low-density lipoprotein-stimulated oxidative stress, arachidonic acid release and prostaglandin E 2 synthesis by RAW 264.7 macrophages. Br J Nutr. 2008;99:1199–1207.
    1. Ndiaye M, Chataigneau T, Andriantsitohaina R, Stoclet J-C, Schini-Kerth VB. Red wine polyphenols cause endothelium-dependent EDHF-mediated relaxations in porcine coronary arteries via a redox-sensitive mechanism. Biochem Biophys Res Commun. 2003;310:371–377.
    1. Stein JH, Keevil JG, Wiebe DA, Aeschlimann S, Folts JD. Purple grape juice improves endothelial function and reduces the susceptibility of LDL cholesterol to oxidation in patients with coronary artery disease. Circulation. 1999;100:1050–1055.
    1. Karim M, McCormick K, Kappagoda CT. Effects of cocoa extracts on endothelium-dependent relaxation. J Nutr. 2000;130:2105S–2108S.
    1. Basu A, Fu DX, Wilkinson M, Simmons B, Wu M, Betts NM, Du M, Lyons TJ. Strawberries decrease atherosclerotic markers in subjects with metabolic syndrome. Nutr Res. 2010;30:462–469.
    1. Li H, Xia N, Förstermann U. Cardiovascular effects and molecular targets of resveratrol. Nitric Oxide. 2012;26:102–110.
    1. Abe R, Beckett J, Nixon A, Rochier A, Yamashita N, Sumpio B. Olive oil polyphenol oleuropein inhibits smooth muscle cell proliferation. Eur J Vasc Endovasc Surg. 2011;41:814–820.
    1. De Gaetano G, De Curtis A, Di Castelnuovo A, Donati MB, Iacoviello L, Rotondo S. Antithrombotic effect of polyphenols in experimental models. Ann N Y Acad Sci. 2002;957:174–188.
    1. Nakanishi T, Mukai K, Yumoto H, Hirao K, Hosokawa Y, Matsuo T. Anti-inflammatory effect of catechin on cultured human dental pulp cells affected by bacteria-derived factors. Eur J Oral Sci. 2010;118:145–150.
    1. Benn M, Nordestgaard BG, Jensen GB, Tybjærg-Hansen A. Improving prediction of ischemic cardiovascular disease in the general population using apolipoprotein B: the Copenhagen City heart study. Arterioscler Thromb Vasc Biol. 2007;27:661–670.
    1. Jamkhande PG, Chandak PG, Dhawale SC, Barde SR, Tidke PS, Sakhare RS. Therapeutic approaches to drug targets in atherosclerosis. Saudi Pharmaceut J. 2014;22:179–190.
    1. Wilensky RL, Hamamdzic D. The molecular basis of vulnerable plaque: potential therapeutic role for immunomodulation. Curr Opin Cardiol. 2007;22:545–551.
    1. Ellis KL, Boffa MB, Sahebkar A, Koschinsky ML, Watts GFJPilr: The renaissance of lipoprotein (a): Brave new world for preventive cardiology? 2017, 68:57–82.
    1. Ferretti G, Bacchetti T, Johnston TP, Banach M, Pirro M, Sahebkar A. Lipoprotein (a): A missing culprit in the management of athero-thrombosis? J Cell Physiol. 2018;233:2966–81.
    1. Vessby B, Kostner G, Lithell H, Thomis J. Diverging effects of cholestyramine on apolipoprotein B and lipoprotein Lp (a): a dose-response study of the effects of cholestyramine in hypercholesterolaemia. Atherosclerosis. 1982;44:61–71.
    1. Armstrong V, Cremer P, Eberle E, Manke A, Schulze F, Wieland H, Kreuzer H, Seidel D. The association between serum Lp (a) concentrations and angiographically assessed coronary atherosclerosis: dependence on serum LDL levels. Atherosclerosis. 1986;62:249–57.
    1. Mellwig K-P, Schatton C, Biermann B, Kottmann T, Horstkotte D, Van Buuren F. Lipoprotein (a)–Einfluss auf die kardiovaskuläre Manifestation. Clin Res Cardiol Suppl. 2015;10:33–8.
    1. Nordestgaard BG, Chapman MJ, Ray K, Borén J, Andreotti F, Watts GF, Ginsberg H, Amarenco P, Catapano A, Fisher E. Lipoprotein (a) as a cardiovascular risk factor: current status. Eur Heart J. 2010;31:2844–53.
    1. Davidson MH, Ballantyne CM, Jacobson TA, Bittner VA, Braun LT, Brown AS, Brown WV, Cromwell WC, Goldberg RB, Remaley AT. Clinical utility of inflammatory markers and advanced lipoprotein testing: advice from an expert panel of lipid specialists. J Clin Lipidol. 2011;5:338–67.
    1. Pirro M, Bianconi V, Paciullo F, Mannarino MR, Bagaglia F, Sahebkar A. Lipoprotein (a) and inflammation: A dangerous duet leading to endothelial loss of integrity. Pharmacol Res. 2017;119:178–87.
    1. Albers JJ, Cabana VG, Warnick GR, Hazzard WR. Lp (a) lipoprotein: Relationship to sinking pre-β lipoprotein, hyperlipoproteinemia, and apolipoprotein B. Metabolism. 1975;24:1047–54.
    1. Duarte MM, Rocha JB, Moresco RN, Duarte T, Da Cruz IB, Loro VL, Schetinger, M. R. Association between ischemia-modified albumin, lipids and inflammation biomarkers in patients with hypercholesterolemia. Clin Biochem, 2009;42:666–71.

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