The effect of barberry (Berberis integerrima) on lipid profile and systemic inflammation in subjects with cardiovascular risk factors: a randomized controlled trial

Hadi Emamat, Ali Zahedmehr, Sanaz Asadian, Javad Nasrollahzadeh, Hadi Emamat, Ali Zahedmehr, Sanaz Asadian, Javad Nasrollahzadeh

Abstract

Background: Despite significant advances in the management of cardiovascular disease (CVDs), there is still a large burden of CVD in the world. The inclusion of functional foods in the diet may provide beneficial effects on CVD. Purple-black barberry due to its richness in anthocyanins and berberine has shown beneficial effects on cardiometabolic factors. We investigated the effects of barberry on plasma lipids as well as inflammatory biomarkers in subjects with cardiovascular risk factors.

Methods: This was an 8-weeks, single-blinded, randomized controlled clinical trial that the participants were randomly assigned to a barberry (10 g/day dried barberry) or placebo group. At baseline and end of the study, plasma lipid profiles including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), small-dense LDL-C (sd-LDL-C), non-HDL-C, and TC/HDL-C, as well as inflammatory biomarkers including C-reactive protein (CRP) and interleukin-6 (IL-6), were determined. An intention-to-treat analysis was performed.

Results: Eighty-four participants were randomly assigned to study groups. The mean (± SD) participants' age was 54.06 ± 10.19 years. Body weight, body mass index (BMI), physical activity, and dietary intake were not different between the two groups at baseline and the end of the study. After adjusting for baseline values, we observed a significant decrease in plasma levels of TG, TC, LDL-C, sd-LDL-C, non-HDL-C, and TC/HDL-C (p < 0.001, p = 0.011, p = 0.015, p = 0.019, p = 0.004, and p = 0.039 respectively) as well as CRP (p = 0.020) in the barberry group compared to the placebo group.

Conclusions: Our results indicate that purple-black barberry consumption decreases plasma levels of CRP and improves lipid profile in subjects with cardiovascular risk factors.

Trial registration: This clinical trial was registered at ClinicalTrials.gov (NCT number: NCT04084847 ).

Keywords: Barberry; CVD; Inflammation; Lipid profile.

Conflict of interest statement

Not applicable.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
CONSORT flowchart

References

    1. Sattar N, Gill JMR, Alazawi W. Improving prevention strategies for cardiometabolic disease. Nat Med. 2020;26:320–325. doi: 10.1038/s41591-020-0786-7.
    1. Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Cheng S, Delling FN, et al. Heart Disease and Stroke Statistics—2021 Update. Circulation. 2021;143:e254–e743. doi: 10.1161/CIR.0000000000000950.
    1. Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, Abbasi-Kangevari M, Abbastabar H, Abd-Allah F, Abdelalim A. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020;396:1204–1222. doi: 10.1016/S0140-6736(20)30925-9.
    1. Dahlöf B. Cardiovascular Disease Risk Factors: Epidemiology and Risk Assessment. Am J Cardiol. 2010;105:3A–9A. doi: 10.1016/j.amjcard.2009.10.007.
    1. Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001;104:2746–2753. doi: 10.1161/hc4601.099487.
    1. Rajman I, Eacho PI, Chowienczyk PJ, Ritter JM. LDL particle size: an important drug target? Br J Clin Pharmacol. 1999;48:125–133. doi: 10.1046/j.1365-2125.1999.00991.x.
    1. Kablak-Ziembicka A, Przewlocki T, Sokołowski A, Tracz W, Podolec P. Carotid intima-media thickness, hs-CRP and TNF-α are independently associated with cardiovascular event risk in patients with atherosclerotic occlusive disease. Atherosclerosis. 2011;214:185–190. doi: 10.1016/j.atherosclerosis.2010.10.017.
    1. Brinks J, Fowler A, Franklin BA, Dulai J. Lifestyle Modification in Secondary Prevention: Beyond Pharmacotherapy. Am J Lifestyle Med. 2016;11:137–152. doi: 10.1177/1559827616651402.
    1. Sikand G, Kris-Etherton P, Boulos NM. Impact of functional foods on prevention of cardiovascular disease and diabetes. Curr Cardiol Rep. 2015;17:39. doi: 10.1007/s11886-015-0593-9.
    1. Luis A, Domingues F, Pereira L. Association between berries intake and cardiovascular diseases risk factors: a systematic review with meta-analysis and trial sequential analysis of randomized controlled trials. Food Funct. 2018;9:740–757. doi: 10.1039/C7FO01551H.
    1. Heneghan C, Kiely M, Lyons J, Lucey A. The Effect of Berry-Based Food Interventions on Markers of Cardiovascular and Metabolic Health: A Systematic Review of Randomized Controlled Trials. Mol Nutr Food Res. 2018;62.
    1. Maatta-Riihinen KR, Kamal-Eldin A, Mattila PH, Gonzalez-Paramas AM, Torronen AR. Distribution and contents of phenolic compounds in eighteen Scandinavian berry species. J Agric Food Chem. 2004;52:4477–4486. doi: 10.1021/jf049595y.
    1. Reis JF, Monteiro VV, de Souza GR. do Carmo MM, da Costa GV. Ribera PC, Monteiro MC: Action mechanism and cardiovascular effect of anthocyanins: a systematic review of animal and human studies. 2016;14:315.
    1. Zargari A. Medicinal Plants (in Persian). Tehran University Press; 1983.
    1. Cicero AF, Ertek S. Berberine: metabolic and cardiovascular effects in preclinical and clinical trials. Nutr Diet Suppl. 2009;1:1–10. doi: 10.2147/NDS.S6084.
    1. Kalmarzi RN, Naleini SN, Ashtary-Larky D, Peluso I. Anti-Inflammatory and Immunomodulatory Effects of Barberry (Berberis vulgaris) and Its Main Compounds. Oxid Med Cell Longev. 2019;2019:6183965. doi: 10.1155/2019/6183965.
    1. Abd El-Wahab AE, Ghareeb DA, Sarhan EE, Abu-Serie MM, El Demellawy MA. In vitro biological assessment of Berberis vulgaris and its active constituent, berberine: antioxidants, anti-acetylcholinesterase, anti-diabetic and anticancer effects. BMC Complement Altern Med. 2013;13:218. doi: 10.1186/1472-6882-13-218.
    1. Minaiyan M, Ghannadi A, Mahzouni P, Jaffari-Shirazi E. Comparative Study of Berberis vulgaris Fruit Extract and Berberine Chloride Effects on Acetic Acid-Induced Colitis in Rats. Iran J Pharm Res. 2011;10:97–104.
    1. Joukar S, Mahdav N. Alterations of Blood Pressure and ECG following Two-Week Consumption of Berberis integerrima Fruit Extract. Int Sch Res Notices. 2014;2014:209683.
    1. Hemmati M, Zohoori E, Mehrpour O, Karamian M, Asghari S, Zarban A, Nasouti R. Anti-atherogenic potential of jujube, saffron and barberry: anti-diabetic and antioxidant actions. EXCLI J. 2015;14:908–915.
    1. Mahdavi N, Joukar S, Najafipour H, Asadi-Shekaari M. The promising effect of barberry (Zereshk) extract against experimental pulmonary microvascular remodeling and hypertension: A comparison with sildenafil. Pharm Biol. 2016;54:509–515. doi: 10.3109/13880209.2015.1050676.
    1. Imenshahid M, Qaredashi R, Hashemzaei M, Hosseinzadeh H. nhibitory Effect of Berberis vulgaris Aqueous Extract on Acquisition and Reinstatement Effects of Morphine in Conditioned Place Preferences (CPP) in Mice. Jundishapur J Nat Pharm Prod. 2014;9(3):e16145.
    1. Fatehi-Hassanabad Z, Jafarzadeh M, Tarhini A, Fatehi M. The antihypertensive and vasodilator effects of aqueous extract from Berberis vulgaris fruit on hypertensive rats. Phytother Res. 2005;19:222–225. doi: 10.1002/ptr.1661.
    1. Zilaee M, Kermany T, Tavalaee S, Salehi M, Ghayour-Mobarhan M, Ferns GA. Barberry treatment reduces serum anti-heat shock protein 27 and 60 antibody titres and high-sensitivity c-reactive protein in patients with metabolic syndrome: a double-blind, randomized placebo-controlled trial. Phytother Res. 2014;28:1211–1215. doi: 10.1002/ptr.5117.
    1. Emamat H, Zahedmehr A, Asadian S, Tangestani H, Nasrollahzadeh J. Effect of barberry (Berberis vulgaris) consumption on blood pressure, plasma lipids, and inflammation in patients with hypertension and other cardiovascular risk factors: study protocol for a randomized clinical trial. Trials. 2020;21:986. doi: 10.1186/s13063-020-04918-7.
    1. Shivappa N, Steck SE, Hurley TG, Hussey JR, Hebert JR. Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr. 2014;17:1689–1696. doi: 10.1017/S1368980013002115.
    1. Hirano T, Ito Y, Saegusa H, Yoshino G. A novel and simple method for quantification of small, dense LDL. J Lipid Res. 2003;44:2193–2201. doi: 10.1194/jlr.D300007-JLR200.
    1. Lazavi F, Mirmiran P, Sohrab G, Nikpayam O, Angoorani P, Hedayati M. The barberry juice effects on metabolic factors and oxidative stress in patients with type 2 diabetes: A randomized clinical trial. Complement Ther Clin Pract. 2018;31:170–174. doi: 10.1016/j.ctcp.2018.01.009.
    1. Iloon Kashkooli R, Najafi SS, Sharif F, Hamed A, Hoseini Asl MK, Najafi Kalyani M, Birjandi M. he effect of berberis vulgaris extract on transaminase activities in non-alcoholic Fatty liver disease. Hepat Mon. 2015;15(2):e25067. doi: 10.5812/hepatmon.25067.
    1. Shidfar F, Ebrahimi SS, Hosseini S, Heydari I, Shidfar S, Hajhassani G. The Effects of Berberis vulgaris Fruit Extract on Serum Lipoproteins, apoB, apoA-I, Homocysteine, Glycemic Control and Total Antioxidant Capacity in Type 2 Diabetic Patients. Iran J Pharm Sci. 2012;11:643–652.
    1. Ebrahimi-Mamaghani M, , Arefhosseini S, Golzarand M, Aliasgarzadeh A, Vahed-Jabbary M. Long-term effects of processed Berberis vulgaris on some metabolic syndrome components. In Iranian Journal of Endocrinology and Metabolism. 2009;11(1):41–47.
    1. Ockermann P, Headley L, Lizio R, Hansmann J. A Review of the Properties of Anthocyanins and Their Influence on Factors Affecting Cardiometabolic and Cognitive Health. Nutrients. 2021;13.(18):2831. doi: 10.3390/nu13082831.
    1. Yu H, Li C, Yang J, Zhang T, Zhou Q. Berberine is a potent agonist of peroxisome proliferator activated receptor alpha. Front Biosci (Landmark Ed) 2016;21:1052–1060. doi: 10.2741/4440.
    1. Dong H, Zhao Y, Zhao L, Lu F. The effects of berberine on blood lipids: a systemic review and meta-analysis of randomized controlled trials. Planta Med. 2013;79:437–446. doi: 10.1055/s-0033-1348620.
    1. Lan J, Zhao Y, Dong F, Yan Z, Zheng W, Fan J, Sun G. Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. J Ethnopharmacol. 2015;161:69–81. doi: 10.1016/j.jep.2014.09.049.
    1. Joseph SV, Edirisinghe I, Burton-Freeman BM. Berries: anti-inflammatory effects in humans. J Agric Food Chem. 2014;62:3886–3903. doi: 10.1021/jf4044056.
    1. Sarraf M, Beig Babaei A, Naji-Tabasi S. Investigating functional properties of barberry species: an overview. J Sci Food Agric. 2019;99:5255–5269. doi: 10.1002/jsfa.9804.
    1. Lee C-H, Chen J-C, Hsiang C-Y, Wu S-L, Wu H-C, Ho T-Y. Berberine suppresses inflammatory agents-induced interleukin-1β and tumor necrosis factor-α productions via the inhibition of IκB degradation in human lung cells. Pharmacol Res. 2007;56:193–201. doi: 10.1016/j.phrs.2007.06.003.

Source: PubMed

赞助者和合作者

医疗条件

药物干预

3
订阅