Antioxidant and anti-inflammatory effects of curcuminoid-piperine combination in subjects with metabolic syndrome: A randomized controlled trial and an updated meta-analysis

• Published in: Clinical nutrition (Edinburgh, Scotland) Vol. 34; no. 6; pp. 1101 - 1108
• Main Authors: Panahi, Yunes, Hosseini, Mahboobeh Sadat, Khalili, Nahid, Naimi, Effat, Majeed, Muhammed, Sahebkar, Amirhossein
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-12-2015
• Subjects: Adult; Alkaloids - administration & dosage; Alkaloids - pharmacokinetics; Anti-Inflammatory Agents - administration & dosage; Anti-Inflammatory Agents - pharmacokinetics; Antioxidant; Antioxidants - administration & dosage; Antioxidants - pharmacokinetics; Benzodioxoles - administration & dosage; Benzodioxoles - pharmacokinetics; Biological Availability; Blood Pressure; Body Mass Index; C-Reactive Protein - metabolism; Cardiovascular disease; Curcuma longa; Curcumin - administration & dosage; Curcumin - pharmacokinetics; Databases, Factual; Dietary Supplements; Double-Blind Method; Female; Gastroenterology and Hepatology; Humans; Inflammation - drug therapy; Male; Malondialdehyde - blood; Meta-Analysis as Topic; Metabolic Syndrome - drug therapy; Middle Aged; Oxidative Stress - drug effects; Piperidines - administration & dosage; Piperidines - pharmacokinetics; Polyunsaturated Alkamides - administration & dosage; Polyunsaturated Alkamides - pharmacokinetics; Randomized controlled trial; Superoxide Dismutase - blood; Turmeric; fasting blood sugar; NCEP-ATPIII; Cardiovascular disease; generally recognized as safe; high-sensitivity C-reactive protein; MDA; systolic blood pressure; HDL-C; DBP; diastolic blood pressure; FBS; high-density lipoprotein cholesterol; reactive oxygen species; Hs-CRP; National Cholesterol Education Program Adult Treatment Panel III; antioxidant response element; BMI; SBP; body mass index; SOD; Antioxidant; Randomized controlled trial; Malondialdehyde; Turmeric; metabolic syndrome; MetS; ARE; Curcuma longa; superoxide dismutase; ROS; coronary heart disease; GRAS; CHD
• ISSN: 0261-5614; 1532-1983
• DOI: 10.1016/j.clnu.2014.12.019

Summary Background Oxidative stress and inflammation have been proposed as emerging components of metabolic syndrome (MetS). Curcuminoids are natural polyphenols with strong antioxidant and anti-inflammatory properties. Objective To study the effectiveness of supplementation with a bioavailable curcuminoid preparation on measures of oxidative stress and inflammation in patients with MetS. Our secondary aim was to perform a meta-analysis of data from all randomized controlled trials in order to estimate the effect size of curcuminoids on plasma C-reactive protein (CRP) concentrations. Methods In this randomized double-blind placebo-controlled trial, 117 subjects with MetS (according to the NCEP-ATPIII diagnostic criteria) were randomly assigned to curcuminoids (n = 59; drop-outs = 9) or placebo (n = 58; drop-outs = 8) for eight weeks. Curcuminoids were administered at a daily dose of 1 g, and were co-supplemented with piperine (10 mg/day) in order to boost oral bioavailability. Serum activities of superoxide dismutase (SOD) and concentrations of malondialdehyde (MDA) and CRP were measured at baseline and at study end. Regarding the importance of CRP as a risk marker and risk factor of cardiovascular disease, a random-effects meta-analysis of clinical trials was performed to estimate the overall impact of curcuminoid therapy on circulating concentrations of CRP. The robustness of estimated effect size was evaluated using leave-one-out sensitivity analysis. Results Supplementation with curcuminoid-piperine combination significantly improved serum SOD activities ( p  < 0.001) and reduced MDA ( p  < 0.001) and CRP ( p  < 0.001) concentrations compared with placebo. Quantitative data synthesis revealed a significant effect of curcuminoids vs. placebo in reducing circulating CRP concentrations (weighed mean difference: −2.20 mg/L; 95% confidence interval [CI]: −3.96, −0.44; p  = 0.01). This effect was robust in sensitivity analysis. Conclusions Short-term supplementation with curcuminoid-piperine combination significantly improves oxidative and inflammatory status in patients with MetS. Curcuminoids could be regarded as natural, safe and effective CRP-lowering agents.