Efeitos de produtos naturais sobre parâmetros metabólicos e do estresse oxidativo em pacientes com síndrome metabólica: uma revisão sistemática

Palavras-chave: Produtos Biológicos, Estresse Oxidativo, Síndrome Metabólica

Resumo

Introdução: Em um contexto de aumento de prevalência da síndrome metabólica (SM), intervenções não farmacológicas, como mudanças de estilo de vida, são recomendadas para prevenção e tratamento. Novas alternativas para esse fim são os produtos naturais, que podem proteger o organismo contra o estresse oxidativo e melhorar parâmetros metabólicos. Objetivo: Avaliar os resultados de estudos clínicos em pacientes com SM a partir da suplementação com produtos naturais. Material e Métodos: Realizou-se a busca por artigos publicados de 2015 a 2020 nos idiomas português e inglês, sendo utilizadas as bases de dados Scientific Electronic Library Online (SciELO), Public Medline (PubMed), Web of Science, Scopus, Embase e Biblioteca Virtual de Saúde. Os termos utilizados para a pesquisa foram: síndrome metabólica; estresse oxidativo; produtos naturais. Resultados: Dos 47 ensaios clínicos randomizados encontrados, oito foram incluídos. A maioria dos estudos revelou uma associação benéfica entre o consumo de produtos naturais e o controle de parâmetros relacionados à SM. Em seis dos oito artigos, a ingestão de produtos naturais apresentou efeito positivo no perfil lipídico; e em três estudos os efeitos benéficos na circunferência abdominal foi verificado. Além disso, em seis dos oito ensaios clínicos, os produtos naturais diminuíram algum marcador de estresse oxidativo. Conclusão: Esta revisão, portanto, fornece dados sugestivos de que a suplementação de produtos naturais à dieta seja um fator de controle e prevenção da SM. Porém, estudos maiores, mais homogêneos e com maior número de parâmetros avaliados são necessários para construção de evidências robustas sobre os efeitos desses produtos em pacientes com essa síndrome.

Referências

Reaven GM. Role of insulin resistance in human disease. Diabetes. 1988; 37(12):1595-607.

Caranti DA, Lazzer S, Dâmaso AR, Agosti F, Zennaro R, De Mello et al. Prevalence and risk factors of metabolic syndrome in Brazilian and Italian obese adolescents: a comparison study. International Journal of Clinical Practice. 2008; 62(10):1526-32.

McCracken E, Monaghan M, Sreenivasan S. Pathophysiology of the metabolic syndrome. Clinics in Dermatology. 2018; 36(1):14-20.

Saklayen MG. The global epidemic of the metabolic syndrome: report. Current Hypertension Reports. 2018; 20(2):1.

Deen D. Metabolic syndrome: time for action. American Family Physician. 2004; 69(12):2875.

Aune D, Giovannucci E, Boffetta P, Fadnes LT, Keum N, Norat T et al. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality: a systematic review and dose-response meta-analysis of prospective studies. International Journal of Epidemiology. 2017; 46(3).

Veiga Junior VF, Pinto AC, Maciel MAM. Plantas medicinais: cura segura? Química Nova. 2005; 28(3):519-28.

Firmo WdCA, de Menezes VdJM, de Castro Passos CE, Dias CN, Alves LPL, Dias ICL et al. Contexto histórico, uso popular e concepção científica sobre plantas medicinais. Cadernos de pesquisa. 2012.

Oliveira RS, Lucas CP, Antonucci G, da Silva FC. Compostos bioativos naturais: agentes promissores na redução do extresse oxidativo e processos inflamatórios. South American Journal of Basic Education, Technical and Technological. 2018; 5(2).

Ferreira ALA, Correa CR, Freire CMM, Moreira PL. Berchieri-Ronchi CB, Reis RAS et al. Síndrome metabólica: atualização de critérios diagnósticos e impacto do estresse oxidativo na patogênese. Rev Bras Clin Med. 2011; 9(1):54-61.

Gottlieb MGV, Cruz IBMD, Schwanke CHA, Bodanese LC. Oxidative stress as an emergent cardiometabolic risk factor. Scientia Medica. 2010; 20(3):243-9.

Urakawa CH, Katsuki CA, Sumida CY, Gabazza CE, Murashima CS, Morioka CK et al. Oxidative Stress Is Associated with Adiposity and Insulin Resistance in Men. The Journal of Clinical Endocrinology & Metabolism. 2003; 88(10):4673-6.

Schenk S, Saberi M, Olefsky J. Insulin sensitivity: modulation by nutrients and inflammation. Journal Of Clinical Investigation. 2008; 118(9):2992-3002.

Teles YCF, Monteiro RP, da Silva Oliveira M, Ribeiro-Filho J. O papel do estresse oxidativo na síndrome metabólica. J Health Sci Inst. 2015; 33(1):89-93.

Keaney FJ, Larson GM, Vasan SR, Wilson WFP, Lipinska MI, Corey AD et al. Obesity and systemic oxidative stress: clinical correlates of oxidative stress in the framingham study, arteriosclerosis, thrombosis, and vascular biology. Journal of the American Heart Association. 2003; 23(3):434-9.

Alberti KGMM, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO Consultation. Diabetic Medicine. 1998; 15(7):539-53.

National Library of M. 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) final report. Circulation. 2002; 106(25):3143.

The IDF consensus worldwide definition of the metabolic syndrome. Ožirenie i Metabolizm. 2005; 2(3):47-9.

Balkau B, Charles MA. Comment on the provisional report from the WHO consultation. Diabetic Medicine. 1999; 16(5):442-3.

Grundy SM, Brewer HB, Cleeman JI, Smith SC, Lenfant C. Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/ American Heart Association conference on scientific issues related to definition. Circulation. 2004; 109(3):433.

Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Annals of internal medicine. 2009; 151(4):W65.

Kim H, Simbo SY, Fang C, McAlister L, Roque A, Banerjee N et al. Açaí (Euterpe oleracea Mart.) beverage consumption improves biomarkers for inflammation but not glucose- or lipid-metabolism in individuals with metabolic syndrome in a randomized, double-blinded, placebo-controlled clinical trial. Food Funct. 2018; 9(6):3097-103.

Fernandez ML, Thomas MS, Lemos BS, DiMarco DM, Missimer A, Melough M et al. TA-65, A Telomerase Activator improves Cardiovascular Markers in Patients with Metabolic Syndrome. Curr Pharm Des. 2018; 24(17):1905-11.

Nair AR, Mariappan N, Stull AJ, Francis J. Blueberry supplementation attenuates oxidative stress within monocytes and modulates immune cell levels in adults with metabolic syndrome: a randomized, double-blind, placebo-controlled trial. Food Funct. 2017; 8(11):4118-28.

Rezazadeh K, Aliashrafi S, Asghari-Jafarabadi M, Ebrahimi-Mameghani M. Antioxidant response to artichoke leaf extract supplementation in metabolic syndrome: A double-blind placebo-controlled randomized clinical trial. Clin Nutr. 2018; 37(3):790-6.

Asgary S, Soltani R, Zolghadr M, Keshvari M, Sarrafzadegan N. Evaluation of the effects of roselle (Hibiscus sabdariffa L.) on oxidative stress and serum levels of lipids, insulin and hs-CRP in adult patients with metabolic syndrome: a double-blind placebo-controlled clinical trial. J Complement Integr Med. 2016; 13(2):175-80.

Hermans N, Van der Auwera A, Breynaert A, Verlaet A, Bruyne T, Van Gaal L et al. A red yeast rice-olive extract supplement reduces biomarkers of oxidative stress, OxLDL and Lp-PLA. Trials. 2017; 18(1):302.

Usharani P, Merugu PL, Nutalapati C. Evaluation of the effects of a standardized aqueous extract of Phyllanthus emblica fruits on endothelial dysfunction, oxidative stress, systemic inflammation and lipid profile in subjects with metabolic syndrome: a randomised, double blind, placebo controlled clinical study. BMC Complement Altern Med. 2019; 19(1):97.

Patti AM, Al-Rasadi K, Katsiki N, Banerjee Y, Nikolic D, Vanella L et al. Effect of a natural supplement containing curcuma longa, guggul, and chlorogenic acid in patients with metabolic syndrome. Angiology. 2015; 66(9):856-61.

Curtis PJ, Van der Velpen V, Berends L, Jennings A, Feelisch M, Umpleby AM, et al. Blueberries improve biomarkers of cardiometabolic function in participants with metabolic syndrome: results from a 6 month, double-blind, randomized controlled trial. The American Journal of Clinical Nutrition. 2019; 109(6):1535-45.

Balusamy SR, Veerappan K, Ranjan A, Kim YJ, Chellappan DK, Dua K et al. Phyllanthus emblica fruit extract attenuates lipid metabolism in 3T3-L1 adipocytes via activating apoptosis mediated cell death. Phytomedicine. 2020; 66:153129.

Usharani P, Fatima N, Muralidhar N. Effects of Phyllanthus emblica extract on endothelial dysfunction and biomarkers of oxidative stress in patients with type 2 diabetes mellitus: a randomized, double-blind, controlled study. Diabetes Metab Syndr Obes. 2013; 6:275-84.

Verhoeven V, Van der Auwera A, Van Gaal L, Remmen R, Apers S, Stalpaert M et al. Can red yeast rice and olive extract improve lipid profile and cardiovascular risk in metabolic syndrome?: a double blind, placebo controlled randomized trial.(Report). BMC Complementary and Alternative Medicine. 2015; 15(1).

Tshongo Muhindo C, Ahn SA, Rousseau MF, Dierckxsens Y, Hermans MP. Efficacy and safety of a combination of red yeast rice and olive extract in hypercholesterolemic patients with and without statin-associated myalgia. Complementary Therapies in Medicine. 2017; 35:140-4.

Cicero AFG, Colletti A. Role of phytochemicals in the management of metabolic syndrome. Phytomedicine. 2016; 23(11):1134-44.

Shah R, Gulati V, Palombo EA. Pharmacological properties of guggulsterones, the major active components of gum guggul. Phytotherapy Research. 2012; 26(11):1594-605.

Shokoohi R, Kianbakht S, Faramarzi M, Rahmanian M, Nabati, F, Mehrzadi S et al. Effects of an herbal combination on glycemic control and lipid profile in diabetic women: a randomized, double-blind, placebo-controlled clinical trial. Journal of Evidence-Based Complementary & Alternative Medicine. 2017; 22(4):798-804.

Zuñiga LY, Aceves-de La Mora MCA-d, González-Ortiz M, Ramos-Núñez JL, Martínez-Abundis E. Effect of chlorogenic acid administration on glycemic control, insulin secretion, and insulin sensitivity in patients with impaired glucose tolerance. Journal of Medicinal Food. 2018; 21(5):469-73.

Watanabe T, Kobayashi S, Yamaguchi T, Hibi M, Fukuhara, I Osaki N. Coffee abundant in chlorogenic acids reduces abdominal fat in overweight adults: A randomized, double-blind, controlled trial. Nutrients. 2019; 11(7).

Ward NC, Hodgson JM, Woodman RJ, Zimmermann D, Poquet L, Leveques A et al. Acute effects of chlorogenic acids on endothelial function and blood pressure in healthy men and women. Food & Function. 2016; 7(5):2197-203.

Upadya H, Prabhu S, Prasad A, Subramanian D, Gupta S, Goel A. A randomized, double blind, placebo controlled, multicenter clinical trial to assess the efficacy and safety of Emblica officinalis extract in patients with dyslipidemia. BMC Complement Altern Med. 2019; 19(1):27.

Del Bó C, Riso P, Campolo J, Møller P, Loft S, Klimis-Zacas D et al. A single portion of blueberry (Vaccinium corymbosum L) improves protection against DNA damage but not vascular function in healthy male volunteers. Nutr Res. 2013; 33(3):220-7.

Riso P, Klimis-Zacas D, Del Bo' C, Martini D, Campolo J, Vendrame S et al. Effect of a wild blueberry (Vaccinium angustifolium) drink intervention on markers of oxidative stress, inflammation and endothelial function in humans with cardiovascular risk factors. Eur J Nutr. 2013; 52(3):949-61.

Aranha LN, Silva MG, Uehara SK, Luiz RR, Nogueira Neto JF, Rosa G et al. Effects of a hypoenergetic diet associated with açaí (Euterpe oleracea Mart.) pulp consumption on antioxidant status, oxidative stress and inflammatory biomarkers in overweight, dyslipidemic individuals. Clin Nutr. 2020; 39(5):1464-9.

Pala D, Barbosa PO, Silva CT, de Souza MO, Freitas FR, Volp ACP et al. Açai (Euterpe oleracea Mart.) dietary intake affects plasma lipids, apolipoproteins, cholesteryl ester transfer to high-density lipoprotein and redox metabolism: a prospective study in women. Clin Nutr. 2018; 37(2):618-23.

Rondanelli M, Giacosa A, Opizzi A, Faliva MA, Sala P, Perna S et al. Beneficial effects of artichoke leaf extract supplementation on increasing HDL-cholesterol in subjects with primary mild hypercholesterolaemia: a double-blind, randomized, placebo-controlled trial. Int J Food Sci Nutr. 2013; 64(1):7-15.

Rondanelli M, Castellazzi AM, Riva A, Allegrini P, Faliva MA, Peroni G et al. Natural killer response and lipo-metabolic profile in adults with low hdl-cholesterol and mild hypercholesterolemia: beneficial effects of artichoke leaf extract supplementation. Evid Based Complement Alternat Med. 2019; 2019:2069701.

Kafeshani M, Entezari MH, Karimian J, Pourmasoumi M, Maracy MR, Amini MR et al. A comparative study of the effect of green tea and sour tea on blood pressure and lipid profile in healthy adult men. ARYA Atheroscler. 2017; 13(3):109-16.

Hadi A, Pourmasoumi M, Kafeshani M, Karimian J, Maracy MR, Entezari MH. The Effect of green tea and sour tea (Hibiscus sabdariffa L.) supplementation on oxidative stress and muscle damage in athletes. J Diet Suppl. 2017; 14(3):346-57.

Shin JY, Kim JY, Kang HT, Han KH, Shim JY. Effect of fruits and vegetables on metabolic syndrome: a systematic review and meta-analysis of randomized controlled trials. International Journal of Food Sciences and Nutrition. 2015; 66(4):416-25.

Lee M, Lim M, Kim J. Fruit and vegetable consumption and the metabolic syndrome: a systematic review and dose – response meta – analysis. 2019; 122(7):723-33.

Khalil A, Gaudreau P, Cherki M, Wagner R, Tessier DM, Fulop T et al. Antioxidant: rich food intakes and their association with blood total antioxidant status and vitamin C and E levels in community: dwelling seniors from the Quebec longitudinal study NuAge. Experimental Gerontology. 2011; 46(6):475-81.

Jayaprakasam B, Vareed SK, Olson LK, Nair MG. Insulin secretion by bioactive anthocyanins and anthocyanidins present in fruits. Journal of agricultural and food chemistry. 2005; 53(1):28.

Jia-Ping C, Guo-Chong C, Wang X-P, Qin L, Bai Y. Dietary fiber and metabolic syndrome: a meta-analysis and review of related mechanisms. Nutrients. 2018; 10(1):24.

Watzl B, Kulling SE, Möseneder J, Barth SW, Bub A. 4-wk intervention with high intake of carotenoid-rich vegetables and fruit reduces plasma C-reactive protein in healthy, nonsmoking men. American journal of clinical nutrition. 2005; 82(5):1052-8.

Mahoney SE, Loprinzi PD. Influence of flavonoid-rich fruit and vegetable intake on diabetic retinopathy and diabetes: related biomarkers. Journal of Diabetes and Its Complications. 2014; 28(6):767-71.

Publicado
2020-12-08
Como Citar
1.
Araújo Lucca AB, Carvalho MF, Silva VRR, Magalhães HA, Costa LM, Guerrieri YD, Bonomo L de F, Silva M. Efeitos de produtos naturais sobre parâmetros metabólicos e do estresse oxidativo em pacientes com síndrome metabólica: uma revisão sistemática. hu rev [Internet]. 8º de dezembro de 2020 [citado 20º de janeiro de 2021];460:1-11. Disponível em: https://periodicos.ufjf.br/index.php/hurevista/article/view/32296
Seção
Artigos de Revisão Sistemática