Curcuminoids Plus Piperine Modulate Adipokines in Type 2 Diabetes Mellitus
Curr Clin Pharmacol. 2017;12(4):253-258
Adipokines such as adiponectin and leptin are known to show anti-inflammatory action along with anti-hyperglycemic actions such as increasing insulin sensitivity, decreasing gluconeogenesis and increasing glucose uptake. Ghrelin is a circulating peptide secreted mainly by the fundus region of the stomach and is known to promote weight gain by stimulating food intake besides possession of anti-inflammatory effects on the release of pro-inflammatory cytokines. Thus, together adiponectin, leptin and ghrelin are seemed to be modulators of energy homeostasis besides showing immunomodulatory effects. Also, the leptin-to-adiponectin ratio is used as a measure of cardiovascular risk (atherosclerotic index). Tumour necrosis factor-alpha (TNF-α) is an important mediator of chronic inflammation that is known be produced by the inflamed adipose tissue and contribute to the development of metabolic disorders such as insulin resistance and type 2 diabetes mellitus. Curcumin, the bioactive constituent of turmeric was known to show a direct effect on the release and expression of adipokines. It was also suggested that curcumin may increase the levels of ghrelin.
To investigate the effects of curcuminoids on the serum levels of adiponectin, leptin and ghrelin irrespective of its effects on body weight changes in human subjects.
A total of 118 adult subjects (age: 18-65 years) diagnosed with type-2 diabetes mellitus (T2DM) were recruited into a randomized double-blinded, placebo-controlled, parallel-group clinical trial. Subjects were allocated to the daily supplementation with either 1000 mg/day curcuminoids (co-administered with 10 mg/day piperine) or placebo for a period of 3 months.
Results and Discussion:
- The curcuminoid-piperine combination was reported to be well tolerated with no severe adverse effect.
- At the end of the study, the net effects of curcuminoids co-administered with piperine were reported to be significant on serum levels of adiponectin (p=0.032), leptin (p<0.001) and TNF-α (p<0.001) as well as leptin-to-adiponectin (p<0.001) ratio compared to placebo are shown in the graph below:
The study suggests the potential of curcuminoids co-administered with piperine to lower inflammatory TNF-α level, and the risk metabolic disorder and cardiovascular diseases by affecting the serum adipokines independent of weight changes. This study once again highlights the immunomodulatory, cardio-protection actions of curcumin among the studied parameters.