Effect of pomegranate polyphenols on lipids metabolism in patients with myocardial infarction: a double-blind placebo controlled trial
DOI:
https://doi.org/10.18203/2320-6012.ijrms20191301Keywords:
Creatine Phospho kinase MB, Coronary artery disease, High density lipoprotein-c, Oxidized Low density lipoprotein, Reactive oxygen speciesAbstract
Background: Myocardial Infarction (MI) is a leading disease globally. Major risk factors for MI are smoking, hypertension, diabetes mellitus, reactive oxygen species (ROS), obesity, coronary artery disease (CAD) and abnormally altered blood lipid levels. It is recommended that for healthy living the risk factors for CAD and ROS should be less. Consumption of natural food supplements rich in antioxidants and polyphenols reduce the risk of MI. One herb is Pomegranate. Pomegranate is polyphenols and antioxidants rich fruit. This prompted us to find out whether the presence of antioxidants in pomegranate offers any prognostic benefits in patients with MI?.
Methods: Pomegranate Extract of Whole Fruit (PEWF) was prepared as tablet of 300mg to investigate its effects in patients with MI. Total 100 participants were included in the trial. Participants were assigned to two groups of 50 each. One group received “Add On” PEWF and other got matching placebo of same colour, shape and size as comparator agent in the dose of 300mg BD for 1 month.
Results: Results were compared by Z test, Chi square test and coefficient of variations. Statistical analysis proves the prognostic effect after active medication (p<0.05). Study results indicate the rejection of Null Hypothesis (H0) and acceptance of Alternative Hypothesis (H1).
Conclusions: Our findings suggest that consumption of antioxidant and polyphenols rich food supplements such as PEWFs for one month reduces the risk factors for CAD.
References
Arriola L, Martinez-Camblor P, Larrañaga N, Basterretxea M, Amiano P, Moreno-Iribas C, et al. Alcohol intake and the risk of coronary heart disease in the Spanish EPIC cohort study. Heart. 2010;96:124-30.
Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2224-60.
Torpy JM, Burke AE, Glass RM. Coronary heart disease risk factors. JAMA. 2009 Dec 2;302(21):2388.
Fuster V. Lewis A. Conner Memorial Lecture. Mechanisms leading to myocardial infarction: insights from studies of vascular biology. Circulation. 1994 Oct;90(4):2126-46.
Matsuura E, Kobayashi K, Tabuchi M, Lopez LR. Oxidative modification of low-density lipoprotein and immune regulation of atherosclerosis. Progress in lipid research. 2006 Nov 1;45(6):466-86.
Nakajima K, Nakano T, Tanaka A. The oxidative modification hypothesis of atherosclerosis: the comparison of atherogenic effects on oxidized LDL and remnant lipoproteins in plasma. Int J clinical Chem Diag Lab Med. 2006;367(1-2):36-47.
Shimaoka T, Kume N, Minami M, Hayashida K, Kataoka H, Kita T, Yonehara S. Molecular cloning of a novel scavenger receptor for oxidized low density lipoprotein, SR-PSOX, on macrophages. J Biol Chem. 2000 Dec 29;275(52):40663-6.
Ansell BJ, Watson KE, Fogelman AM, Navab M, Fonarow GC. High-density lipoprotein function: recent advances. J Am Coll Cardiol. 2005 Nov 15;46(10):1792-8.
Assman G, Nofer JR. Atheroprotective effects of high-density lipoproteins. Annual Review Med. 2000;(54):321-41.
Calabresi L, Gomaraschi M, Franceschini G. Endotelial protection by high-density lipoproteins. Atherosclerosis Thrombotic Vascular Biol. 2003;23:1724-31.
Grundy SM, Vega GL. Two different views of the relationship of hypertriglyceridemia to coronary heart disease. Arch Int Med. 1992;152(1):28-34.
McNamara JR, Shah PK, Nakajima K, Cupples LA, Wilson PW, Ordovas JM, Schaefer EJ. Remnant-like particle (RLP) cholesterol is an independent cardiovascular disease risk factor in women: results from the Framingham Heart Study. Atherosclerosis. 2001 Jan 1;154(1):229-36.
Yilmaz MI, Saglam M, Caglar K, Cakir E, Sonmez A, Ozgurtas T, et al. The determinants of endothelial dysfunction in CKD: oxidative stress and asymmetric dimethylarginine. Am J Kidney Dis. 2006 Jan 1;47(1):42-50.
Seeram NP, Aviram M, Zhang Y, Henning SM, Feng L, Dreher M, et al. Comparison of antioxidant potency of commonly consumed polyphenol-rich beverages in the United States. J Agricul Food Chem. 2008 Jan 26;56(4):1415-22.
Elfalleh W, Hannachi H, Tlili N, Yahia Y, Nasri N, Ferchichi A. Total phenolic contents and antioxidant activities of pomegranate peel, seed, leaf and flower. J Med Plants Res. 2012 Aug 31;6(32):4724-30.
Chiarug A. Poly (ADP-ribose) polymerase: killer or conspirator? The ‘suicide hypothesis’ revisited. Trends in Pharmacol Sci. 2002;23(3):123-9.
Faruqi R, de la Motte C, DiCorleto PE. Alpha-tocopherol inhibits agonist-induced monocytic cell adhesion to cultured human endothelial cells. J Clin Invest. 1994;94:592-600.
Bae YS, Lee JH, Choi SH, Kim S, Almazan F, Witztum JL, et al. Macrophages generate reactive oxygen species in response to minimally oxidized low-density lipoprotein: toll-like receptor 4-and spleen tyrosine kinase-dependent activation of NADPH oxidase 2. Circulation Res. 2009 Jan 30;104(2):210-8.
Kalita D, Jayanty SS. Comparison of Polyphenol Content and Antioxidant Capacity of Colored Potato Tubers, Pomegranate and Blueberries. J Food Processing Technol. 2014;5(8):1-8.
Conseil G, Baubichon-Cortay H, Dayan G, Jault JM, Barron D, Di Pietro A. Flavonoids: a class of modulators with bifunctional interactions at vicinal ATP and steroid-binding sites on mouse P-glycoprotein. Proceeding for National Medical Sciences. USA. 1998;95:9831-6.
Leslie EM, Mao Q, Oleschuk CJ, Deeley RG, Cole SP. Modulation of multidrug resistance protein 1 (MRP1/ABCC1) transport and ATPase activities by interaction with dietary flavonoids. Molecular Pharmacol. 2001;59:1171-80.
Loest HB, Noh SK, Koo SI. Green tea extract inhibits the lymphatic absorption of cholesterol and tocopherol in ovariectomized rats. J Nutrition. 2002;132:1282-8.
Osada K, Suzuki T, Kawakami Y, Senda M, Kasai A, Sami M, et al. Dose dependent hypo cholesterolemic action of dietary Apple polyphenols in rat fed cholesterol. Lipids. 2006;41:133-9.
Rodrigo L, Mackness B, Durrington PN, Hernandez A, Mackness MI. Hydrolysis of platelet-activating factor by human serum paraoxonase. J Biochemistry. 2001;354:1-7.
Arrol S, Mackness MI, Durrington PN. High-density lipoprotein associated enzymes and the prevention of low-density lipoprotein oxidation. Euro J Laboratory Med. 1996;4:33-8.
