The effect of enriched chicory inulin on liver enzymes, calcium homeostasis and hematological parameters in patients with type 2 diabetes mellitus: A randomized placebo-controlled trial

Published:February 09, 2016DOI:https://doi.org/10.1016/j.pcd.2015.10.009

      Highlights

      • We evaluated the effect of a prebiotic on liver enzymes and hematological parameters.
      • Two months prebiotic supplementation reduced serum AST and ALP in patients with T2DM.
      • Serum calcium significantly increased after chicory supplementation.
      • Chicory also reduced hematocrit and MCV values.

      Abstract

      Backgrounds and aims

      Type 2 diabetic mellitus (T2DM) as one of the main causes of morbidity and mortality is associated with immune system disturbances and metabolic abnormalities. In the current study we aimed to evaluate the effects of enriched chicory inulin supplementation on liver enzymes, serum calcium and phosphorous concentrations and hematological parameters in patients with T2DM.

      Methods

      Forty-six diabetic females patients were randomly allocated into intervention (n = 27) and control (n = 22) groups. Subjects in the intervention group received a daily dose of 10 g of chicory and subjects in control group received a placebo for two months. Anthropometric variables, glucose homeostasis, hematological parameters and metabolic indices including serum alanine aminotransfersae (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), calcium and phosphorous as well as creatinine concentrations, glomerular filtration rate (GFR) and blood pressure were assessed at the beginning and end of the trial.

      Results

      Significant reductions in fasting serum glucose (FSG), Hb A1C, AST and ALP concentrations were observed in chicory-treated group. Systolic and diastolic blood pressures were also reduced in chicory-treated group. Serum calcium significantly increased after chicory supplementation but no change in placebo treated group has been occurred (P = 0.014). Supplementation with enriched chicory for two months significantly reduced hematocrit and mean corpuscular volume (MCV) values (P < 0.05). Changes in serum insulin, creatinine and GFR were not significant.

      Conclusion

      The present study showed beneficial effects of oligofructose-enriched chicory on the improvement of the glucose and calcium homeostasis, liver function tests, blood pressure and reduction in hematologic risk factors of diabetes in female patients with T2DM. Further studies in both genders are needed to generalize these findings to total population.

      Keywords

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      References

        • Wild S.
        • Roglic G.
        • Green A.
        • Sicree R.
        • King H.
        Global prevalence of diabetes estimates for the year 2000 and projections for 2030.
        Diabetes Care. 2004; 27: 1047-1053
        • Dehghan P.
        • Farhangi M.A.
        • Tavakoli F.
        • Aliasgarzadeh A.
        • Akbari A.M.
        Impact of prebiotic supplementation on T-cell subsets and their related cytokines, anthropometric features and blood pressure in patients with type 2 diabetes mellitus: A randomized placebo-controlled Trial.
        Complement. Ther. Med. 2016; 24: 96-102
        • Bouillon R.
        • Bex M.
        • Van Herck E.
        • Laureys J.
        • Dooms L.
        • Lesaffre E.
        • Ravussin E.
        Influence of age, sex, and insulin on osteoblast function: osteoblast dysfunction in diabetes mellitus.
        J. Clin. Endocrinol. Metab. 1995; 80: 1194-1202
        • Farhangi M.A.
        • Ostadrahimi A.
        • Mahboob S.
        Serum calcium: magnesium, phosphorous and lipid profile in healthy Iranian premenopausal women.
        Biochem. Medica. 2011; 21: 312-320
        • Saggese G.
        • Bertelloni S.
        • Baroncelli G.I.
        • Federico G.
        • Calisti L.
        • Fusaro C.
        Bone demineralization and impaired mineral metabolism in insulin-dependent diabetes mellitus. A possible role of magnesium deficiency.
        Helv. Paediatr. Acta. 1989; 43: 405-414
        • Pittas A.G.
        • Lau J.
        • Hu F.B.
        • Dawson-Hughes B.
        The role of vitamin D and calcium in type 2 diabetes. a systematic review and meta-analysis.
        J. Clin. Endocrinol. Metab. 2007; 92: 2017-2029
        • Meisinger C.
        • Rückert I.M.
        • Stöckl D.
        • Thorand B.
        • Peters A.
        • Kowall B.
        • Rathmann W.
        Hematological parameters and prediabetes and diabetes in adults from the general population: a cross-sectional study.
        J. Diabetes Metab. 2014; 5: 2-6
        • Farhangi M.A.
        • Keshavarz S.A.
        • Eshraghian M.
        • Ostadrahimi A.
        • Saboor-Yaraghi A.
        White blood cell count in women: relation to inflammatory biomarkers, haematological profiles, visceral adiposity, and other cardiovascular risk factors.
        J. Health Pop. Nutr. 2013; 31: 58-64
        • Leevy C.M.
        • Ryan C.M.
        • Fineberg J.C.
        Diabetes mellitus and liver dysfunction: etiologic and therapeutic considerations.
        Am. J. Med. 1950; 8: 290-299
        • Younossi Z.M.
        • Gramlich T.
        • Bacon B.R.
        • Matteoni C.A.
        • Boparai N.
        • O’Neill R.
        • McCullough A.J.
        Hepatic iron and nonalcoholic fatty liver disease.
        Hepatology. 1999; 30: 847-850
        • Targher G.
        • Bertolini L.
        • Rodella S.
        • Tessari R.
        • Zenari L.
        • Lippi G.
        • Arcaro G.
        Nonalcoholic fatty liver disease is independently associated with an increased incidence of cardiovascular events in type 2 diabetic patients.
        Diabetes Care. 2007; 30: 2119-2121
        • Tamariz L.J.
        • Young J.H.
        • Pankow J.S.
        • Yeh H.C.
        • Schmidt M.I.
        • Astor B.
        • Brancati F.L.
        Blood viscosity and hematocrit as risk factors for type 2 diabetes mellitus the Atherosclerosis Risk in Communities (ARIC) study.
        Am. J. Epidemiol. 2008; 168: 1153-1160
        • Roberfroid M.B.
        • Cumps J.
        • Devogelaer J.P.
        Dietary chicory inulin increases whole-body bone mineral density in growing male rats.
        J. Nutr. 2002; 132: 3599-3602
        • Roberfroid M.B.
        Inulin-type fructans: functional food ingredients.
        J. Nutr. 2007; 137: 2493S-2502S
        • Holloway L.
        • Moynihan S.
        • Abrams S.A.
        • Kent K.
        • Hsu A.R.
        • Friedlander A.L.
        Effects of oligofructose-enriched inulin on intestinal absorption of calcium and magnesium and bone turnover markers in postmenopausal women.
        Br. J. Nutr. 2007; 97: 365-372
        • Shahvazian N.
        • Shakiba M.
        • Farahzadi M.H.
        • Mahmoodabadi F.
        Efficacy of chicory in decreasing serum ferritin and liver enzymes in major beta thalassemia patients.
        Iran J. Pediatr. Hematol. Oncol. 2010; 1: 4-7
        • Levey A.S.
        • Bosch J.P.
        • Lewis J.B.
        • Greene T.
        • Rogers N.
        • Roth D.
        A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation.
        Ann. Intern. Med. 1999; 130 (Modification of Diet in Renal Disease Study Group): 461-470
        • Roberfroid M.
        Functional foods: concepts and application to inulin and olifructose.
        Br. J. Nutr. 2002; 87: 139-143
        • Greger J.L.
        Nondigestible carbohydrates and mineral bioavailability.
        J. Nutr. 1999; 129: 1434S-1435S
        • Mitri J.
        • Dawson-Hughes B.
        • Hu F.B.
        • Pittas A.G.
        Effects of vitamin D and calcium supplementation on pancreatic β cell function, insulin sensitivity, and glycemia in adults at high risk of diabetes: the calcium and vitamin D for diabetes mellitus (CaDDM) randomized controlled trial.
        Am. J. Clin. Nutr. 2011; 94: 486-494
        • Harris E.H.
        Elevated liver function tests in type 2 diabetes.
        Clin. Diabetes. 2005; 23: 115-119
        • Cho N.H.
        • Jang H.C.
        • Choi S.H.
        • Kim H.R.
        • Lee H.K.
        • Chan J.C.N.
        • Lim S.
        Abnormal liver function test predicts type 2 diabetes: a community-based prospective study.
        Diabetes Care. 2007; 30: 2566-2568
        • Adams L.A.
        • Angulo P.
        Recent concepts in non-alcoholic fatty liver disease.
        Diabet. Med. 2005; 22: 1129-1133
        • Jimba S.
        • Nakagami T.
        • Takahashi M.
        • Wakamatsu T.
        • Hirota Y.
        • Iwamoto Y.
        • Wasada T.
        Prevalence of non-alcoholic fatty liver disease and its association with impaired glucose metabolism in Japanese adults.
        Diabet. Med. 2005; 22: 1141-1145
        • Lazo M.
        • Solga S.F.
        • Horska A.
        • Bonekamp S.
        • Diehl A.M.
        • Brancati F.L.
        • Wagenknecht L.E.
        • Pi-Sunyer F.X.
        • Kahn S.E.
        • Clark J.M.
        Effect of a 12-month intensive lifestyle intervention on hepatic steatosis in adults with type 2 diabetes.
        Diabetes Care. 2010; 33: 2156-2163
        • Baba C.S.
        • Alexander G.
        • Kalyani B.
        • Pandey R.
        • Rastogi S.
        • Pandey A.
        • Chodhuri G.
        Effect of exercise and dietary modification on serum aminotransferase levels in patients with nonalcoholic steatohepatitis.
        J. Gastroenterol. Hepatol. 2006; 21: 191-198
        • Dixon J.B.
        • Bhathal P.S.
        • Hughes N.R.
        • O’Brien P.E.
        Nonalcoholic fatty liver disease: improvement in liver histological analysis with weight loss.
        Hepatology. 2004; 39: 1647-1654
        • Yamashita K.
        • Kawai K.
        • Itakura M.
        Effects of fructooligosaccharides on blood glucose and serum lipids in diabetic subjects.
        Nutr. Res. 1984; 4: 961-966
        • Bonsu N.K.A.
        • Johnson C.S.
        • Mcleod K.M.
        Can dietary fructans lower serum glucose?.
        J. Diabetes Metab. 2011; 3: 58-66
      1. Canadian Diabetes Association. The benefits of eating fiber. Available from 〈http://www.diabetes.ca/diabetes-and-you/nutrition/fibre/2013〉.

        • Rault-Nania M.H.
        • Demougeot C.
        • Gueux E.
        • Berthelot A.
        • Dzimira S.
        • Rayssiguier Y.
        • Rock E.
        • Mazur A.
        Inulin supplementation prevents high fructose diet-induced hypertension in rats.
        Clin. Nutr. 2008; 27: 276-282
        • Pourghassem Gargari B.
        • Dehghan P.
        • Aliasgharzadeh A.
        • Asghari Jafar-Abadi M.
        Effects of high performance inulin supplementation on glycemic control and antioxidant status in women with type 2 diabetes.
        Diabetes Metab. J. 2013; 37: 140-148
        • Aliasgharzadeh A.
        • Khalili M.
        • Mirtaheri E.
        • Pourghassem-Gargari B.
        • Tavakoli F.
        • Abbasalizad Farhangi M.
        • Babaei H.
        • Dehghan P.
        A combination of prebiotic inulin and oligofructose improve some of cardiovascular disease risk factors in women with type 2 diabetes: a randomized controlled clinical trial.
        Adv. Pharm. Bull. 2015; 5 (In Press)
        • Parnell J.A.
        • Raman M.
        • Rioux K.
        • Reimer R.A.
        The potential role of prebiotic fibre for treatment and management of non-alcoholic fatty liver disease and associated obesity and insulin resistance.
        Liver Int. 2012; 32: 701-711
        • Creely S.
        • McTernan P.
        • Kusminski C.M.
        • Fisher F.M.
        • Da Silva N.F.
        • Khanolkar M.
        • Evans M.
        • Harte A.L.
        • Kumar S.
        Lipopolysaccharide activates an innate immune system response in human adipose tissue in obesity and type 2 diabetes.
        Am. J. Physiol. Endocrinol. Metab. 2007; 292: 740-747
        • Dehghan P.
        • Pourghassem Gargari B.
        • Asghari Jafar-abadi M.
        Oligofructose-enriched inulin improves some inflammatory markers and metabolic endotoxemia in women with type 2 diabetes mellitus: a randomized controlled clinical trial.
        Nutrition. 2014; 30: 418-423
        • Tulloch-Reid M.K.
        • Hanson R.L.
        • Saremi A.
        • Looker H.
        • Williams D.
        • Krakoff J.
        • Knowler W.
        Hematocrit and the incidence of type 2 diabetes in the Pima Indians.
        Diabetes Care. 2004; 27: 2245-2246
        • Bersch N.
        • Groopman J.E.
        • Golde D.W.
        Natural and biosynthetic insulin stimulates the growth of human erythroid progenitors in vitro.
        J. Clin. Endocrinol. Metab. 1982; 55: 1209-1211
        • Hilsted J.
        • Christensen N.J.
        Dual effect of insulin on plasma volume and transcapillary albumin transport.
        Diabetologia. 1992; 35: 99-103
        • Farhangi M.A.
        • Keshavarz S.A.
        • Eshraghian M.
        • Ostadrahimi A.
        • Saboor-Yaraghi A.A.
        The effect of vitamin A supplementation on thyroid function in premenopausal women.
        J. Am. Coll. Nutr. 2012; 31: 268-274