Phytosomal Curcumin Improves Glycemic Factors, Liver Function, and Serum Cortisol in Overweight Subjects

by | Apr 15, 2019 | 2019, Curcumin, Liver Health, Obesity

Written by Angeline A. De Leon, Staff Writer. An eight-week supplementation with a phytosomal preparation of curcumin containing phosphatidylserine and piperine improved glycemic factors, hepatic function and serum cortisol levels in participating overweight subjects.

botanicals - curcuminCritical to the prevention of cardiometabolic diseases like type 2 diabetes and non-alcoholic fatty liver disease (NAFLD) is the regulation of glucose and lipid metabolism, particularly in overweight and obese individuals 1,2. In the evolving market of nutraceutical products, curcumin remains one of the most popular, due to its anti-diabetic properties, protective effects on the liver, and attenuation of insulin resistance 3-5. Curcumin demonstrates the ability to increase glucose uptake by pancreatic cells and has been shown to exert anti-inflammatory effects in adipose tissue 6. Despite its favorable impact on glucose metabolism, curcumin is known to have low bioavailability, with limited absorption in the body reducing its potential efficacy 7. In an effort to enhance the intestinal absorption of curcumin, the herbal extract has been experimentally formulated and combined with phytosomes (complex of a natural active ingredient combined with a phospholipid for more efficient absorption) to increase solubility and bioavailability 8,9. Certain phospholipids, when combined with active ingredients like curcumin, can also offer additional benefits. Phosphatidylserine, for example, boasts anti-atherosclerotic properties 10. Piperine (black pepper extract), while not a phospholipid, is also recognized for significantly boosting curcumin absorption by inhibiting the metabolic breakdown of curcumin compounds and reducing its elimination through urine 11,12. A recent study demonstrated that a phytosomal preparation of curcumin containing phosphatidylserine and piperine can improve anthropometric measures in overweight subjects 13. In a 2019 follow-up study 14, researchers at the University of Bologna explored the effects of phosphatidylserine- and piperine-containing curcumin phytosomes on insulin resistance and other metabolic parameters in overweight subjects with suboptimal fasting plasma glucose (FPG).

Using a randomized, double-blind, placebo-controlled, parallel-group study design, researchers recruited a total of 80 subjects (aged 18-70 years) with a body mass index (BMI) between 30 kg/m2 and FPG levels between 100 and 125 mg/dL. Subjects completed two weeks of diet (Mediterranean diet) and physical activity (walking/cycling weekly) and were then randomized to consume 800 mg phytosomal curcumin (200 mg curcumin, 120 mg phosphatidylserine, 480 mg phosphatidylcholine, 8 mg piperine) or matching placebo daily for eight weeks. At baseline, week 4, and week 8, fasting venous blood samples were collected and analyzed to determine total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), FPG, and liver transaminases (glutamic-oxalacetic transaminase, GOT; glutamic-pyruvic transaminase, GPT; gamma-glutamyl transferase, gamma-GT). Researchers also assessed fasting plasma insulin (FPI) and total serum cortisol and computed lipid accumulation product (LAP), hepatic steatosis index (HSI) and fatty liver index (FLI).

From baseline to day 28, the curcumin-treated group exhibited significant improvement in FPG, FPI, homeostatic model assessment of insulin resistance (HOMA-IR) index, and serum cortisol (p < 0.05 for all). Improvement in HOMA-IR was significantly greater for the curcumin group vs. placebo (3.9 +/- 1.2 vs. 4.7 +/- 1.4, respectively, p < 0.05). From baseline to Day 56, the curcumin group also showed significant improvement in BMI, waist circumference, systolic blood pressure, TG, HDL-C, FPG, FPI, HOMA-IR, GOT, GPT, gamma-GT, LAP, HSI, and FLI (p < 0.05 for all). For the curcumin group, in comparison to placebo, FPI (15 +/- 3 vs. 18 +/- 5 mcU/mL, respectively), TG (151 +/- 16 vs. 157 +/- 19 mg/dL), GOT (16 +/- 5 vs. 21 +/- 8 U/L), GPT (15 +/- 3 vs. 21 +/- 9 U/L), FLI (54 +/- 9 vs. 57 +/- 10), and serum cortisol levels were also all significantly improved (p < 0.05 for all). From baseline to the end of the study, placebo exhibited an improvement only in FPG and TG (p < 0.05 for both).

Based on study evidence, a phytosomal preparation of curcumin containing phosphatidylserine and piperine appears to improve glycemic factors and support liver function in overweight, pre-diabetic individuals. Supplementation with curcumin was found to enhance fasting plasma glucose, triglycerides, and serum cortisol levels, and consistent with prior research linking curcumin-phosphatidylcholine phytosomes to improved liver function in patients with NAFLD 15, treatment with curcumin in the present trial reduced activities of liver transaminases (GOT, GPT, gamma GT) and improved FLI score. Thus, the combination of curcumin, phosphatidylserine, and piperine appears to exert a positive synergistic effect that produces powerful overall benefits for cardiometabolic health in overweight individuals. The study’s limitations include a relatively short follow-up period, which prevents observation of the longer-term effects of curcumin on glycemic indices, and the use of a single dose of phytosomal curcumin, which leaves the dose-response relationship of the observed effects open to investigation. In addition to accounting for these study limitations, future trials are warranted to confirm the efficacy of phytosomal curcumin in subjects with type 2 diabetes, NAFLD and other cardiometabolic disorders.
Source: Cicero ARG, Sahebkar A, Fogacci F, et al. Effects of phytosomal curcumin on anthropometric parameters, insulin resistance, cortisolemia, and non-alcoholic fatty liver disease indices: a double-blind, placebo-controlled clinical trial. European Journal of Nutrition. 2019. DOI: 10.1007/s00394-019-0196-7. 

© The Author(s) 2019

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Posted April 15, 2019.

Angeline A. De Leon, MA, graduated from the University of Illinois at Urbana-Champaign in 2010, completing a bachelor’s degree in psychology, with a concentration in neuroscience. She received her master’s degree from The Ohio State University in 2013, where she studied clinical neuroscience within an integrative health program. Her specialized area of research involves the complementary use of neuroimaging and neuropsychology-based methodologies to examine how lifestyle factors, such as physical activity and meditation, can influence brain plasticity and enhance overall connectivity.

References:

  1. Bastien M, Poirier P, Lemieux I, Despres JP. Overview of epidemiology and contribution of obesity to cardiovascular disease. Progress in cardiovascular diseases. 2014;56(4):369-381.
  2. Walker GE, Marzullo P, Ricotti R, Bona G, Prodam F. The pathophysiology of abdominal adipose tissue depots in health and disease. Hormone molecular biology and clinical investigation. 2014;19(1):57-74.
  3. Panahi Y, Khalili N, Sahebi E, et al. Effects of Curcuminoids Plus Piperine on Glycemic, Hepatic and Inflammatory Biomarkers in Patients with Type 2 Diabetes Mellitus: A Randomized Double-Blind Placebo-Controlled Trial. Drug Res (Stuttg). 2018;68(7):403-409.
  4. Zabihi NA, Pirro M, Johnston TP, Sahebkar A. Is There a Role for Curcumin Supplementation in the Treatment of Non-Alcoholic Fatty Liver Disease? The Data Suggest Yes. Curr Pharm Des. 2017;23(7):969-982.
  5. Schuppan D, Schattenberg JM. Non-alcoholic steatohepatitis: pathogenesis and novel therapeutic approaches. J Gastroenterol Hepatol. 2013;28 Suppl 1:68-76.
  6. Hajavi J, Momtazi AA, Johnston TP, Banach M, Majeed M, Sahebkar A. Curcumin: A Naturally Occurring Modulator of Adipokines in Diabetes. Journal of cellular biochemistry. 2017;118(12):4170-4182.
  7. Liu W, Zhai Y, Heng X, et al. Oral bioavailability of curcumin: problems and advancements. Journal of drug targeting. 2016;24(8):694-702.
  8. Mirzaei H, Shakeri A, Rashidi B, Jalili A, Banikazemi Z, Sahebkar A. Phytosomal curcumin: A review of pharmacokinetic, experimental and clinical studies. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie. 2017;85:102-112.
  9. Shakeri A, Sahebkar A. Opinion Paper: Phytosome: A Fatty Solution for Efficient Formulation of Phytopharmaceuticals. Recent patents on drug delivery & formulation. 2016;10(1):7-10.
  10. Darabi M, Kontush A. Phosphatidylserine in atherosclerosis. Curr Opin Lipidol. 2016;27(4):414-420.
  11. Shoba G, Joy D, Joseph T, Majeed M, Rajendran R, Srinivas P. Influence of piperine on the pharmacokinetics of curcumin in animals and human volunteers. Planta medica. 1998;64(04):353-356.
  12. Anand P, Kunnumakkara AB, Newman RA, Aggarwal BB. Bioavailability of curcumin: problems and promises. Molecular pharmaceutics. 2007;4(6):807-818.
  13. Di Pierro F, Bressan A, Ranaldi D, Rapacioli G, Giacomelli L, Bertuccioli A. Potential role of bioavailable curcumin in weight loss and omental adipose tissue decrease: Preliminary data of a randomized, controlled trial in overweight people with metabolic syndrome. Preliminary study. Eur Rev Med Pharmacol Sci. 2015;19:4195-4202.
  14. Cicero AFG, Sahebkar A, Fogacci F, Bove M, Giovannini M, Borghi C. Effects of phytosomal curcumin on anthropometric parameters, insulin resistance, cortisolemia and non-alcoholic fatty liver disease indices: a double-blind, placebo-controlled clinical trial. Eur J Nutr. 2019.
  15. Bedogni G, Bellentani S, Miglioli L, et al. The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population. BMC Gastroenterol. 2006;6:33.