Pine Bark Extract Improves Lipid Profile and Anthropometric Measures in T2D Patients with Microalbuminuria

by | Oct 13, 2021 | 2021, Blood Lipids, Blood Sugar

Written by Chrystal Moulton, Staff Writer. Urinary albumin-to-creatinine ratio [UACR] (P<0.001), total cholesterol (P =0.03), VCAM-1 levels (P<0.001), and HbA1C levels (P <0.001) were significantly lower in the PBE group compared to placebo at the end of the trial.

diabetesType 2 diabetes mellitus (T2DM) is a major public health issue projected to affect 642 million people worldwide by the year 2040 1. Abnormalities commonly associated with diabetes include oxidative stress, hyperglycemia, inflammation, and endothelial dysfunction which contributes to retinopathy, nephropathy, and atherosclerosis 2,3. Vascular cell adhesion molecule (VCAM-1), which is increased during inflammation and endothelial dysfunction,3 can lead to vascular complications specifically microalbuminuria 4. Vascular cell adhesion molecule level (VCAM-1) is negatively correlated with glomerular filtration rate in type 2 diabetes patients 5 and positively correlated with urinary albumin-to-creatinine ratio (UACR) 2,3. Thus, vascular cell adhesion molecules (VCAM-1) may serve as a predictive marker of nephropathy. Pine bark extract (PBE) is a standardized herbal supplement demonstrating positive effects on metabolic syndrome 6. In vitro studies have reported that pine bark extract (PBE) can decrease expression of cell adhesion molecules in endothelial cells 7. However, few studies have investigated the effect of pine bark extract (PBE) supplementations on VCAM-1 in humans. In the current trial 8, researchers evaluated the effect of pine bark extract (PBE) supplementation on VCAM- 1 level, lipid profile, urinary albumin-to-creatinine ratio (UACR), and anthropometric measures in type 2 diabetes patients with microalbuminuria.

In this randomized double-blind placebo-controlled study, 46 patients with microalbuminuria and type 2 diabetes were randomized to receive pine bark extract (PBE) or placebo for 8 weeks. Patients were randomly assigned using block randomization procedure matching subjects in each block by age, body mass index (BMI), and sex. Twenty-three patients were assigned to the intervention group receiving two capsules (50MG pine bark extract (PBE)/ capsule) and 23 patients were assigned to the placebo group receiving two capsules containing maltodextrin. Venous blood samples were collected at baseline and 8 weeks following 12-hour overnight fasting. Serum concentration of insulin, VCAM- 1 levels, urinary albumin-to-creatinine ratio (UACR), fasting blood sugar, and lipid profile (HDL-C, triglycerides, LDL-C, and total cholesterol) were measured. Anthropometric parameters including body weight, BMI, waist circumference, waist-to-hip ratio (WHR), and waist-to-height ratio (WHTR) were measured as well. Patients were instructed not to change their routine physical activity and dietary pattern during the trial. Primary outcome measurements for the study were changes in serum insulin, HbA1C, fasting blood sugar, VCAM-1 levels, and the UACR. Secondary outcomes were changes in anthropometric parameters and serum lipid profile.

At the end of the trial, researchers observed significant decreases in HbA1C levels (by 10.65%, P< 0.001), total cholesterol (by 14.56% P= 0.005), UACR (by 34.24% P< 0.001), and VCAM-1 (by 26.79% P< 0.001) in the PBE group. VCAM-1 levels increased in the placebo group at the end of the trial (baseline: 24.00 7.10 vs week 8: 26.61 7.35, P= 0.02).  Even after adjusting for baseline values and mean changes in daily energy intake and BMI between the two groups, UACR (P<0.001), total cholesterol (P =0.03), VCAM-1 levels (P<0.001), and HbA1C levels (P <0.001) remained significantly different between the two groups at week 8. Non-significant reduction in fasting blood sugar was observed in the PBE group. Significant improvement in waist-to-height ratio (by 1.51%, P= 0.02) and waist circumference (by 1.77%, P= 0.04) was observed following PBE supplementation. No significant changes in daily intake or physical activity were observed throughout the intervention. Compliance rate was more than 92% of treatment protocol consumed in a prescribed manner during the study. No adverse effects were reported.

In conclusion, 8 weeks supplementation with 100MG/ day of pine bark extract significantly reduced serum VCAM-1 levels, UACR, HbA1C, total cholesterol, waist circumference, and waist to height ratio compared to placebo. Further studies will be needed to validate these results.

Source: Navval-Esfahlan, Elham, Maryam Rafraf, Somayyeh Asghari, Hossein Imani, Mohammad Asghari-Jafarabadi, and Sanaz Karimi-Avval. “Effect of French maritime pine bark extract supplementation on metabolic status and serum vascular cell adhesion molecule-1 levels in patients with type 2 diabetes and microalbuminuria.” Complementary Therapies in Medicine 58 (2021): 102689.

© 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license

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Posted October 13, 2021.

Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.

References:

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