The metabolic syndrome is a high prevalence disease worldwide. About a quarter of the adult population suffers from the disease and predispose the onset of diseases like cardiovascular disease and diabetes mellitus type 2. The first line of treatment for metabolic syndrome is diet and exercise but patients have a low attachment to the treatment, so pharmacologic therapy is required. There is no a single drug that could help to the treatment of all metabolic syndrome components. Irvingia gabonensis, better known as African mango, is widely consumed in central and western Africa, mainly the fruit and seeds. Besides being part of the diet of African the seeds have been used for the treatment of diseases such as dysentery, diabetes and as an analgesic. Resent investigations have demonstrated that an extract of African mango seeds induce significantly weight loss in subjects with obesity, and also improves some biochemical parameters such as glucose and the lipid profile. The aim of this study is to evaluate the effect of Irvingia gabonensis on metabolic syndrome, insulin secretion and insulin sensitivity.
A randomized, double-blind, placebo-controlled, clinical trial is going to be carried out in 24 patients of both sexes aged between 30 and 60 years, with diagnosis of metabolic syndrome according to the modified International Diabetes Federation (IDF) criteria (without diabetes and without previous treatment for metabolic syndrome components). The patients will be assigned randomly into two groups of 12 patients each. The patients will receive 150 mg of Irvingia gabonensis before breakfast and dinner (300 mg per day) or placebo during 12 weeks. Waist circumference, triglycerides, high density lipoproteins (HDL-c) and blood pressure will be evaluated before and after intervention in both groups. First phase of insulin secretion (Stumvoll index), total insulin secretion (Insulinogenic index) and Insulin sensitivity (Matsuda index) will be calculated from the concentration of glucose and insulin obtained from an Oral Glucose Tolerance Test. Data from statistical analysis will be presented through measures of central tendency and dispersion, mean and standard deviation for quantitative variables and frequencies and percentages for qualitative variables. Qualitative variables will be analyzed by X2. The inter group differences will be analyzed through Mann-Whitney U test and Wilcoxon Test for intra-group differences. Statistical significance will be considered with a p\<0.05. This protocol was approved by a local ethics committee and written informed consent will be obtained from all volunteers.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
24
Intervention will be administered 30 minutes before meals
Intervention will be administered 30 minutes before meals
Instituto de Terapéutica Experimental y Clínica
Guadalajara, Jalisco, Mexico
Fasting Glucose Levels at Week 12
Fasting glucose will be evaluated at baseline and week 12 with enzymatic-colorimetric techniques
Time frame: 12 weeks
Triglycerides Levels at Week 12
Triglycerides will be evaluated at baseline and week 12 with enzymatic-colorimetric techniques
Time frame: 12 weeks
High Density Lipoprotein (HDL-C) Levels at Week 12
The HDL-C will be evaluated at baseline and week 12 with enzymatic-colorimetric techniques
Time frame: 12 weeks
Systolic Blood Pressure at Week 12
The systolic and blood pressure will be evaluated at baseline and at week 12 with a digital sphygmomanometer
Time frame: 12 weeks
Diastolic Blood Pressure at Week 12.
The diastolic and blood pressure will be evaluated at baseline and at week 12 with a digital sphygmomanometer
Time frame: Baseline. Week 12
Waist Circumference at Week 12
The waist circumference will be evaluated at baseline and at week 12 with a flexible validated metric tape
Time frame: 12 weeks
First Phase of Insulin Secretion at Week 12
The first phase of insulin secretion will be calculated at baseline and week 12 with the stumvoll index from concentrations of glucose and insulin obtained of an oral glucose tolerance test. Human studies support the critical physiologic role of the first-phase of insulin secretion in the maintenance of postmeal glucose homeostasis. First phase of insulin secretion was estimated using the Stumvoll index (1283+ 1.829 x insulin 30' - 138.7 x glucose 30' + 3.772 x insulin 0'), the entered values reflect the first phase of insulin secretion
Time frame: 12 weeks
Total Insulin Secretion at Week 12
Total insulin secretion will be calculated at baseline and week 12 with the insulinogenic index from concentrations of glucose and insulin obtained of an oral glucose tolerance test. The insulinogenic index is a ratio that relates enhancement of circulating insulin to the magnitude of the corresponding glycemic stimulus. Total insulin secretion was calculated with the insulinogenic index (ΔABC insulin/ΔABC glucose), the entered values reflect the total insulin secretion
Time frame: 12 weeks
Total Insulin Sensitivity at Week 12
Insulin sensitivity will be calculated at baseline and week 12 with the stumvoll index from concentrations of glucose and insulin obtained of an oral glucose tolerance test. Matsuda Index value is used to indicate insulin resistance on diabetes. Insulin sensitivity was calculated with Matsuda index \[10,000 / √glucose 0' x insulin 0') (mean glucose oral glucose tolerance test (OGTT) x mean insulin OGTT)\]. The entered values reflect the insulin sensitivity
Time frame: 12 weeks
Body Weight at Week 12
The body weight will be measured at baseline and week 12 with a bioimpedance balance.
Time frame: 12 weeks
Body Mass Index at Week 12
The body mass index will be calculated at baseline and week 12 with the Quetelet index
Time frame: 12 weeks
Total Cholesterol at Week 12
Total cholesterol will be estimated bye standardized techniques at baseline and week 12
Time frame: 12 weeks
Low Density Lipoproteins (LDL-C) at Week 12
The LDL-C will be calculated at baseline and week 12 with the Friedewald formula
Time frame: 12 weeks
Aspartate Aminotransferase at Week 12
The aspartate aminotransferase will be determinated by standardized techniques at baseline and week 12
Time frame: 12 weeks
Alanine Aminotransferase at Week 12
The alanine aminotransferase will be determinated by standardized techniques at baseline and week 12
Time frame: 12 weeks
Creatinine at Week 12
Creatinine levels will be measured at baseline and week 12 with standardized techniques
Time frame: 12 weeks
Uric Acid at Week 12
Uric acid levels will be measured at baseline and week 12 with standardized techniques
Time frame: 12 weeks
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