European Journal of Biomedical and Pharmaceutical Sciences

A STUDY OF TERMINALIA CHEBULA EXTRACT ON ENDOTHELIAL DYSFUNCTION AND BIOMARKERS OF OXIDATIVE STRESS IN PATIENTS WITH METABOLIC SYNDROME.

K. Kiran Kishore, Kishan P. V., Ramakanth G. S. H., Chandrasekhar N. and *Usharani Pingali

ABSTRACT

Background: Metabolic syndrome subjects have endothelial dysfunction via increased oxidative stress increasing the risk of atherosclerosis and coronary heart disease. Terminalia chebula (T.chebula) is known for its antioxidant and antihyperlipidemic activity. The present study compared the effects of an aqueous extract of T.chebula 250 and 500mg versus placebo on endothelial dysfunction and biomarkers of oxidative stress in patients with metabolic syndrome. Methods: Eligible patients were randomized to receive either T.chebula 250 mg, T.chebula 500 mg or placebo twice daily for 12 weeks. The primary efficacy parameter was the change in endothelial function at baseline and after 12 weeks of treatment. Secondary efficacy parameters were changes in biomarkers of oxidative stress (malondialdehyde, nitric oxide, and glutathione), high sensitivity C-reactive protein levels and lipid profile. Laboratory safety parameters were measured at baseline and after 12 weeks of treatment. Results: Fifty six patients completed the study. Treatment with T.chebula 250 mg and 500 mg for 12 weeks produced significant reductions in the reflection index (−2.25%±0.70% to −3.72%±1.35% versus −2.35%±0.85% to −6.14%±1.01% respectively), suggesting improvement in endothelial function compared with baseline. There was a significant improvement in biomarkers of oxidative stress and systemic inflammation compared with baseline and placebo. Further, the treatments significantly improved the lipid profile compared with baseline and placebo. All treatments were well tolerated. Conclusion: Both T.chebula 250 and 500mg significantly improved endothelial function and reduced biomarkers of oxidative stress and systemic inflammation in patients with metabolic syndrome, without any significant changes in laboratory safety parameters. However, T.chebula 500mg produced better improvement in endothelial function than T.chebula 250mg.

Keywords: Terminalia chebula, endothelial dysfunction, oxidative stress, metabolic syndrome.