Effects of curcumin on PCOS pathophysiology

reference

SOHEIE S, Amani R, Tarrahi MJ, Ghasemi-Tehrani H. The effects of a curcumin supplementation on glycemic status, the lipid profile and the HS CRP levels for overweight/obese women with polycystic ovarian syndrome: a randomized, double-blind, placebo-controlled study Clinical study. Supplement Ther Med . 2019; 47: 102201.

draft

a 6-week, randomized, double-blind, placebo-controlled clinical study

objective

The researchers carried out this study to determine the effect of a curcumin supplementation on the glycemic status, the lipid profile and the mirror of the highly sensitive C-reactive protein (HS-CRP) for overweight/obese women with polycystic syndrome (PCOS).

participant

sixty women with PCOS, diagnosed according to the Rotterdam criteria, aged 18 to 40 years and with a body mass index (BMI) between 25 and 35 kg/m 2 participated in the study. Exclusion criteria included pregnancy, lactation, hyperprolactinemia, thyroid disease, digestive problems, type 2 diabetes mellitus, congenital adrenal hyperplasia and open infection. The use of one of the following means in the 3 months before the study also led to the exclusion: oral contraceptives, nutritional supplements with antioxidants and all interventions that could change insulin sensitivity, inflammation or oxidative stress.

Intervention

The experimental group (n = 30) received 500 mg standardized turmeric extract every day (475 mg curcuminoids, which contain curcuminoids in the following shares: 70 % –80 % - 20 % Demethoxycurcumin, 2.5 % –6.5 % up to it. The control group (n = 30) followed the same dosage plan, but with placebo. The participants should take the nutritional supplements with 2 main meals.

target parameter

The primary target parameters included total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density-lipoprotein (HDL), LDL/HDL ratio, sober-blood sugar, insulin, homeostasis model of assessment Insulin resistance (Homa-IR), quantitative insulin sensitivity check index (Quicki) and HS-CRP. The investigators received measurements at the beginning of the course and in week 6.

important knowledge

Finf-fifty of the 60 participants ended the study, 27 in the curcumin group and 24 in the placebo group. Three broke off the intervention due to pregnancy, the rest withdrew for personal reasons that were not more detailed. In the experimental group, 3 participants reported on gastrointestinal symptoms; Otherwise, no other disadvantageous effects were found.

After 6 weeks of intervention, statistically significant changes in serum insulin ( p = 0.020) and Quicki ( p = 0.003), Baseline vs. end, occurred at those who took curcumin. All other parameters were not significantly improved and the differences between the groups were not significant.

practice implications

The polycystic ovarian syndrome is a complex, multifactorial endocrine disorder that affects up to 18 % of women of childbearing age. ^{1 It is characterized by hyperandrogenism, ovulatory dysfunction and polycystic ovarian morphology, with 2 of the 3 for diagnosis according to the diagnosis Redterdam criteria are required. 2 Metabolic disorders, including dysglycaemia and dyslipidemia, are as widespread in people with PCOS as chronic inflammation. In view of the predisposition for cardiometabolic diseases, the treatment goals should include the normalization of blood sugar, lipid and inflammatory status.}

It was not mentioned to combine a curcumin supplement either with food fat or black pepper for improved bioavailability.

metformin, a conventional means of the first choice for PCOS, demonstrated demonstrably the serum glucose and insulin level, normalizes the lipid and reduces inflammation, although not all patients can take the medication. ^{4.5 Alternative interventions like inositol have become an interesting topic among researchers. The authors of the article, which is currently being checked, set the hypothesis that curcumin would function similarly in view of its anti -inflammatory, antioxidative and hypolipidemic properties. In this study, however, the advantages were only limited to improvements in insulin levels. 7}

The overwhelming results can be attributed to restrictions on the study design. A 6-week intervention period is probably not sufficient to evaluate the effectiveness of a nutritional supplement. The authors recognize this, although they also quote several studies in which effects were found within 1 month after the start of treatment with curcumin. Based on these earlier results, the test duration was considered appropriate. The authors also recognize the likelihood of variability in the absorption. They did not carry out any metabolite tests to determine the curcumin level, although this could have proven to be useful. The researchers instructed the participants to take dietary supplements at meals to maximize the absorption, but it was not mentioned that a curcumin supplement should be combined either with food fat or black pepper for improved bioavailability.

Since the publication of this article in 2019, two randomized control studies on curcumin and overweight/obese PCOS women have been carried out. Jamilian et al. After 12 weeks of taking 500 mg curcumin, a significant benefit for the metabolic parameters. They found improvements in glycemic control, the lipid parameters (except triglycerides and lipoprotein very low density), weight and gene expression of the peroxisoma proliferator-activated receptor gamma (PPAR-turn). Curcumin and led to a highly regulated activity of proteins and enzymes that serve as modulators of oxidative stress. 10

It is obvious that research on curcumin and PCOS is coming, whereby the results of these studies serve as preliminary evidence. Further research is necessary to clarify his role in the change in PCOS pathophysiology and to determine the therapeutic dosage. In view of the fact that there are numerous other therapies with well -documented advantages, it can be advisable to reserve the recommendation for those who also have comorbidities that are known to respond to curcumin. Apart from that, the encouragement of the patients to add a few additional splashes of turmeric can be a sensible addition to a rounded treatment plan without a significant effect on PCOS pathophysiology.