Clinical Evidence

Curcuminoids Plus Piperine Modulate Adipokines in Type 2 Diabetes Mellitus
Curr Clin Pharmacol.  2017;12(4):253-258
Adipokines such as adiponectin and leptin are known to show anti-inflammatory action along with anti-hyperglycemic actions such as increasing insulin sensitivity, decreasing gluconeogenesis and increasing glucose uptake. Ghrelin is a circulating peptide secreted mainly by the fundus region of the stomach and is known to promote weight gain by stimulating food intake besides possession of anti-inflammatory effects on the release of pro-inflammatory cytokines. Thus, together adiponectin, leptin and ghrelin are seemed to be modulators of energy homeostasis besides showing immunomodulatory effects. Also, the leptin-to-adiponectin ratio is used as a measure of cardiovascular risk (atherosclerotic index). Tumour necrosis factor-alpha (TNF-α) is an important mediator of chronic inflammation that is known be produced by the inflamed adipose tissue and contribute to the development of metabolic disorders such as insulin resistance and type 2 diabetes mellitus. Curcumin, the bioactive constituent of turmeric was known to show a direct effect on the release and expression of adipokines. It was also suggested that curcumin may increase the levels of ghrelin.

Objective:

To investigate the effects of curcuminoids on the serum levels of adiponectin, leptin and ghrelin irrespective of its effects on body weight changes in human subjects.

Methodology:

A total of 118 adult subjects (age: 18-65 years) diagnosed with type-2 diabetes mellitus (T2DM) were recruited into a randomized double-blinded, placebo-controlled, parallel-group clinical trial. Subjects were allocated to the daily supplementation with either 1000 mg/day curcuminoids (co-administered with 10 mg/day piperine) or placebo for a period of 3 months.

Results and Discussion:
  • The curcuminoid-piperine combination was reported to be well tolerated with no severe adverse effect
  • At the end of the study, the net effects of curcuminoids co-administered with piperine were reported to be significant on serum levels of adiponectin (p=0.032), leptin (p<0.001) and TNF-α (p<0.001) as well as leptin-to-adiponectin (p<0.001) ratio compared to placebo are shown in the graph below:
Conclusion

The study suggests the potential of curcuminoids co-administered with piperine to lower inflammatory TNF-α level, and the risk metabolic disorder and cardiovascular diseases by affecting the serum adipokines independent of weight changes. This study once again highlights the immunomodulatory, cardio-protection actions of curcumin among the studied parameters.