Intervention of Ayurvedic drug Tinospora cordifolia attenuates the metabolic alterations in hypertriglyceridemia: a pilot clinical trial

Abstract

Purpose

Hypertriglyceridemia (HG) is an independent risk factor with more prevalence than hypercholesterolemia and its attributes to cardiovascular disease (CVD) and pancreatitis. Hence, it becomes imperative to search for new triglyceride (TG) lowering agents. Tinospora cordifolia (TC) is a well-known Ayurvedic drug and a rich source of protoberberine alkaloids hence can contribute to TG lowering without side effects. Hence, to explore the therapeutic efficacy of T. cordifolia and its effects on biochemistry and metabolome in the patients of hyper-triglyceridemia, clinical trials were conducted.

Methods

Patients (n = 24) with hypertriglyceridemia were randomized into two groups to receive T. cordifolia extract (TCE) (3.0 g/per day) and metformin (850 mg/day) for 14 days having >300 mg/dl triglyceride level and cholesterol in the range of 130–230 mg/dl. Lipid profiles of blood samples were analyzed. Urine samples were subjected to HPLC-QTOF-MS to quantify oxidative damage and abnormal metabolic regulation.

Results

Intervention with TCE reduced the triglyceride, LDL, and VLDL levels to 380.45 ± 17.44, 133.25 ± 3.18, and 31.85 ± 5.88 mg/dL and increased the HDL to 47.50 ± 9.05 mg/dL significantly (p < 0.05) in the HG patients after 14 days treatment. TCE dosage potently suppressed the inflammatory and oxidative stress marker’s i.e. levels of isoprostanes significantly (p < 0.01). Qualitative metabolomics approach i.e. PCA and PLS-DA showed significant alterations (p < 0.05) in the levels of 40 metabolites in the urine samples from different groups.

Conclusion

TCE administration depleted the levels of markers of HG i.e. VLDL, TG, and LDL significantly. Metabolomics studies established that the anti-HG activity of TCE was due to its antioxidative potential and modulation of the biopterin, butanoate, amino acid, and vitamin metabolism.

Clinical trials registry

India (CTRI) registration no. CTRI- 2016-08-007187.

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Abbreviations

HG:

Hyper-triglyceridemia

PPAR:

Peroxisome proliferator-activated receptors

PLS-DA:

Partial least-squares-discriminant analysis

HL:

Hyperlipidemia

H:

Healthy

RRLC:

Rapid Resolution Liquid Chromatography

ESI-Q-TOF-MS:

Electrospray Ionization Quadrupole Time of Flight Mass Spectrometry

TCE:

Tinospora cordifolia Extract

AST:

Aspartate transaminase

ALT:

Alanine transaminase

RT:

Retention time

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Acknowledgements

Authors wish to acknowledge the CCRAS, Ministry of AYUSH, Govt of India for supporting the work.

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Authors

Contributions

AS and RD design the study and conducted the experiment. AY, RD and TK Mandal interpret the data and design the manuscript.

Corresponding author

Correspondence to Rajesh Dabur.

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Ethics approval

Human Ethics Committee of the PDDYP Ayurveda College, Pune, India approved the study wide letter no. RRI/2011/HEC/2023 dated 18-02-2011.

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All authors declare that they have no conflict of interest.

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Shirolkar, A., Yadav, A., Mandal, T.K. et al. Intervention of Ayurvedic drug Tinospora cordifolia attenuates the metabolic alterations in hypertriglyceridemia: a pilot clinical trial. J Diabetes Metab Disord (2020). https://doi.org/10.1007/s40200-020-00657-3

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Keywords

  • Tinospora cordifolia
  • Hyperlipidemia
  • Hyper-triglyceridemia
  • Metabolomics
  • HPLC-QTOF-MS