Long-Term Effects of Stevia rebaudiana on Glucose and Lipid Profile,  Adipocytokines, Markers of Inflammation and Oxidation Status  in  Patients with Metabolic Syndrome

Presentation Number: SUN 577
Date of Presentation: April 3rd, 2016

Eva N Kassi, MD, PhD*1, Georgios Landis2, Aikaterini Pavlaki1, George Lambrou1, Emilia Mantzou1, Ioannis Androulakis3, Andreas Giannakou1, Eleni Papanikolaou1 and George P. Chrousos4
1Endocrine Unit of Clinical and Translational Research, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece, 2University of Athens Medical School, Athens, Greece, 3National and Kapodistrian University of Athens, Greece, 41st Dept. of Pediatrics, National and Kapodistrian University of Athens, Medical School, Athens, Greece

Abstract

Metabolic syndrome (MetS) is a cluster of interconnected factors that directly increase the risk of diabetes mellitus type 2 (DMT2) and CVD. Stevia rebaudiana (a low calorie natural sweetener) and its compounds are known for anti-hyperglycemic, anti-inflammatory, anti-oxidant, anti-hypertensive effects.

40 patients (age 47.3±10.3 y) (nmales=14, nfemales=26) with MetS (ΝCEP/ATPIII criteria) were included in the study. Mets patients were following the same low calorie diet and  were randomly assigned to consume either a stevia snack (n= 20) four times a week (Stevia group) or a sweet of their choice (n=20) once a week (control group), for four months. BMI, waist/hip ratio (W/H), systolic and diastolic blood pressure (sBP, dBP) were measured before and after intervention.  Glucose (Glu), triglycerides, cholesterol (LDL,HDL), uric acid, renal and liver function tests were determined in Cobas 8000 (Roche). Insulin (μIU/mL) was measured with CLIA, and HOMA-IR was calculated.  Leptin (ng/dL), adiponectin (μg/ml), Plasminogen Activator Inhibitor 1 (pg/ml) (PAI1), IL-6 (pg/ml),ox-LDL (ng/ml),  suPAR  (pg/ml) were measured with ELISA, HbA1c in DCA BAYER analyzer and total oxidant status : Perox (μmol/lt) photometrically.The normal distribution of the continuous variables was assessed by Kolmogorov-Smirnov test. The Chi square test was applied to compare qualitative variables between Steviaand control group. Paired t-test and Wilcoxon was used  for comparing the variables with normal and non-normal distribution of patients and controls before and after the intervention. To compare variables between the two groups unpaired t-test and Mann-Whitney for variables with normal distribution and non-normal distribution, respectively, was used.

After a four month dietary intervention, a decrease in BMI (p=0.01) sBP (p=0.02), SGOT (p=0.004), γGT (p=0.035), alk phospatase (p=0.008) was observed in the control group. Patients in the Stevia group presented significantly lower levels in TCHOL (p=0.022),  SGOT(p<0.001), γ-GT (p<0.001), ox-LDL(p=0.016), BMI (p<0.001), sBP (p<0.001), dBP (p<0.001) and W/H (p=0.001) after a four month dietary intervention. A marginally significant decrease in suPAR (p=0.078), as well as in HbA1c (p=0.07), LDL (p=0.072), and leptin (p=0.071) was also observed.Comparing the changes in serum values, BMI, W/H, BP and HOMA-IR between the two groups over the four month period, patients in group presented significantly lower levels of ox-LDL (p=0.01) and sBP(p=0.003) and a marginally significant decrease in fasting Glu (p=0.058) and leptin (p=0.054) than patients in the control group.

The introduction of low glycemic load snacks based on Stevia in a low calorie diet in patients with MetS proved to be safe and can lead to a further reduction in BP, fasting glucose, ox-LDL and  leptin compared to a hypocaloric diet alone, decreasing thus further the risk of atherosclerosis and DMT2.

 

Nothing to Disclose: ENK, GL, AP, GL, EM, IA, AG, EP, GPC