The Effects of Fenugreek on Cardiometabolic Risk Factors in Adults: A Systematic Review and Meta-analysis
Introduction
Cardiovascular disease (CVD) is the leading cause of mortality across the world.1 Based on the report from World Health Organization (WHO), around 31% of all deaths each year occurred due to CVD worldwide.2 Cardiometabolic risk factors are a combination of vascular and metabolic factors including glycemic and lipid profile parameters, anthropometric indices and blood pressure that are likely to enhance the risk of CVDs and diabetes.3
The first-line treatment of cardiometabolic risk factors are lifestyle modifications. 4,5 However, pharmacotherapy along with primary approaches is commonly required to prevent complications and to treat metabolic disorders.6 Potential therapeutic benefits of medicinal herbs and other types of complementary therapies for the management of cariometabolic risk factors have attracted considerable attentions over the last several decades. 7 WHO recommends that more research on medicinal herbs should be conducted to clarify the efficacy and adverse events of medicinal herbs. 8 Early evidence demonstrates that some herbs such as Urtica dioica, 9 Nigella sativa, 10 Cinnamomum verum 11 and Trigonella foenum 12,13 may exert positive effects on cardiometabolic parameters.
Fenugreek (Trigonella foenum-graecum L.) is a medicinal herb from the Fabaceae family and is cultivated mostly in India and North African countries. 14 Fenugreek seeds have been used both as spice and therapeutic materials in traditional medicine. 15 Fenugreek seeds contain soluble and insoluble dietary fiber, alkaloids, steroidal saponins and flavenoids. 16 Anti-inflammatory and anti-oxidant components of fenugreek are key factors for therapeutic effects of this plant. 17,18 Evidence showed diverse beneficial effects of fenugreek such as anti-diabetic, digestive stimulant, cardioprotective and gastroprotective properties. 19 Several animal studies 20, 21, 22, 23 and clinical trials 24, 25, 26 showed beneficial effects of fenugreek on metabolic parameters. However, findings are conflicting.
To the best of our knowledge, two meta-analyses have been published so far. Gong et al (2016) assessed the effects of fenugreek on hyperglycemia and hyperlipidemia, 27 while another earlier meta-analysis only evaluated anti-hyperglycemic impact of fenugreek. 28 However, limitations exist in these two meta-analyses: (i) in both, search was not performed systematically and (ii) other cardiometabolic effects of fenugreek were not examined. In addition, the meta-analysis by Gong et al. limited to patients with pre-diabetes and diabetes and did not cover other CVD risk factors. 27 Thus, in the current systematic review and meta-analysis we aim to assess the effectiveness and safety of fenugreek on key cardiometabolic risk factors in adult populations.
Section snippets
Methods
The present meta-analysis was designed in accordance to the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) statement guideline. 29 Participants, intervention, comparison and outcomes were defined in Table 1 according to PICO criteria 30 and a comprehensive search was conducted.
Four electronic databases including PubMed/Medline, Scopus, Embase and Cochrane Library were searched by two independent investigators (N.N and M.KH) from 2000 to 31 July 2019 to identify
Study Selection
In total, 2,738 publications were identified from PubMed (n = 533), Scopus (n = 985), Embase (n = 1,063) and Cochrane library (n = 157). Of which, 1,206 were duplicates. As depicted in Fig. 1, initial screening based on titles and abstracts was performed and 24 publications were considered potentially relevant. Six additional publications were found after hand-search. Out of these, 16 studies were excluded and the reasons of exclusions were as follows: bioactive components (not whole plant) (n
Discussion
The current systematic review and meta-analysis indicates that fenugreek seed can reduce serum levels of FBS, LDL-C and HbA1c compared to placebo. Furthermore, reduction in FBS concentrations in patients with T2DM following fenugreek treatment was -22.80 mg/dL compare to control treatment. Due to high level of heterogeneity in glycemic parameters, findings must be interpreted with great caution.
To the best of our knowledge, only two meta-analysis were previously conducted to evaluate effects of
Conclusion
Based on the current systematic review and meta-analysis, fenugreek seed as an adjutant therapy may reduce serum levels of FBS, LDL-C and HbA1c. Taking into account the high heterogeneity in glycemic status, findings must be interpreted with great caution. More placebo-controlled clinical trials with larger sample size are warranted to further assess the effectiveness of fenugreek as a complementary therapy for both diabetic and non-diabetic patients to control cardio-metabolic risk factors.
Conflict of interest
Authors declared no conflict of interest.
Acknowledgment
We would like to thank Endocrinology & Metabolism Research Institute, Tehran University of Medical Sciences for financial support (grant number is 1398-2-97-913).
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Quality-controlled LC-ESI-MS food metabolomics of fenugreek (Trigonella foenum-graecum) sprouts: Insights into changes in primary and specialized metabolites
2023, Food Research InternationalCitation Excerpt :Fenugreek is also one of the well-researched medicinal plants that is consumed as a functional food against impaired glycemic control, metabolic disorders and obesity (Avalos-Soriano, De la Cruz-Cordero, Rosado, & Garcia-Gasca, 2016; Hamden et al., 2010; L. Liu, Du, Zhang, & Zhou, 2018; Mayakrishnan et al., 2015; Verma et al., 2016). This application is supported by a meta-analysis based on 12 controlled clinical trials, as recently concluded by Khodamoradi et al. (2020). A list of products currently available on the global market has recently been compiled as well (Yao et al., 2020).
Effects of fenugreek supplementation on the components of metabolic syndrome: A systematic review and dose-response meta-analysis of randomized clinical trials
2023, Pharmacological ResearchCitation Excerpt :Also, another meta-analysis in 2016 [62] reported a significant reduction in TG and FPG levels, but the results for HDL-c were not significant; however, this meta-analysis only included studies that were conducted in diabetic and pre-diabetic patients. Another meta-analysis was carried out in 2020 [63] to assess the effect of fenugreek on cardiometabolic risk factors including glycemic indices, lipidemic parameters, and anthropometric indices; however, they didn’t include any studies for WC and blood pressure. Similar to our study fenugreek could reduce FPG, except the magnitude of reduction which is greater in our study and the result for BMI was insignificant like the current meta-analysis; in contrast, pooled results for TG and HDL-c weren’t significant.
Targeting dyslipidemia by herbal medicines: A systematic review of meta-analyses
2021, Journal of EthnopharmacologyCitation Excerpt :The remaining 60 meta-analyses have been categorized as “other herbal medicines” group, as they contained lower number of herbal medicines. This group was included pooled effect of avocado, berberis, cinnamon, cumin, fenugreek, garlic, ginger, ginseng, grape, sour tea, pomegranate, saffron, cayenne pepper, cardamom, purslane, aronia, rhus, tulsi, Artichoke, white mulberry, Spirulina, and other herbs (Mahmassani et al., 2018; Peou et al., 2016; Pourmasoumi et al., 2018, 2019, 2020; Hadi et al., 2019a, 2019b; Zhang et al., 2016b, 2019, 2020; Ju et al., 2018; Phimarn et al., 2017; Huang et al., 2016; Lan et al., 2015; Dong et al., 2013; Heydarpour et al., 2020; Ainehchi et al., 2019; Allen et al., 2013; Jafarnejad et al., 2017, 2018; Askarpour et al., 2020; Heshmat-Ghahdarijani et al., 2020; Khodamoradi et al., 2020; Gong et al., 2016; Shabani et al., 2019; Sun et al., 2018; Ried et al., 2013; Silagy and Neil, 1994; Maharlouei et al., 2019; Mazidi et al., 2016; Ziaei et al., 2020; Hernández-García et al., 2019; Gui et al., 2016; Asbaghi et al., 2019, 2020b; Feringa et al., 2011; Bule et al., 2020; Najafpour Boushehri et al., 2020; Aziz et al., 2013; Jandari et al., 2020; Sahebkar et al., 2016a, 2016c, 2018; Taherifard et al., 2020; Rahmani et al., 2019a, 2019b; Hallajzadeh et al., 2020; Jang et al., 2020; Payab et al., 2020; Shekarchizadeh-Esfahani et al., 2020; Lee et al., 2020; Akbari-Fakhrabadi et al., 2018; Mohammadi et al., 2019a; Jamshidi et al., 2018; Teoh et al., 2018;; Sawangjit et al., 2017; Daryabeygi-Khotbehsara et al., 2017; Serban et al., 2016; Onakpoya et al., 2015; Cheng et al., 2013). Along with healthy subjects, the underlying disorders of participants were DM, HLP, obesity, NAFLD, CAD, MetS, chronic kidney disease (CKD), and HTN.
The Effect of Fenugreek in Type 2 Diabetes and Prediabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
2023, International Journal of Molecular SciencesIntegration of molecular docking, molecular dynamics and network pharmacology to explore the multi-target pharmacology of fenugreek against diabetes
2023, Journal of Cellular and Molecular Medicine