Hong, Meegun
(Department of Internal Medicine, Hallym University College of Medicine)
,
Lee, Yoon Hyeong
(Department of Internal Medicine, Hallym University College of Medicine)
,
Kim, Seungwoo
(Department of Biomedical Science, Hallym University College of Medicine)
,
Suk, Ki Tae
(Department of Internal Medicine, Hallym University College of Medicine)
,
Bang, Chang Seok
(Department of Internal Medicine, Hallym University College of Medicine)
,
Yoon, Jai Hoon
(Department of Internal Medicine, Hallym University College of Medicine)
,
Baik, Gwang Ho
(Department of Internal Medicine, Hallym University College of Medicine)
,
Kim, Dong Joon
(Department of Internal Medicine, Hallym University College of Medicine)
,
Kim, Myong Jo
(College of Agriculture and Life Science, Kangwon National University)
Background: Korean Red Ginseng (KRG) is a well-known natural product with anticarcinogenic and antioxidant effects. We evaluated the antifatigue effect of KRG in patients with nonalcoholic fatty liver disease (NAFLD). Methods: Eighty patients with NAFLD were prospectively randomized to receive 3 wk ...
Background: Korean Red Ginseng (KRG) is a well-known natural product with anticarcinogenic and antioxidant effects. We evaluated the antifatigue effect of KRG in patients with nonalcoholic fatty liver disease (NAFLD). Methods: Eighty patients with NAFLD were prospectively randomized to receive 3 wk of KRG or placebo in addition to counseling on healthy eating and regular exercise. Liver function test, proinflammatory cytokines, adiponectin, antioxidant activity, and fatigue score were measured and compared according to the body mass index between the KRG and placebo groups. Results: The liver function tests were significantly improved after 3 wk of treatment in both groups. The mean levels (at baseline and after treatment) of tumor necrosis factor-${\alpha}$ were $108.0pg/mL{\pm}54.8pg/mL$ and $92.7pg/mL{\pm}39.0pg/mL$ (p = 0.018) in the KRG group and $123.1pg/mL{\pm}42.1pg/mL$ and $127.5pg/mL{\pm}62.2pg/mL$ (p = 0.694) in the placebo group, respectively. There was a significant difference in change of adiponectin levels between the KRG ($7,751.2pg/mL{\pm}3,108.1pg/mL$ and $8,197.3pg/mL{\pm}2,714.5pg/mL$) and placebo groups ($7,711.6pg/mL{\pm}3,041.3pg/mL$ and $7,286.1pg/mL{\pm}5,188.7pg/mL$, p = 0.027). In patients with overweight, the fatigue score was significantly decreased in the KRG group ($35.0{\pm}13.2$ and $24.5{\pm}8.9$, p = 0.019). Conclusion: Our results show that KRG might be effective in reducing proinflammatory cytokine and fatigue in overweight patients with NAFLD, in addition to improvements in adiponectin levels.
Background: Korean Red Ginseng (KRG) is a well-known natural product with anticarcinogenic and antioxidant effects. We evaluated the antifatigue effect of KRG in patients with nonalcoholic fatty liver disease (NAFLD). Methods: Eighty patients with NAFLD were prospectively randomized to receive 3 wk of KRG or placebo in addition to counseling on healthy eating and regular exercise. Liver function test, proinflammatory cytokines, adiponectin, antioxidant activity, and fatigue score were measured and compared according to the body mass index between the KRG and placebo groups. Results: The liver function tests were significantly improved after 3 wk of treatment in both groups. The mean levels (at baseline and after treatment) of tumor necrosis factor-${\alpha}$ were $108.0pg/mL{\pm}54.8pg/mL$ and $92.7pg/mL{\pm}39.0pg/mL$ (p = 0.018) in the KRG group and $123.1pg/mL{\pm}42.1pg/mL$ and $127.5pg/mL{\pm}62.2pg/mL$ (p = 0.694) in the placebo group, respectively. There was a significant difference in change of adiponectin levels between the KRG ($7,751.2pg/mL{\pm}3,108.1pg/mL$ and $8,197.3pg/mL{\pm}2,714.5pg/mL$) and placebo groups ($7,711.6pg/mL{\pm}3,041.3pg/mL$ and $7,286.1pg/mL{\pm}5,188.7pg/mL$, p = 0.027). In patients with overweight, the fatigue score was significantly decreased in the KRG group ($35.0{\pm}13.2$ and $24.5{\pm}8.9$, p = 0.019). Conclusion: Our results show that KRG might be effective in reducing proinflammatory cytokine and fatigue in overweight patients with NAFLD, in addition to improvements in adiponectin levels.
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문제 정의
This study is a clinical trial that evaluated fatigue and other outcomes in patients with nonalcoholic steatohepatitis. Therefore, we assumed the sample size by calculating with the difference of 0.
제안 방법
The levels of liver enzymes, proinflammatory cytokines [tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6)], adiponectin, antioxidant activity, and fatigue severity score were measured at the beginning of the study (baseline) and after 3 wk of medication (Fig. 2).
However, few studies have evaluated whether ginseng has a direct effect on fatigue resulting from liver disease or on the biomarker of liver disease. Therefore, in this study, we evaluated the anti-inflammatory antioxidant, and antifatigue activities of Korean Red Ginseng (KRG) in patients with NAFLD.
For the measurements of cytokines and adiponectin, serum was processed using the TNF alpha human ELISA kit (ab100654; Abcam, Inc., Cambridge, United Kingdom), the IL-6 human ELISA kit (ab100572; Abcam, Inc.), and the adiponectin human ELISA kit (ab99968; Abcam, Inc.). All procedures were performed according to the manufacturer’s instructions.
The survey had the following nine questions: (1) my motivation is lower when I am fatigued; (2) exercise brings on my fatigue; (3) I am easily fatigued; (4) fatigue interferes with my physical functioning; (5) fatigue causes frequent problems for me; (6) my fatigue prevents sustained physical functioning; (7) fatigue interferes with carrying out certain duties and responsibilities; (8) fatigue is among my three most disabling symptoms; and (9) fatigue interferes with my work, family, or social life. All patients scored each question on a 7-point scale (1 = strongly disagree, 4 = neither disagree nor agree, and 7 = strongly agree). All answers were collected and calculated by one research nurse in the Department of Internal Medicine.
대상 데이터
Randomization was performed using a computerized procedure. A total of 80 patients were enrolled. Among them, 14 patients (5 patients in the KRG group and 9 patients in the placebo group) were excluded (8 patients refused to participate, 4 patients had inadequate records, and 2 patients were consuming alcohol; Fig.
Serum biochemical parameters included total bilirubin (TB), ALT, AST, gamma-glutamyl transpeptidase (γ-GT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), albumin, blood urea nitrogen, α1-antitrypsin, creatinine, α-fetoprotein, prothrombin time, blood glucose, triglycerides, total protein (TP), and total cholesterol. All patients were tested for several hepatitis viruses and human immunodeficiency virus. Hepatitis A virus was detected using antihepatitis A IgG and IgM antibodies, and hepatitis B virus was detected using the IgM antibody against the hepatitis B core antigen, the hepatitis B surface antigen, and the hepatitis B surface antibody.
No other medication was prescribed. The placebos were manufactured at the Korea Ginseng Corporation (Seoul, South Korea), and resembled the KRG capsule powder in both shape and size.
7 and standard deviation (SD) of 1 in the fatigue score. A total of 60 patients were needed for this study. The primary outcome was change in liver enzyme levels and fatigue scale score at 3 wk.
Sixty-six patients (35 patients in the KRG group and 31 in the placebo group) completed the study. The mean age was 49.
이론/모형
We used the Krupp Fatigue Severity Scale [17]. The survey had the following nine questions: (1) my motivation is lower when I am fatigued; (2) exercise brings on my fatigue; (3) I am easily fatigued; (4) fatigue interferes with my physical functioning; (5) fatigue causes frequent problems for me; (6) my fatigue prevents sustained physical functioning; (7) fatigue interferes with carrying out certain duties and responsibilities; (8) fatigue is among my three most disabling symptoms; and (9) fatigue interferes with my work, family, or social life.
성능/효과
ginseng Meyer in treating fatigue in overweight patients. Based on the results of this study, it is concluded that KRG is effective in treating fatigue in NAFLD patients, especially in overweight patients.
In conclusion, KRG reduced TNF-α serum levels and increased adiponectin serum levels in patients with NAFLD.
It was reported that structures produced by adipocytes are homologous to adiponectin and TNF-α and are antagonistic to the insulin-modulating effects of these compounds [26,32]. In this study, patients with a BMI of 25 kg/m2 or more showed a significant increase in serum adiponectin levels compared to patients with a BMI less than 25 kg/m2 . In addition, overweight patients treated with KRG had significantly decreased TNF-α levels.
후속연구
notoginseng saponins downregulated IL-6 in rats with liver fibrosis [33]. For the evaluation of exact mechanism of KRG, more research is required to further investigate the therapeutic effect of KRG on IL-6 levels.
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