Sumac fruit supplementation improve glycemic parameters in patients with metabolic syndrome and related disorders: A systematic review and meta-analysis.

Atie Ghafouri, M Dulce Estêvão, Pooya Alibakhshi, Ana Beatriz Pizarro, Amirhossein Faghihi Kashani, Emma Persad, Hafez Heydari, Motahareh Hasani, Javad Heshmati, Mojgan Morvaridzadeh

Journal: Phytomedicine : international journal of phytotherapy and phytopharmacology 2021;90():153661

PMID: 34334274

Full Text on Elsevier Science View on PubMed

Abstract

BACKGROUND

Metabolic syndrome (MetS) is the one of the main causes of mortality worldwide. Several randomized controlled trials (RCTs) have revealed the beneficial effects of sumac (Rhus coriaria) on cardiometabolic risk factors. However, the entirety of the evidence has yet to be summarized in a systematic review.

OBJECTIVE

The aim of this systematic review and meta-analysis was to evaluate the effects of sumac on several cardiometabolic risk factors in patients with MetS and related disorders.

METHODS

We reviewed Medline, Scopus, Web of Science and Cochrane CENTRAL for RCTs published from inception to December 2020 evaluating the impact of sumac in adults with MetS or related disorders. Outcome measures included anthropometric measures, glycemic indices, blood lipids, blood pressure and liver enzymes. Pooled effect sizes were reported as standard mean differences (SMDs) and 95% confidence intervals (CIs). Trials were pooled using a random effects model.

RESULTS

Nine studies enrolling 526 participants met the inclusion criteria for this meta-analysis. Our results indicate that sumac intake significantly decrease fasting blood sugar (FBS) (SMD: -0.28; 95% CI: -0.54, -0.02; I = 00.0%), insulin (SMD: -0.67; 95% CI: -0.99, -0.36; I = 03.7%), and insulin resistance (measured through the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)) (SMD: -0.79; 95% CI: -1.24, -0.34; I = 50.1%). Sumac intake did not have a significant impact on weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), waist to hip ratio (WHR), HbA1c, total cholesterol (TC), triglycerides (TG), high density lipoproteins (HDL), low density lipoprotein (LDL), systolic blood pressure (SBP), diastolic blood pressure (DBP), aspartate transaminase (AST) and alanine transaminase (ALT).

CONCLUSION

Sumac, as an adjuvant therapy, may decrease serum levels of FBS, insulin and HOMA-IR. However, due to high heterogeneity in the included studies, these findings must be interpreted with great caution. Larger, well-designed placebo-controlled clinical trials are still needed to further evaluate the capacity of sumac as a complementary treatment to control MetS risk factors.

Address: Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.; Universidade do Algarve, Escola Superior de Saúde, Campus de Gambelas, Faro, Portugal.; Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.; Clinical Research Center, Fundación Valle del Lili, Cali, Colombia.; Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran.; Department for Evidence-based Medicine and Evaluation, Danube University Krems, Krems, Austria.; Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran.; Songhor Healthcare Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.

DOI: 10.1016/j.phymed.2021.153661