Journal of Sports and Biomotor Sciences

Journal of Sports and Biomotor Sciences

Effect of supplementation of Mulberry leaf extract and combined exercises on serum levels of TNF-α and interleukin 18 in elderly patients with type 2 diabetes

Document Type : Original Article

Authors
1 PhD Candidate, Department of Exercise Physiology, Mahallat Branch, Islamic Azad University, Mahallat, Iran
2 Professor, Department of Exercise Physiology, Tehran north Branch, Islamic Azad University, Tehran. Iran
3 Assistant Professor, Department of Exercise Physiology, Pardis Branch, Islamic Azad University, Pardis, Iran
Abstract
Introduction and Purpose: Inflammatory markers play an important role in the pathogenesis of diabetes. However, the effect of exercise and Mulberry leaf extract on diabetics is not well known. The purpose of this study was to investigate the effect of eight weeks of aerobic-resistance exercises along with the consumption of Mulberry leaf extract on the serum levels of TNF-α and interleukin 18 in elderly patients with type 2 diabetes.
Materials and Methods: In this clinical study, 40 elderly men (mean age: 67.07±1.50) with type 2 diabetes were randomly divided into five control groups (8 people), placebo (8 people), and Mulberry leaf extract (8 people). Combined training (8 people) and Mulberry leaf extract + combined training (8 people) were included. The exercises were done for eight weeks and three sessions per week for 90 minutes. 3000 mg of Mulberry leaf extract per day was prescribed along with three main meals. Before the intervention and 48 hours after the last training session, serum levels of TNF-α and interleukin 18 were measured through blood samples. The SPSS software and the analysis of covariance statistical test, followed by the Benferroni post hoc test at a significance level of 0.05, were used to analyze the data.
Results: A significant decrease in TNF-α and interleukin 18 levels was observed in the exercise, extract and exercise+extract groups (P<0.05). The results between the groups showed a significant difference in TNF-α (P=0.001) and interleukin 18 (P=0.001), which is greater in the extract + exercise group than the exercise and extract groups.
Discussion and Conclusion: It seems that 8 weeks of combined exercise combined with the consumption of Mulberry leaf extract reduces the inflammatory cytokines TNF-α and interleukin-18 in elderly men with type 2 diabetes.
Keywords

Rossi G, Association AD. Diagnosis and classification of diabetes mellitus. Recenti progressi in medicina. 2010;101(7-
8):274-6. doi.org/10.2337/dc10-S062.
2. Saed L, Deihim Z, Naghshbandi MK, Rajabnia M, Naleini SN. Cardiovascular events in patients with over 10 years
history of type 2 diabetes mellitus. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019;13(1):68-72.
doi.org/10.1016/j.dsx.2018.08.026.
3. Tenger C, Sundborger A, Jawien J, Zhou X. IL-18 accelerates atherosclerosis accompanied by elevation of IFN-γ and
CXCL16 expression independently of T cells. Arteriosclerosis, thrombosis, and vascular biology. 2005;25(4):791-6.
doi.org/10.1161/01.ATV.0000153516.02782.65.
4. Frayling TM, Rafiq S, Murray A, Hurst AJ, Weedon MN, Henley W, et al. An interleukin-18 polymorphism is associated
with reduced serum concentrations and better physical functioning in older people. The journals of gerontology Series A,
Biological sciences and medical sciences. 2007;62(1):73-8. doi.org/10.1093/gerona/62.1.73.
5. Wilund KR. Is the anti-inflammatory effect of regular exercise responsible for reduced cardiovascular disease? Clinical
Science. 2007;112(11):543-55. https://doi.org/10.1042/CS20060368.
6. Zirlik A, Abdullah SM, Gerdes N, MacFarlane L, Schönbeck U, Khera A, et al. Interleukin-18, the metabolic syndrome,
and subclinical atherosclerosis: results from the Dallas Heart Study. Arteriosclerosis, thrombosis, and vascular biology.
2007;27(9):2043-9. https://doi.org/10.1161/ATVBAHA.107.149484.
7. Kabir b, Taghian F, Ghatreh Samani K. Dose 12 week resistance training Influence IL-18 and CRP levels in Elderly
men? Razi Journal of Medical Sciences. 2018;24(165):77-84. [In Persian]
8. Yamaoka-Tojo M, Tojo T, Wakaume K, Kameda R, Nemoto S, Takahira N, et al. Circulating interleukin-18: a specific
biomarker for atherosclerosis-prone patients with metabolic syndrome. Nutrition & metabolism. 2011;8(1):1-8.
doi.org/10.1186/1743-7075-8-3.
9. Agha Alinejad H, Mehrabani J, Ansari Dogahe R, Piri M. The Influence of Resistance, Endurance, and Combined
Resistance-endurance Exercise Training on Interleukin-18 and C-reactive Protein Level in Inactive Female Adolescents.
Tabari Biomedical Student Research Journal. 2016; 2 (1) :38-47. [In Persian]
10. Macêdo Santiago LÂ, Neto LGL, Borges Pereira G, Leite RD, Mostarda CT, de Oliveira Brito Monzani J, Sousa WR,
Rodrigues Pinheiro AJM, Navarro F. Effects of Resistance Training on Immunoinflammatory Response, TNF-Alpha
Gene Expression, and Body Composition in Elderly Women. Journal of Aging Research. 2018 Oct 28;2018:1467025.
doi.org/10.1155/2018/1467025.
11. Kohut M, McCann D, Russell D, Konopka D, Cunnick J, Franke W, et al. Aerobic exercise, but not flexibility/resistance
exercise, reduces serum IL-18, CRP, and IL-6 independent of β-blockers, BMI, and psychosocial factors in older adults.
Brain, behavior, and immunity. 2006;20(3):201-9. doi.org/10.1016/j.bbi.2005.12.002.
12. Vatandost M, Zolfaghari F, Agha-Alinejad H, Peeri M, Nasirzade A, Khanmohamadi S, et al. The effect of 6 weeks
resistance training on serum levels of IL-18 and TNF-α in type I diabetic male rats. Annals of Biological Research.
2012;3(2):924-9.
13. Kouhi F, Moradi F, Absazadegan M. Effect of resistance training on serum interleukin-18 and C-reactive protein in obese
men. Journal of Gorgan University of Medical Sciences. 2014;16(1). [In Persian]
14. Tond SB, Fallah S, Salemi Z, Seifi M. Influence of mulberry leaf extract on serum adiponectin, visfatin and lipid profile
levels in type 2 diabetic rats. Brazilian Archives of Biology and Technology. 2016;59.
15. Kim DS, Kang YM, Jin WY, Sung YY, Choi G, Kim HK. Antioxidant activities and polyphenol content of Morus alba
leaf extracts collected from varying regions. Biomedical reports. 2014;2(5):675-80.
16. Park JM, Bong HY, Jeong HI, Kim YK, Kim JY, Kwon O. Postprandial hypoglycemic effect of mulberry leaf in GotoKakizaki rats and counterpart control Wistar rats. Nutrition Research and Practice. 2009;3(4):272.
doi.org/10.4162/nrp.2009.3.4.272.
17. Jeszka-Skowron M, Flaczyk E, Jeszka J, Krejpcio Z, Król E, Buchowski MS. Mulberry leaf extract intake reduces
hyperglycaemia in streptozotocin (STZ)-induced diabetic rats fed high-fat diet. Journal of Functional Foods. 2014;8:9-
17. doi.org/10.1016/j.jff.2014.02.018.
18. Riche DM, Riche KD, East HE, Barrett EK, May WL. Impact of mulberry leaf extract on type 2 diabetes (Mul-DM): a
randomized, placebo-controlled pilot study. Complementary therapies in medicine. 2017;32:105-8.
doi.org/10.1016/j.ctim.2017.04.006
19. Uchiyama H, Komatsu K-I, Nakata A, Sato K, Mihara Y, Takaguri A, et al. Global Liver Gene Expression Analysis on a
Murine Hepatic Steatosis Model Treated with Mulberry (Morus alba L.) Leaf Powder. Anticancer research.
2018;38(7):4305-11. /doi.org/10.21873/anticanres.12729
20. Touvra A-M, Volaklis KA, Spassis AT, Zois CE, Douda HT, Kotsa K, et al. Combined strength and aerobic training
increases transforming growth factor-β1 in patients with type 2 diabetes. Hormones. 2011;10(2):125-30. DOI:
10.14310/horm.2002.1302..
21. Shenoy S, Guglani R, Sandhu JS. Effectiveness of an aerobic walking program using heart rate monitor and pedometer
on the parameters of diabetes control in Asian Indians with type 2 diabetes. Primary Care Diabetes. 2010;4(1):41-5.
doi.org/10.1016/j.pcd.2009.10.004
22. Seyedizadeh SH, Cheragh-Birjandi S, Hamedi Nia MR. The effects of combined exercise training (resistance-aerobic) on
serum kinesin and physical function in type 2 diabetes patients with diabetic peripheral neuropathy (randomized
controlled trials). Journal of diabetes research. 2020; doi.org/10.1155/2020/6978128. [In Persian]
23. Ferriolli E, Pessanha FPAS, Marchesi JCLS. Diabetes and exercise in the elderly. Diabetes and physical activity.
2014;60:122-9. DOI: https://doi.org/10.1159/000357342.
24. Kołakowska U, Kuroczycka–Saniutycz E, Wasilewska A, Olański W. Is the serum level of salusin-β associated with
hypertension and atherosclerosis in the pediatric population? Pediatric Nephrology. 2015;30(3):523-31.
doi.org/10.1007/s00467-014-2960-y.
25. Aliniya N, Elmieh A, Fadaei Chafy MR. Interaction Effect of Combined Exercise and Supplementation With Portulaca
Oleracea on Liver Enzymes in Obese Postmenopausal Women With Non-Alcoholic Fatty Liver Disease. complementary
Medicine Journal. 2020;10(1):68-79.doi. 10.32598/cmja.10.1.960.1..
26. Jackson AS, Pollock ML. Generalized equations for predicting body density of men. British journal of nutrition.
1978;40(3):497-504. doi.org/10.1080/00140138208924958
27. Ho SS, Dhaliwal SS, Hills AP, Pal S. Effects of chronic exercise training on inflammatory markers in Australian
overweight and obese individuals in a randomized controlled trial. Inflammation. 2013;36:625-32.
28. Abd El-Kader MS, Al-Jiffri O, Ashmawy EM. Impact of weight loss on markers of systemic inflammation in obese Saudi
children with asthma. African Health Sciences. 2013;13(3):682-8. doi: 10.4314/ahs.v13i3.23.
29. Zwetsloot KA, John CS, Lawrence MM, Battista RA, Shanely RA. High-intensity interval training induces a modest
systemic inflammatory response in active, young men. Journal of inflammation research. 2014;7:9-17.
30. Tonet A, Nóbrega O. Immunossenescence: the relationship between leukocytes, cytokines and chronic diseases. Brazilian Journal of Geriatrics and Gerontology. 2008;2(11). doi.org/10.1590/1809-9823.2008.110210.
31. Persson GR, Pettersson T, Ohlsson O, Renvert S. High‐sensitivity serum C‐reactive protein levels in subjects with or
without myocardial infarction or periodontitis. Journal of clinical periodontology. 2005;32(3):219-24.
doi.org/10.1111/j.1600-051X.2005.00648.x.
32. Petersen AMW, Pedersen BK. The anti-inflammatory effect of exercise. Journal of applied physiology. 2005;98(4):1154-
62. doi.org/10.1152/japplphysiol.00164.2004.
33. Prestes J, Foschini D, Marchetti P, Charro M, Tibana R. Prescrição e periodização do treinamento de força em academias
(2a edição revisada e atualizada): Editora Manole; 2016. /doi.org/10.3945/jn.111.139964.
34. Kelly KR, Haus JM, Solomon TP, Patrick-Melin AJ, Cook M, Rocco M, et al. A low-glycemic index diet and exercise
intervention reduces TNF (alpha) in isolated mononuclear cells of older, obese adults. The Journal of Nutrition.
2011;141(6):1089-94.
35. Lopes LMP, de Oliveira EC, Becker LK, Costa GP, Pinto KMC, Talvani A, et al. Resistance Training Associated with
Dietetic Advice Reduces Inflammatory Biomarkers in the Elderly. BioMed Research International. 2020;2020:7351716.
doi.org/10.1155/2020/7351716.
36. Chung HI, Kim J, Kim JY, Kwon O. Acute intake of mulberry leaf aqueous extract affects postprandial glucose response
after maltose loading: Randomized double-blind placebo-controlled pilot study. Journal of Functional Foods.
2013;5(3):1502-6. doi.org/10.1016/j.jff.2013.04.015.
37. Asai A, Nakagawa K, Higuchi O, Kimura T, Kojima Y, Kariya J, et al. Effect of mulberry leaf extract with enriched
1‐deoxynojirimycin content on postprandial glycemic control in subjects with impaired glucose metabolism. Journal of
Diabetes Investigation. 2011;2(4):318-23. doi.org/10.1111/j.2040-1124.2011.00101.
38. Mudra M, Ercan-Fang N, Zhong L, Furne J, Levitt M. Influence of mulberry leaf extract on the blood glucose and breath
hydrogen response to ingestion of 75 g sucrose by type 2 diabetic and control subjects. Diabetes care. 2007;30(5):1272-4.
Volume 15, Issue 29 - Serial Number 29
September 2023
Pages 77-88

  • Receive Date 01 March 2023
  • Accept Date 24 July 2023