PMID- 37778521
OWN - NLM
STAT- MEDLINE
DCOM- 20231120
LR  - 20231120
IS  - 1872-7573 (Electronic)
IS  - 0378-8741 (Linking)
VI  - 319
IP  - Pt 2
DP  - 2024 Jan 30
TI  - Effect of Crocus sativus L. (saffron) and crocin in the treatment of patients 
      with type-2 diabetes mellitus: A systematic review and meta-analysis.
PG  - 117255
LID - S0378-8741(23)01125-X [pii]
LID - 10.1016/j.jep.2023.117255 [doi]
AB  - ETHNOPHARMACOLOGICAL RELEVANCE: Crocus sativus L. (saffron, Iridaceae) has been 
      traditionally used for thousands of years as herbal medicine for many diseases, 
      including type-2 diabetes mellitus (T2DM), especially in Sri Lanka. Systematic 
      reviews and meta-analysis on C. sativus for T2DM value traditional knowledge 
      about this species. AIM OF THE STUDY: To assess the effectiveness of C. sativus 
      powdered plant, hydroethanolic extract and crocin in reducing fasting blood sugar 
      (FBG), glycated hemoglobin (HbA1c), blood pressure, and other metabolic 
      parameters in patients with T2DM. MATERIAL AND METHODS: Systematic review and 
      meta-analysis based on searches in PubMed, Embase, and Cochrane, including all 
      randomized clinical trials (RCTs) published before January 2, 2023. Two 
      independent reviewers extracted the data and assessed the risks of bias. The 
      effects of C. sativus and crocin were assessed on glycemic, metabolic, and blood 
      pressure parameters. Weighted (WMD) or standardized (SMD) mean differences 
      (before-after) and 95% confidence intervals (95%CI) of the outcomes were 
      extracted or estimated and meta-analyses were conducted using RevMan 5.4 
      (Cochrane Collaboration). This protocol was registered in PROSPERO 
      (#CRD42023390073). RESULTS: Fifteen of 29 studies were included. Saffron powdered 
      plant decreased AST (WMD -1.19, 95%CI -2.24, -0.13), but increased BMI (WMD 0.56, 
      95%CI 0.07, 1.05); saffron extract decreased HbA1c (WMD -0.35, 95%CI -0.65, 
      -0.06), FBG (WMD -26.90, 95%CI -38.87, -14.93), creatinine (WMD -0.12, 95%CI 
      -0.19, -0.05), and total cholesterol (WMD -9.29, 95%CI -18.25, -0.33); and crocin 
      decreased HbA1c (WMD -0.43, 95%CI -0.66, -0.20), FBG (WMD -14.10, 95%CI -22.91, 
      -5.30), and systolic blood pressure (WMD -8.18, 95%CI -12.75, -3.61), but 
      increased creatinine levels (WMD 0.24, 95%CI 0.17, 0.32). Of the 15 included 
      studies, 14 had a moderate risk of bias, and one study had a low risk of bias. 
      CONCLUSION: C. sativus (saffron) powdered plant, extract, and crocin have 
      potential as an adjunct treatment for T2DM, improving control of metabolic and 
      clinical parameters. However, C. sativus extract seems to be superior because it 
      was effective in more parameters and did not induce adverse effects. Since many 
      studies were at moderate risk of bias, further high-quality research is needed to 
      firmly establish the clinical efficacy of this plant.
CI  - Copyright (c) 2023. Published by Elsevier B.V.
FAU - Amatto, Pedro de Padua G
AU  - Amatto PPG
AD  - Departamento de Biotecnologia em Plantas Medicinais, Universidade de Ribeirao 
      Preto, 14096-900, Ribeirao Preto, SP, Brazil. Electronic address: 
      pedro.goulart@sou.unaerp.edu.br.
FAU - Chaves, Lucas
AU  - Chaves L
AD  - Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo, 14049-900, 
      Ribeirao Preto, SP, Brazil. Electronic address: l.chaves@usp.br.
FAU - Braga, Giovana Graca
AU  - Braga GG
AD  - Departamento de Biotecnologia em Plantas Medicinais, Universidade de Ribeirao 
      Preto, 14096-900, Ribeirao Preto, SP, Brazil; Faculdade de Ciencias Farmaceuticas 
      de Ribeirao Preto, Universidade de Sao Paulo, 14040-903, Ribeirao Preto, SP, 
      Brazil. Electronic address: Gi07braga@usp.br.
FAU - Carmona, Fabio
AU  - Carmona F
AD  - Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo, 14049-900, 
      Ribeirao Preto, SP, Brazil. Electronic address: carmona@usp.br.
FAU - Pereira, Ana Maria Soares
AU  - Pereira AMS
AD  - Departamento de Biotecnologia em Plantas Medicinais, Universidade de Ribeirao 
      Preto, 14096-900, Ribeirao Preto, SP, Brazil; Botanical Garden of Medicinal 
      Plants Ordem e Progresso, 14690-000, Jardinopolis, Brazil. Electronic address: 
      apereira@unaerp.br.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20230929
PL  - Ireland
TA  - J Ethnopharmacol
JT  - Journal of ethnopharmacology
JID - 7903310
RN  - 877GWI46C2 (crocin)
RN  - 0 (Glycated Hemoglobin)
RN  - AYI8EX34EU (Creatinine)
RN  - 0 (Biological Products)
SB  - IM
MH  - Humans
MH  - *Crocus
MH  - Glycated Hemoglobin
MH  - Creatinine
MH  - *Diabetes Mellitus, Type 2/drug therapy
MH  - *Biological Products/therapeutic use
OTO - NOTNLM
OT  - Cardiovascular risk factors
OT  - Meta-analysis
OT  - Saffron
OT  - Systematic review
OT  - Type-2 diabetes mellitus
COIS- Declaration of competing interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2023/10/02 00:41
MHDA- 2023/11/20 06:55
CRDT- 2023/10/01 19:28
PHST- 2023/04/24 00:00 [received]
PHST- 2023/08/30 00:00 [revised]
PHST- 2023/09/28 00:00 [accepted]
PHST- 2023/11/20 06:55 [medline]
PHST- 2023/10/02 00:41 [pubmed]
PHST- 2023/10/01 19:28 [entrez]
AID - S0378-8741(23)01125-X [pii]
AID - 10.1016/j.jep.2023.117255 [doi]
PST - ppublish
SO  - J Ethnopharmacol. 2024 Jan 30;319(Pt 2):117255. doi: 10.1016/j.jep.2023.117255. 
      Epub 2023 Sep 29.