Effect of Ginger Extract on Postprandial Glycaemia of Healthy Adults and Its Antioxidant Properties
Condition: Hyperglycemia, Postprandial
MeSH terms: Hyperglycemia
Study type: Interventional

Summary: 
      Background: Hyperglycemia is a risk factor to disease development, namely, diabetes mellitus.
      The blood glucose level management, particularly on post-prandial period has an important
      role in the prevention of different diseases. Ginger is a specie that has been demonstrated a
      benefit effect on glycaemia on diabetes.

      Aim: The aim of this study was 1) to investigate the effects of ginger infusion in the
      glycaemic response in nondiabetic adults; 2) to evaluate total phenolic content the
      antioxidant activity of Ginger (Zingiber officinale Roscoe) aqueous extracts.

      Methodology: 24 nondiabetic subjects were randomly allocated into two groups: intervention
      group (GI; n=15) and control group (GC; n=15). An oral glucose solution (OGTT) and an OGTT
      following ginger extract solution were administrated in control and intervention groups,
      respectively. Blood glucose levels were measurement at fasting and after 30, 60, 90 and 120
      minutes after interventions in both groups. Total phenolic content and flavonoids compounds
      determination of the aqueous ginger extract was determined according to Prabha method.
      Antioxidant activity was also measured through ABTS method and free radicals inhibition
      capacity. Repeated Measures ANOVA of mixed type and independent samples t-test were used in
      statistical analysis.
    

Detailed description: 
      This clinical trial was approved by Ethical Committee (process number 519 at 23 November
      2016). All participants signed a written informed consent after aim and experimental risk
      procedures explanation and its protected confidentiality was guaranteed. The experimental
      procedure involving human was care out according Declaration of Helsinki.

      This blind (to participants) randomized controlled clinical trial was conducted at Egas Moniz
      higher education school in 30 nondiabetic adults. Participants with ages between 18 and 40
      were selected and randomly allocated in intervention group (IG) (n=15) and control group (CG)
      (n=15), in which participants were alternated include in the groups. The IG performed an oral
      glucose tolerance test (OGTT) followed by aqueous ginger extract administration and the CG
      performed an OGTT administration alone.

      For ginger extract preparation, powder ginger (Zingibre officinalle Roscoe) was obtained from
      Portugal Company with India origin and stored in a dried environmental locally until needed.
      The product has a batch number of LI1GIGRNT150012. Powder ginger was individually weight
      (0.2g each dose) and added to 100mL of boiled water obtaining the ginger extract, infusing 10
      minutes. Ginger extract solution was after cooled at room temperature and distributed to each
      participant. This method was adapted by Wilkinson, J. M. (2000). For chemical analysis, a
      aqueous ginger extract previously obtained was used.

      Regarding to blood glucose level assessment, the blood sample were collected for each
      participant using a capillary drop blood before the intervention (fasting) and after 30, 60,
      90 and 120 minutes. The blood glucose level analysis was performed using a strips for glucose
      meter (Onetouch Select Plus Flex), a sterilized lancet and a glucose meter equipment.

      General characteristics data of the participants were collected, namely, anthropometrics
      data, pharmacologic treatment and medical condition using a questionnaire. In addition, a
      24-hour dietary recall at the day before the intervention was employing to sample
      participants. The nutritional analyzed of diet ingested was performed by Food Processor SQL
      (version 10.5.0).

      The total phenolic compounds determination of the aqueous ginger extract was determined
      according to Folin-Ciocalteu method. The total phenolic results were expressed as mg gallic
      acid equivalent (GAE)/L of ginger extract. A volume of 125 μL of ginger extract and 2 mL of
      sodium carbonate were added to 2.5 mL of Folin-Ciocalteu reagent. After 15 min the absorbance
      was measured at 765 nm. The flavonoids compounds determination of the aqueous ginger extract
      was determined according to Prabha method. The flavonoids results were expressed as mg
      quercetin equivalent (GAE)/L of ginger extract. A volume of 2 mL of ginger extract were added
      to 0.1 mL of aluminum chloride anhydrous solution (10%), 0.1 mL of potassium acetate (1M) and
      2.8 mL of distilled water. After 30 min the absorbance was measured at 415 nm.

      The antioxidant activity was measured through different assays:

      The superoxide anion radicals scavenging activity was determined based on Morais et al
      method. Superoxide anion was generated by reacting phenazine methosulfate (PMS), nicotinamide
      adenine dinucleotide hydride (NADH), and oxygen causing reduced NBT in Formazan. A volume of
      0.5mL of sample was added to 0.5mL of a solution containing NADH (189 microM) and NBT (120
      microM) with Tris-HCl (40mM, pH = 8). The reaction started after the addition of 0.5mL of PMS
      (60microM). Control sample was measured using only distilled water. After 5min of incubation,
      control absorbance was measured at 560 nm at room temperature.

      The nitric oxide inhibitory activity was determined according Khayami et al method. A volume
      of 1mL of sodium nitroprusside 10nm was added to 250microL de phosphate buffered saline (PBS)
      and 250microL of test solution and it was shaken. The previous solution was incubated for 150
      min at 25ºC and following add 3mL of sulfanilic acid and 0.33% of acetic acid glacial. After
      5 min at room temperature, it was add 3mL of n-(1-naphthyl)ethylenediamine dihydrochloride
      (NED, 0.1% m/v) and incubated for 30 min at 25ºC. The absorbance was measured at 533nm. The
      previous procedure was employed to control obtained using water.

      The free radical 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) was obtained
      by ABTS oxidation with potassium persulfate 140mM for 12h in dark, according Zulueta et al
      method. It was prepared a solution with 10mL ABTS 7nm and 176microL persulfate and storage at
      room temperature by 12h in dark. The previous solution was diluted with ethanol until 0.7
      absorbance at 734nm. A volume of 2850microL of ABTS radical was added to 150microL of sample
      and to 150microL of water. After 30min in dark the absorbance was determined at 734nm. The
      Trolox concentration was using as standard (mM Trolox/L). This test was performed for several
      extract concentrations in order to calculate IC50.

      Data statistical analysis was performed using SPSS Statistics (Statistical Package for Social
      Sciences) (version 22) software. Mean and standard error of the mean were used. Shapiro-Wilk
      and Repeated Measures ANOVA of mixed type were used. Independent samples T-test was used to
      assess the difference between the 2 groups for total caloric value, carbohydrates, protein
      and lipid ingested, Cmax (maximum concentration), ΔCmax (variation of maximum concentration),
      and AUC (area under the curve) Incremental values. The AUC was calculated by Software
      GraphPad Prim (version 7.03). All statistical tests were performed at the 5% level of
      significance.
    

Intervention name(s): Placebo OGGT; Ginger aqueous extract
Intervention type(s): Other; Other
Intervention description(s): After overnight fasting, blood glucose level was assessed through a capillary drop blood The control group participants ingested glucose solution alone (OGTT) prepared with 75 g of anhydrous oral glucose as prescribed by the ADA, dissolved in 200 ml of water. Blood glucose level was also measured at 30 (t30), 60 (t60), 90 (t90) and 120 (t120) minutes immediately after intervention, for each participant, in control and intervention groups.
Glucometer equipment, strips for glucose meters (One Touch Select Plus) and sterilized lancets (Sarstedt normal 21G) were used to measure blood glucose concentrations, taking due care of safety and asepsis.; After overnight fasting, blood glucose level was assessed through a capillary drop blood The intervention group participants ingested glucose solution alone (OGTT) prepared with 75 g of anhydrous oral glucose as prescribed by the ADA, dissolved in 200 ml of water, followed by 100mL of ginger extract (0.2g). Blood glucose level was also measured at 30 (t30), 60 (t60), 90 (t90) and 120 (t120) minutes immediately after intervention, for each participant, in control and intervention groups.
Glucometer equipment, strips for glucose meters (One Touch Select Plus) and sterilized lancets (Sarstedt normal 21G) were used to measure blood glucose concentrations, taking due care of safety and asepsis.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: Ginger, hyperglycemia, antioxidant, phenols, flavonoids