Promising effects of Persian shallot extract on the serum markers and blood pressure of patients with metabolic syndrome: a double-blinded randomized controlled trial

doi:10.19852/j.cnki.jtcm.2025.01.008

Abstract

Abstract:

OBJECTIVE: To evaluate the effect of Persian shallot extract on the serum markers and blood pressure of patients with metabolic syndrome (MetS).

METHODS: Fifty patients with MetS diagnosis were randomly assigned to the intervention (Persian shallot extract) and the control (placebo) group. Both groups received treatment for three months. Before the study and at the end of the study, 5 mL peripheral blood was taken from each patient. The measured factors included total antioxidant capacity (TAC), superoxide dismutase enzyme (SOD), malondialdehyde, oxidized low-density lipoprotein (Ox-LDL), apolipoprotein H (Apo-H), fasting blood glucose (FBS), total cholesterol, triglycerides, high-density lipoprotein (HDL), LDL, and systolic and diastolic blood pressure.

RESULTS: At baseline, the evaluated parameters were not significantly different between the intervention and control groups. At the end of the study, the mean serum levels of malondialdehyde and ox-LDL were significantly lower in the intervention group. The mean FBS, cholesterol, triglycerides, and LDL were significantly lower in the intervention group. The mean TAC and HDL were significantly higher in the intervention group (P < 0.05). Moreover, the intervention group significantly reduced systolic and diastolic blood pressure. No other significant association was observed.

CONCLUSION: Persian shallot extract has several beneficial effects in MetS patients, including optimizing oxidative balance, reducing blood pressure, fasting blood sugar, and blood lipid profile

Key words: shallots, medicine, Persian, metabolic syndrome, antioxidants

Neda Naimipoor, Zahra Bagheri-Hosseinabadi, Mohammad Reza Hajizadeh, Mitra Abbasifard, Mohammad Reza Mirzaei, Akram Ghadiri Anari, Maryam Mohammad-Sadeghipour, Mehdi Mahmoodi. Promising effects of Persian shallot extract on the serum markers and blood pressure of patients with metabolic syndrome: a double-blinded randomized controlled trial[J]. Journal of Traditional Chinese Medicine, 2025, 45(1): 100-106.

Figures/Tables 4

References 52.

1.	Saklayen MG. The global epidemic of the metabolic syndrome. Curr Hypertens Rep 2018; 20: 12-20. DOI PMID
2.	Alemany M. The metabolic syndrome, a human disease. Int J Mol Med Sci 2024; 25: 2251-347.
3.	Kim D, Touros A, Kim WR. Nonalcoholic fatty liver disease and metabolic syndrome. Clin Liver Dis 2018; 22: 133-40. DOI PMID
4.	Pasquali R. Metabolic syndrome in polycystic ovary syndrome. Front Horm Res 2018; 49: 114-30. DOI PMID
5.	Dwyer AA, Quinton R. The metabolic syndrome in central hypogonadotrophic hypogonadism. Front Horm Res 2018; 49: 156-69. DOI PMID
6.	Hess PL, Al‐Khalidi HR, Friedman DJ, et al. The metabolic syndrome and risk of sudden cardiac death: the atherosclerosis risk in communities study. J Am Heart Assoc 2017; 6: e006103-11.
7.	Hao Y, Zhu YJ, Zou S, et al. Metabolic syndrome and psoriasis: Mechanisms and future directions. Front Immunol 2021; 12: 711060-70.
8.	Libowitz MR, Nurmi EL. The burden of antipsychotic-induced weight gain and metabolic syndrome in children. Front Psychiatry 2021; 12: 623681-705.
9.	Bagherifard A, Kadijani AA, Yahyazadeh H, et al. The value of serum total oxidant to the antioxidant ratio as a biomarker of knee osteoarthritis. Clin Nutr ESPEN 2020; 38: 118-23. DOI PMID
10.	Dziegielewska-Gesiak S. Metabolic syndrome in an aging society-role of oxidant-antioxidant imbalance and inflammation markers in disentangling atherosclerosis. Clin Interv Aging 2021; 16: 1057-70. DOI PMID
11.	Rubio-Ruiz ME, Guarner-Lans V, Cano-Martínez A, et al. Resveratrol and quercetin administration improves antioxidant DEFENSES and reduces fatty liver in metabolic syndrome rats. Molecules 2019; 24: 1297-315.
12.	Monserrat-Mesquida M, Quetglas-Llabrés M, Capó X, et al. Metabolic syndrome is associated with oxidative stress and proinflammatory state. Antioxidants 2020; 9: 236-50.
13.	Francisqueti FV, Chiaverini LCT, Santos KCd, et al. The role of oxidative stress on the pathophysiology of metabolic syndrome. Rev Assoc Med Bras 2017; 63: 85-91.
14.	Patti AM, Al-Rasadi K, Giglio RV, et al. Natural approaches in metabolic syndrome management. Arch Med Sci 2018; 14: 422-41. DOI PMID
15.	Wang J, Liao B, Wang C, Zhong O, Lei X, Yang Y. Effects of antioxidant supplementation on metabolic disorders in obese patients from randomized clinical controls: a Meta-analysis and systematic review. Oxid Med Cell Longev 2022; 2022: 7255413-33.
16.	Zhang S, Xu M, Zhang W, Liu C, Chen S. Natural polyphenols in metabolic syndrome: protective mechanisms and clinical applications. Int J Mol Sci 2021; 22: 6110.
17.	Abdelrahman M, Ariyanti NA, Sawada Y, et al. Metabolome-Based Discrimination analysis of shallot landraces and bulb onion cultivars associated with differences in the amino acid and flavonoid profiles. Molecules 2020; 25: 5300-13.
18.	Kothari D, Lee WD, Niu KM, Kim SK. The genus Allium as poultry feed additive: a review. Animals 2019; 9: 1032-53.
19.	De Greef D, Barton EM, Sandberg EN, et al., editors. Anticancer potential of garlic and its bioactive constituents: a systematic and comprehensive review. Semin Cancer Biol 2021; 73: 219-64. DOI PMID
20.	Ghafarifarsani H, Hoseinifar SH, Talebi M, et al. Combined and singular effects of ethanolic extract of persian shallot (Allium hirtifolium Boiss) and synbiotic Biomin® IMBO on growth performance, serum-and mucus-immune parameters and antioxidant defense in Zebrafish (Danio rerio). Animals 2021; 11: 2995-3010.
21.	Ghafarifarsani H, Yousefi M, Hoseinifar SH, et al. Beneficial effects of Persian shallot (Allium hirtifolium) extract on growth performance, biochemical, immunological and antioxidant responses of rainbow trout oncorhynchus mykiss fingerlings. Aquaculture 2022; 555: 738162-78.
22.	Omidifar N, Nili-Ahmadabadi A, Gholami A, Dastan D, Ahmadimoghaddam D, Nili-Ahmadabadi H. Biochemical and histological evidence on the protective effects of Allium hirtifolium boiss (Persian Shallot) as an herbal supplement in cadmium-induced hepatotoxicity. Evid Based Complement Alternat Med 2020; 2020: 7457504-12.
23.	Sun W, Shahrajabian MH, Cheng Q. The insight and survey on medicinal properties and nutritive components of shallot. J Med Plant Res 2019; 13: 452-7.
24.	Grewal AS, Sharma N, Singh S. In silico docking studies of compounds from Persian shallot as allosteric glucokinase. Plant Arch 2022; 22: 547-70.
25.	Khaleghi S, Bahrami G, Mahmoodi M, Asgari V, Mostafaie A. Hypoglycemic effect of hydroalcoholic extract and hexane fraction of persian shallot (Allium hirtifolium boiss) extract in streptozotocin-induced diabetic rats. JRPS 2016; 5: 33-40.
26.	Hosseini FS, Falahati-Pour SK, Hajizadeh MR, et al. Persian shallot, Allium hirtifolium Boiss, induced apoptosis in human hepatocellular carcinoma cells. Cytotechnology 2017; 69: 551-63. DOI PMID
27.	Satvati SAR, Shooriabi M, Amin M, Shiezadeh F. Evaluation of the antimicrobial activity of Tribulus terrestris, Allium sativum, Salvia officinalis, and Allium hirtifolium Boiss against Enterococcus faecalis. Int J Enteric Pathog 2017; 5: 63-7.
28.	Mehriardestani M, Aliahmadi A, Toliat T, Rahimi R. Medicinal plants and their isolated compounds showing anti-trichomonas vaginalis-activity. Biomed Pharmacother 2017; 88: 885-93. DOI PMID
29.	Eftekhari MH, Akbarzadeh M, MH Dabbaghmanesh, et al. The effect of calcitriol on lipid profile and oxidative stress in hyperlipidemic patients with type 2 diabetes mellitus. ARYA Atheroscler 2014; 10: 82-8. PMID
30.	Altun HK, Ermumcu MSK, Kurklu NS. Evaluation of dietary supplement, functional food and herbal medicine use by dietitians during the COVID-19 pandemic. Public Health Nutr 2021; 24: 861-9. DOI PMID
31.	Barkat MA, Goyal A, Barkat HA, Salauddin M, Pottoo FH, Anwer ET. Herbal medicine: clinical perspective and regulatory status. Comb Chem High Throughput Screen 2021; 24: 1573-82. DOI PMID
32.	Xu YXZ, Xi S, Qian X. Evaluating Traditional Chinese Medicine and herbal products for the treatment of gestational diabetes mellitus. J Diabetes Res 2019; 2019: 9182595.
33.	Heshmat-Ghahdarijani K, Soltani R, Ghanadian M, Soleymani H. The effect of Allium hirtifolium bulb on serum lipid profile in adult patients with hyperlipidemia: a randomized double-blind placebo-controlled clinical trial. Complement Ther Clin Pract 2022; 49: 101654-61.
34.	Karthikkumar V, Anbu S, Rajasekar P. Beneficial biological role of Allium hirtifolium on various diseases. RJPT 2020; 13: 1009-14.
35.	Mehdi M, Javad H, Seyed-Mostafa HZ, Mohammadreza M, Ebrahim M. The effect of Persian shallot (Allium hirtifolium Boiss.) extract on blood sugar and serum levels of some hormones in diabetic rats. Pak J Pharm Sci 2013; 26: 397-402. PMID
36.	Panahandeh J, Farhadi N, Motallebi Azar A, Alizadeh Salteh S. Evaluation of Persian shallot (Allium hirtifolium) ecotypes for phytochemical components and antioxidant activity. JMPB 2016; 5: 217-26.
37.	Rahimi-Madiseh M, Heidarian E, Kheiri S, Rafieian-Kopaei M. Effect of hydroalcoholic Allium ampeloprasum extract on oxidative stress, diabetes mellitus and dyslipidemia in alloxan-induced diabetic rats. Biomed Pharmacother 2017; 86: 363-7. DOI PMID
38.	Liu DS, Wang SL, Li JM, Liang ES, Yan MZ, Gao W. Allicin improves carotid artery intima‑media thickness in coronary artery disease patients with hyperhomocysteinemia. Exp Ther Med 2017; 14: 1722-6.
39.	Marón FJM, Camargo AB, Manucha W. Allicin pharmacology: common molecular mechanisms against neuroinflammation and cardiovascular diseases. Life Sci 2020; 249: 117513-20.
40.	Salehi B, Zucca P, Orhan IE, et al. Allicin and health: a comprehensive review. Trends Food Sci Technol 2019; 86: 502-16.
41.	Sánchez-Gloria JL, Arellano-Buendía AS, Juárez-Rojas JG, et al. Cellular mechanisms underlying the cardioprotective role of allicin on cardiovascular diseases. Int J Mol Sci 2022; 23: 9082-103.
42.	Lu J, Fang B, Meng Z, Zheng Y, Tian X, Guan S. Protective effects of allicin on 1, 3-DCP-induced lipid metabolism disorder in HepG2 cells. Biomed Pharmacother 2017; 96: 1411-17.
43.	Shi Xe, Zhou X, Chu X, et al. Allicin improves metabolism in high-fat diet-induced obese mice by modulating the gut microbiota. Nutrients 2019; 11: 2909-23.
44.	Ma L, Chen S, Li S, Deng L, Li Y, Li H. Effect of allicin against ischemia/hypoxia-induced H9c2 myoblast apoptosis via eNOS/NO pathway-mediated antioxidant activity. Evid Based Complement Alternat Med 2018; 2018: 3207973-83.
45.	García Trejo EMÁ, Arellano Buendía AS, Sánchez Reyes O, et al. The beneficial effects of allicin in chronic kidney disease are comparable to losartan. Int J Mol Sci 2017; 18: 1980-99.
46.	Nazeri Z, Azizidoost S, Cheraghzadeh M, Mohammadi A, Kheirollah A. Increased protein expression of ABCA1, HMG-CoA reductase, and CYP46A1 induced by garlic and allicin in the brain mouse and astrocytes-isolated from C57BL/6J. Avicenna J Phytomed 2021; 11: 473-83. DOI PMID
47.	Cheng B, Li T, Li F. Use of Network pharmacology to investigate the mechanism by which Allicin ameliorates lipid metabolism disorder in HepG2 cells. Evid Based Complement Alternat Med 2021; 2021: 3956504-15.
48.	Cui T, Liu W, Chen S, Yu C, Li Y, Zhang JY. Antihypertensive effects of allicin on spontaneously hypertensive rats via vasorelaxation and hydrogen sulfide mechanisms. Biomed Pharmacother 2020; 128: 110240-52.
49.	Russo B, Picconi F, Malandrucco I, Frontoni S. Flavonoids and insulin-resistance: from molecular evidences to clinical trials. Int J Mol Sci 2019; 20: 2061-79.
50.	He C, Liu X, Jiang Z, Geng S, Ma H, Liu B. Interaction mechanism of flavonoids and α-glucosidase: experimental and molecular modelling studies. Foods 2019; 8: 355-64.
51.	Nishimura M, Muro T, Kobori M, Nishihira J. Effect of daily ingestion of quercetin-rich onion powder for 12 weeks on visceral fat: a randomised, double-blind, placebo-controlled, parallel-group study. Nutrients 2020; 12: 91-103.
52.	Sok Yen F, Shu Qin C, Tan Shi Xuan S, et al. Hypoglycemic effects of plant flavonoids: a review. Evid Based Complement Alternat Med 2021; 2021: 2057333-45.

Variable		Placebo group (n = 25)	Intervention group (n = 25)	^aP value
Age (years)		43.8±7.3	45.1±6.9	0.51
Sex [n (%)]	Male	11 (44)	12 (48)	0.50
	Female	14 (56)	13 (52)
Height (cm)		167.2±8.9	170.9±9.5	0.26
Weight (Kg)		78.5±10.3	81.5±10.4	0.11
BMI (kg/m²)		26.9±0.9	27.4±1.5	0.16
Waist circumference (cm)		97.4±5.2	98.9±6.1	0.23
Systolic blood pressure (mm Hg)		132.5±4.8	132.5±5.0	0.91
Diastolic blood pressure (mm Hg)		82.3±1.5	82.7±1.9	0.38

Variable		Placebo group (n = 25)	Intervention group (n = 25)	^aP value
Age (years)		43.8±7.3	45.1±6.9	0.51
Sex [n (%)]	Male	11 (44)	12 (48)	0.50
	Female	14 (56)	13 (52)
Height (cm)		167.2±8.9	170.9±9.5	0.26
Weight (Kg)		78.5±10.3	81.5±10.4	0.11
BMI (kg/m²)		26.9±0.9	27.4±1.5	0.16
Waist circumference (cm)		97.4±5.2	98.9±6.1	0.23
Systolic blood pressure (mm Hg)		132.5±4.8	132.5±5.0	0.91
Diastolic blood pressure (mm Hg)		82.3±1.5	82.7±1.9	0.38

Variable	Intervention group (n = 25)?			Placebo group (n = 25)?			Between two groups
Variable	Before	After	P value^a	Before	After	P value^a	P value (before)^b	P value (after)^b
Serum levels of MDA (μmol/L)	5.17±0.78	3.81±0.75	<0.001	4.87±0.66	4.45±0.67	<0.001	0.146	0.003
Total antioxidant capacity (μmol/L)	0.62±0.11	1.03±0.19	<0.001	0.61±0.12	0.71±0.11	<0.001	0.823	<0.001
SOD activity level (U/mL)	43.69±5.27	45.58±6.03	0.159	41.45±6.39	42.14±6.80	0.571	0.154	0.065
Serum ox-LDL levels (ng/L)	278.39±32.22	241.32±37.71	<0.001	277.77±41.19	264.70±33.95	0.002	0.953	0.026
Serum level of Apo-H (ng/mL)	19.12±2.86	17.15±2.56	0.001	18.08±2.55	17.15±2.17	0.080	0.180	0.995
FBS (mg/dL)	116.96±8.88	99.12±8.77	<0.001	110.44±10.67	105.36±10.54	<0.001	0.023	0.027
Serum cholesterol level (mg/dL)	213.36±19.49	191.52±16.56	<0.001	210.24±17.57	201.56±17.83	<0.001	0.627	0.026
Serum HDL level (mg/dL)	40.56±2.61	45±3.34	<0.001	42.32±2.77	42.56±2.61	0.109	0.026	0.006
Serum LDL level (mg/dL)	120.32±12.36	108.64±10.90	<0.001	121.40±11.19	117.16±10.62	<0.001	0.748	0.003
Serum TG level (mg/dL)	193.20±14.24	171.52±13.58	<0.001	191.12±17.51	189.00±17.81	0.236	0.647	<0.001
Systolic blood pressure (mm Hg)	132.52±5.00	125.88±4.20	<0.001	132.52±4.80	132.12±5.04	0.412	1.00	<0.001
Diastolic blood pressure (mm Hg)?	82.72±1.90	81.64±1.35	0.001	82.28±1.45	82.48±1.47	0.197	0.380	0.048

Variable	Intervention group (n = 25)?			Placebo group (n = 25)?			Between two groups
Variable	Before	After	P value^a	Before	After	P value^a	P value (before)^b	P value (after)^b
Serum levels of MDA (μmol/L)	5.17±0.78	3.81±0.75	<0.001	4.87±0.66	4.45±0.67	<0.001	0.146	0.003
Total antioxidant capacity (μmol/L)	0.62±0.11	1.03±0.19	<0.001	0.61±0.12	0.71±0.11	<0.001	0.823	<0.001
SOD activity level (U/mL)	43.69±5.27	45.58±6.03	0.159	41.45±6.39	42.14±6.80	0.571	0.154	0.065
Serum ox-LDL levels (ng/L)	278.39±32.22	241.32±37.71	<0.001	277.77±41.19	264.70±33.95	0.002	0.953	0.026
Serum level of Apo-H (ng/mL)	19.12±2.86	17.15±2.56	0.001	18.08±2.55	17.15±2.17	0.080	0.180	0.995
FBS (mg/dL)	116.96±8.88	99.12±8.77	<0.001	110.44±10.67	105.36±10.54	<0.001	0.023	0.027
Serum cholesterol level (mg/dL)	213.36±19.49	191.52±16.56	<0.001	210.24±17.57	201.56±17.83	<0.001	0.627	0.026
Serum HDL level (mg/dL)	40.56±2.61	45±3.34	<0.001	42.32±2.77	42.56±2.61	0.109	0.026	0.006
Serum LDL level (mg/dL)	120.32±12.36	108.64±10.90	<0.001	121.40±11.19	117.16±10.62	<0.001	0.748	0.003
Serum TG level (mg/dL)	193.20±14.24	171.52±13.58	<0.001	191.12±17.51	189.00±17.81	0.236	0.647	<0.001
Systolic blood pressure (mm Hg)	132.52±5.00	125.88±4.20	<0.001	132.52±4.80	132.12±5.04	0.412	1.00	<0.001
Diastolic blood pressure (mm Hg)?	82.72±1.90	81.64±1.35	0.001	82.28±1.45	82.48±1.47	0.197	0.380	0.048

Variable	Type Ⅲ sum of squares	Df (degree of freedom)	Mean square	F test	P value	Partial eta squared
FBS before the intervention	3679.44	1	3679.437	207.61	<0.001	0.82
	1629.17	1	1629.17	91.93	<0.001	0.66
HDL before the intervention	390.58	1	390.58	441.43	<0.001	0.90
	208.11	1	208.11	235.21	<0.001	0.83

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