Hypoglycemic activity of Garcinia mangostana L. extracts on diabetes rodent models: A systematic review and network meta-analysis

Moragot Chatatikun; Aman Tedasen; Phichayut Phinyo; Pakpoom Wongyikul; Wiyada Kwanhian Klangbud; Fumitaka Kawakami; Motoki Imai; Sirithip Chuaijit; Sarawut Rachmuangfang; Siriporn Phuwarinyodsakul; Rattana Leelawattana; Atthaphong Phongphithakchai

doi:10.3389/fphar.2024.1472419

Hypoglycemic activity of Garcinia mangostana L. extracts on diabetes rodent models: A systematic review and network meta-analysis

Front Pharmacol. 2024 Oct 2:15:1472419. doi: 10.3389/fphar.2024.1472419. eCollection 2024.

Authors

Affiliations

¹ Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand.
² Center of Excellence Research for Melioidosis and Microorganisms (CERMM), Walailak University, Nakhon Si Thammarat, Thailand.
³ Research Excellence Center for Innovation and Health Products (RECIHP), Walailak University, Nakhon Si Thammarat, Thailand.
⁴ Center for Clinical Epidemiology and Clinical Statistics, Department of Biomedical Informatics and Clinical Epidemiology (BioCE), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
⁵ Medical Technology program, Faculty of Science, Nakhon Phanom University, Nakhon Phanom, Thailand.
⁶ Research Facility of Regenerative Medicine and Cell Design, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan.
⁷ Department of Regulation Biochemistry, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan.
⁸ Department of Molecular Diagnostics, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan.
⁹ Department of Medical Science, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand.
¹⁰ Endocrinology and Metabolism Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
¹¹ Nephrology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.

Abstract

Background: Diabetes mellitus is a significant global health issue, and alternative treatments from natural products like Garcinia mangostana L. [Clusiaceae] or GM are being explored for their potential benefits. This study focused on evaluating the hypoglycemic effects of GM on diabetic rodent models.

Methods: A comprehensive search was conducted in PubMed, Scopus, and Embase for studies reporting blood glucose levels within 2 weeks as the primary outcome and changes in total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) as secondary outcomes. A network meta-analysis (NMA) was performed to determine the pooled effectiveness of each intervention, estimating the weighted mean difference (WMD) and 95% confidence interval (CI) from both direct and indirect evidence. The surface under the cumulative ranking curve (SURCA) was used to rank the interventions.

Results: Ten articles were identified, with nine included for quantitative analysis. All GM extracts showed greater effectiveness than the control in decreasing blood glucose levels within 2 weeks. GM at 200 mg/kg (GM200) was the top-ranked extract for reducing glucose levels beyond 2 weeks and increasing HDL-C levels. The ethanol extract of GM at 200 mg/kg (GME200) was the most effective for blood glucose reduction within 2 weeks and for TC and TG reductions. The methanol extract of GM at 200 mg/kg (GMM200) was the top-ranked extract for LDL-C reductions.

Conclusion: GM and its extracts demonstrated significant hypoglycemic activity and improvements in lipid profiles in diabetic rodent models, highlighting their potential as therapeutic agents for the prevention and treatment of diabetes mellitus. Further research in human trials is warranted to confirm these findings and establish clinical applications.

Clinical trial registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023426254.

Keywords: Garcinia mangostana; diabetes mellitus; glucose; mangosteen; network meta-analysis.

Publication types

Systematic Review

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by Center of Excellence Research for Melioidosis and Microorganisms (CERMM), Walailak University, Nakhon Si Thammarat, Thailand.