Journal of Nutritional Sciences and Dietetics 2016. 2(5):.

The potential role of quercetin supplementation in modulating glucocorticoid-induced hyperglycemia
Masoud Khorshidi, Meysam Zarezadeh, Mohammadreza Emami

Abstract


Dear editor,

Glucocorticoid are a large class of drugs that have anti-inflammatory and immunosuppressive properties and remain a necessary component of treatment for many disease (1). Despite their therapeutic effect, corticosteroids have several side effects which onset and progress in hyperglycemia in non-diabetic patient and exacerbate hyperglycemia in patients with diabetes is one of them (2), Glucocorticoids also lead to increase insulin resistance in all patients (3). The major mechanism which cause glucose intolerance after administration of glucocorticoids, is reduction in insulin sensitivity (4). Glucocorticoids impair glucose use through post receptor defects, such as diminished GLUT4 expression and migration and decreased glycogen synthesis through reduction of glycogen synthase activity (5). Moreover, glucocorticoids enhance hepatic gluconeogenesis by increase phosphoenolpyruvate carboxykinase and glucose-6-phosphatase activity (6). Furthermore, mRNA expression of the AMP-activated protein kinase (AMPK) is correlated negatively with mRNA expression of the glucocorticoids which AMPK can reduce blood glucose level by reduction of glucose production in the liver (7). In addition, Glucocorticoids inhibit production and secretion of insulin by pancreatic β cells (8). This hyperglycemia is associated with endothelial dysfunction and cardiovascular disease (9).

Currently, blood glucose lowering agents in diabetic patients including sulfonylureas, metformin, thiazolidinediones (TZDs) and insulin are the only option for treatment of these patient (10). These agents have many complications such as hypoglycemia, lactic acidosis and increase in risk of bone fracture (11, 12). Previous studies suggested that some bioflavonoids such as quercetin could be beneficial in controlling blood glucose (13).

Quercetin is one of the most abundant flavonols, which is found in some sources such as tea, onion and apple. This flavonol has many features such as antioxidant, dyslipidemia improving, endothelial function- improving, Antihyperglycemic effection and so on (14-17). Antihyperglycemia mechanism of quercetin involves its effects on GLUT4 transposition from cytoplasm to cell membrane through upregulation the level of AS160 phosphorylation (18). Moreover, this flavonoid protected pancreatic β cells from oxidative stress resulting in increased insulin secretion(19). quercetin could also inhibit intestinal α-glucosidase activity and decrease postprandial hyperglycemia (20). Furthermore, quercetin is an AMPK activator and affects energy metabolism and blood glucose levels (18).

Taken together, this evidence show quercetin could potentially be alternative hypoglycemic agent without side effects in this patients. Given the fact that so far no study has been done on this issue, this can be the subject of future studies.


Keywords


quercetin; glucocorticoid; hyperglycemia

References


Barnes PJ. How corticosteroids control inflammation: quintiles prize lecture 2005. British journal of pharmacology. 2006;148(3):245-54.

Liu X-x, Zhu X-m, Miao Q, Ye H-y, Zhang Z-y, Li Y-m. Hyperglycemia induced by glucocorticoids in nondiabetic patients: a meta-analysis. Annals of Nutrition and Metabolism. 2014;65(4):324-32.

Qi D, Rodrigues B. Glucocorticoids produce whole body insulin resistance with changes in cardiac metabolism. American Journal of Physiology-Endocrinology and Metabolism. 2007;292(3):E654-E67.

Clore J, Thurby-Hay L. Glucocorticoid-induced hyperglycemia. Endocrine Practice. 2009;15(5):469-74.

Ekstrand A, Schalin-Jäntti C, Löfman M, Parkkonen M, Widén E, Franssila-Kallunki A, et al. The effect of (steroid) immunosuppression on skeletal muscle glycogen metabolism in patients after kidney transplantation. Transplantation. 1996;61(6):889-93.

Vander Kooi BT, Onuma H, Oeser JK, Svitek CA, Allen SR, Vander Kooi CW, et al. The glucose-6-phosphatase catalytic subunit gene promoter contains both positive and negative glucocorticoid response elements. Molecular Endocrinology. 2005;19(12):3001-22.

Nader N, Ng SSM, Lambrou GI, Pervanidou P, Wang Y, Chrousos GP, et al. AMPK regulates metabolic actions of glucocorticoids by phosphorylating the glucocorticoid receptor through p38 MAPK. Molecular Endocrinology. 2010;24(9):1748-64.

van Raalte DH, Nofrate V, Bunck MC, van Iersel T, Elassaiss Schaap J, Nassander UK, et al. Acute and 2-week exposure to prednisolone impair different aspects of beta-cell function in healthy men. European journal of endocrinology. 2010;162(4):729-35.

Ceriello A, Esposito K, Piconi L, Ihnat MA, Thorpe JE, Testa R, et al. Oscillating glucose is more deleterious to endothelial function and oxidative stress than mean glucose in normal and type 2 diabetic patients. Diabetes. 2008;57(5):1349-54.

Hoogwerf B, Danese RD. Drug selection and the management of corticosteroid-related diabetes mellitus. Rheumatic Disease Clinics of North America. 1999;25(3):489-505.

Luther P, Baldwin D. Pioglitazone in the management of diabetes mellitus after transplantation. American Journal of Transplantation. 2004;4(12):2135-8.

Meier C, Kraenzlin ME, Bodmer M, Jick SS, Jick H, Meier CR. Use of thiazolidinediones and fracture risk. Archives of Internal Medicine. 2008;168(8):820-5.

Alam MM, Meerza D, Naseem I. Protective effect of quercetin on hyperglycemia, oxidative stress and DNA damage in alloxan induced type 2 diabetic mice. Life sciences. 2014;109(1):8-14.

Jullian C, Moyano L, Yanez C, Olea-Azar C. Complexation of quercetin with three kinds of cyclodextrins: an antioxidant study. Spectrochimica acta Part A, Molecular and biomolecular spectroscopy. 2007;67(1):230-4.

Kelly GS. Quercetin. Altern Med Rev. 2011;16(2):172-94.

Kim J-H, Kang M-J, Choi H-N, Jeong S-M, Lee Y-M, Kim J-I. Quercetin attenuates fasting and postprandial hyperglycemia in animal models of diabetes mellitus. Nutrition research and practice. 2011;5(2):107-11.

Sanchez M, Lodi F, Vera R, Villar IC, Cogolludo A, Jimenez R, et al. Quercetin and isorhamnetin prevent endothelial dysfunction, superoxide production, and overexpression of p47phox induced by angiotensin II in rat aorta. The Journal of nutrition. 2007;137(4):910-5.

Xiao N, Mei F, Sun Y, Pan G, Liu B, Liu K. Quercetin, luteolin, and epigallocatechin gallate promote glucose disposal in adipocytes with regulation of AMP-activated kinase and/or sirtuin 1 activity. Planta medica. 2014;80(12):993-1000.

Coskun O, Kanter M, Korkmaz A, Oter S. Quercetin, a flavonoid antioxidant, prevents and protects streptozotocin-induced oxidative stress and β-cell damage in rat pancreas. Pharmacological research. 2005;51(2):117-23.

Hussain S, Mahwi T, Aziz T. Quercetin dampens postprandial hyperglycemia in type 2 diabetic patients challenged with carbohydrates load. International Journal of Diabetes Research. 2012;1(3):32-5.


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