Chung-Hua Hsu

Effect of green tea extract on obese women: a randomized, double-blind, placebo-controlled clinical trial.

AIMS To examine the effect of green tea extract (GTE) on obese women and to explore the relationship between GTE and obesity-related hormone peptides. METHODS A randomized, double-blind, placebo-controlled clinical trial was conducted from July 2006 to June 2007 in Taipei Hospital, Taiwan. Seventy-eight of 100 obese women aged between 16 and 60 years with BMI>27 kg/m(2) and who had not received any other weight control maneuvers within the last 3 months completed this study. The subjects were randomly divided into Groups A and B. Group A (n=41) received GTE while Group B (n=37) took cellulose as a placebo, one capsule (400mg) three times each day for 12 weeks. The body weight (BW), body mass index (BMI) and waist circumflex (WC) were measured at the beginning of the study and after 12 weeks of treatment with GTE. The data were compared and expressed as % reduction. RESULTS There was only a 0.3% reduction in BW (0.15 kg) after 12 weeks of treatment with GTE. There was no statistical difference in % reduction in BW, BMI and WC between the GTE and placebo groups. Within group comparison revealed that the GTE group had significant reduction in LDL-cholesterol and triglyceride, and marked increase in the level of HDL-cholesterol, adiponectin and ghrelin. On the other hand, the placebo group showed significant reduction in triglyceride only, and a marked increase in the level of ghrelin alone. CONCLUSIONS This study showed no statistical difference in % reduction in BW, BMI and WC between the GTE and placebo groups after 12 weeks of treatment. The intake of GTE (491 mg catechins containing 302 mg EGCG) for 12 weeks is considered safe as shown by the results.

Effects of green tea extract on insulin resistance and glucagon-like peptide 1 in patients with type 2 diabetes and lipid abnormalities: a randomized, double-blinded, and placebo-controlled trial.

The aim of this study is to investigate the effect of green tea extract on patients with type 2 diabetes mellitus and lipid abnormalities on glycemic and lipid profiles, and hormone peptides by a double-blinded, randomized and placebo-controlled clinical trial. This trial enrolled 92 subjects with type 2 diabetes mellitus and lipid abnormalities randomized into 2 arms, each arm comprising 46 participants. Of the participants, 39 in therapeutic arm took 500 mg green tea extract, three times a day, while 38 in control arm took cellulose with the same dose and frequency to complete the 16-week study. Anthropometrics measurements, glycemic and lipid profiles, safety parameters, and obesity-related hormone peptides were analyzed at screening and after 16-week course. Within-group comparisons showed that green tea extract caused a significant decrease in triglyceride and homeostasis model assessment of insulin resistance index after 16 weeks. Green tea extract also increased significantly high density lipoprotein cholesterol. The HOMA-IR index decreased from 5.4±3.9 to 3.5±2.0 in therapeutic arm only. Adiponectin, apolipoprotein A1, and apolipoprotein B100 increased significantly in both arms, but only glucagon-like peptide 1 increased in the therapeutic arm. However, only decreasing trend in triglyceride was found in between-group comparison. Our study suggested that green tea extract significantly improved insulin resistance and increased glucagon-like peptide 1 only in within-group comparison. The potential effects of green tea extract on insulin resistance and glucagon-like peptide 1 warrant further investigation. Trial Registration ClinicalTrials.gov NCT01360567

The Mushroom Agaricus blazei Murill Extract Normalizes Liver Function in Patients with Chronic Hepatitis B

BACKGROUND Hepatitis B is a global health problem. Use of complementary and alternative medicine has been popular among patients with hepatitis B. This 1-year open-label pilot study aims to observe whether Agaricus blazei Murill extract improves liver function in patients with hepatitis B. METHODS This study involved 12 months of clinical observation. Four (4) patients with hepatitis B who met the criteria (1) aged between 20 and 65 years; (2) being Chinese; (3) having been a hepatic B carrier (HBAg(+)) for more than 3 years; (4) alanine aminotransferase > 100 IU/L; and (5) not taking lamivudine, alpha-interferon, or other drugs for hepatitis participated in the study with informed consent. The enrolled patients were given Agaricus blazei Murill (ABM) extract of 1500 mg daily for 12 months. The level of alanine aminotransferase was taken as the major outcome measurement. RESULTS At the end of the study, the mean level of aspartate aminotransferase and alanine aminotransferase decreased from 246.0 (+/- standard deviation [SD] 138.9) to 61.3 (+/- SD 32.6) IU/L and 151.0 (+/- SD 86.9) to 46.1 (+/- SD 22.5) IU/L, respectively. CONCLUSIONS Our initial observation seems to indicate the potential benefit of ABM extract in normalizing liver function of patients with hepatitis B. Controlled studies with larger samples should be conducted in the future.

Effects of electroacupuncture in reducing weight and waist circumference in obese women: a randomized crossover trial

OBJECTIVE:To compare the effects of weight control on simple obese women between electroacupuncture and sit-up exercise.DESIGN:Randomized and crossover trial conducted from 1 January 2002 to 31 December 2002. The subjects were randomly divided into groups A and B. Group A received electroacupuncture treatment first while group B received sit-up exercise treatment first. After 6 weeks of treatment and 7 days of washout, group A switched to sit-up exercise treatment and group B received electroacupuncture treatment for another 6 weeks.PATIENTS:In total, 54 simple obese women, with waist circumference (WC)>90 cm and body mass index (BMI)>30 kg/m2, and who had not received any other weight control maneuver within the last 3 months.MEASUREMENT:The measurements of body weight (BW), BMI and WC were performed at the beginning, 6, 8 and 13 weeks. The data at different time periods were compared and expressed as % reductions.RESULTS:Electroacupuncture (n=46) showed significant differences in the % reductions in BW (P=0.001), BMI (P=0.003) and WC (P=0.005) compared with sit-up exercise. At the end of 13 weeks, there were no significant difference between groups A (n=24) and B (n=22) in all the measurements. At the end of the study, groups A and B showed significant differences in the % reductions in BW (P=0.004; 0.001), BMI (P=0.003; 0.021) and WC (P≤0.001; 0.001) compared with the initial values.CONCLUSIONS:Electroacupuncture treatment is more effective than sit-up exercise in reducing weight and WC, making it an alternative treatment option for weight and WC control on obese women.

Integrating acupuncture into cancer care.

Oncology acupuncture has become a new and promising field of research because more and more cancer patients have sought non-pharmacological alternatives for symptom management. While different mechanisms have been proposed to explain its efficacy, including theories of the neural system, endocrine cytokine or immunological regulation, its eventual role has become that of alleviating the side effects induced by chemotherapy or radiotherapy. In this paper, we have reviewed the related articles focusing on acupuncture mechanisms and applications in cancer care to provide a quick sketch of acupuncture in cancer care. A detailed search was performed to identify the randomized controlled trials (RCTs) and systematic reviews on acupuncture in oncology, using PUBMED and Cochrane. The search terms included: Acupuncture, acupressure, and cancer. Additional terms were used to target specific symptoms (i.e., breast cancer, hot flash, xerostomia, nausea, vomiting, cancer pain, insomnia, fatigue). Two authors independently extracted data for analysis and review. Ultimately, 25 articles underwent full-text review. Recent trials made efforts in studying (a) hot flashes in breast cancer, (b) xerostomia induced by radiotherapy in head and neck cancer, (c) nausea and vomiting post-chemotherapy, (d) cancer pain, and (e) fatigue and insomnia in cancer patients. Controversial results for acupuncture application in cancer care appeared in different categories, but a trend emerged that acupuncture can palliate cancer-related symptoms. The research to date certainly offers us a valid complementary therapy in treating cancer-related symptoms. Meanwhile, practical strategies with safe measures for enhancing the efficacy are needed in further interventions, as well as continuing research with a validated methodology.

Waist circumference is a better predictor than body mass index of insulin resistance in type 2 diabetes

UNLABELLED Summay: BACKGROUND Insulin resistance is an important pathogenic factor in type 2 diabetes patents. An easy and efficiency measurement predicting insulin resistance; which can be done easily by type 2 patients is desired. OBJECTIVE To examine whether waist circumference is a better predictor of insulin resistance in type 2 diabetes than body mass index (BMI). METHODS From a population of 1356 registered diabetic patients, 144 who met (1) aged between 30 and 75 years, (2) being Chinese, (3) having had type 2 diabetes for more than one year, and (4) having been taking gliclazide and metformin for more than 6 months were enrolled in this study. The main outcome evaluated is the associations of HOMA insulin resistance index (HOMA index); which were assessed using multiple linear regression analysis. RESULTS The coefficients of multiple regression analysis with stepwise model showed that waist circumference (β = 0.35, p < 0.001) but not BMI (β = 0.01, p = 0.94), adiponectin (β = -0.25, p = 0.04) and hemoglobulin A1c% (HbA1c) (β = 0.25, p = 0.01) were the main predictors of HOMA index. CONCLUSIONS These initial findings indicate that waist circumference is a better predictor of insulin resistance in type 2 diabetes than BMI.

Adiponectin Level Predicts HDL-Cholesterol Level in Type 2 Diabetes

Background: Atherosclerotic cardiovascular complications are the major causes of morbidity and mortality in Type 2 diabetic patients. Many studies have demonstrated that adiponectin has both anti-atherogenic and anti-diabetic properties. This study aims to examine the regulatory roles of serum adiponectin in a homogeneous Type 2 diabetic cohort. Method: Of a population of 1256 registered diabetic patients, 116 subjects (1) aged between 40 and 70 years, (2) from the Chinese population, (3) having had Type 2 diabetes for more than one year, and (4) having been taking gliclazide and metformin for more than 6 months were enrolled in the study. All subjects were assigned to one of the plasma adiponectin level categories according to the quartiles. The main outcome evaluated is the associations of plasma adiponectin level; which were evaluated using multiple linear regression analysis. Results: Adiponectin concentration was the only and main predictor of HDL-cholesterol level ( = 0.321, p = 0.002) after adjusting other factors for the homogeneous Type 2 diabetic subjects. Conclusion: These initial findings seem to denote a positive association between adiponectin concentration and HDLcholesterol level in Type 2 diabetes. Adiponectin concentration might be a valuable marker of artherosclerosis in Type 2 diabetic patients. Keyword: Type 2 diabetes, Adiponectin, HDL-cholesterol, Atherosclerosis. The risk of atherosclerotic cardiovascular disease in Type 2 diabetic patients is two to four folds higher than that in nondiabetic ones [1]. Atherosclerotic cardiovascular complications are among the major causes of morbidity and mortality in Type 2 diabetic patients [2]. This increased risk might be attributed to hyperglycemia, dyslipidemia, and inflammatory mechanism [3,4]. Monitoring a valuable marker on atherosclerotic pathogenesis and insulin resistance are desired and beneficial to these patients. Some related studies have been reported [5]. Adiponectin is a hormone produced in adipocytes, and appears to play a very important role in the above pathway [6-13]. HDLcholesterol is known to have help prevent the development of atherosclerotic cardiovascular complications. We hypothesized that a strong association between adiponectin concentration and HDL-cholesterol level might exist in homogeneous Type 2 diabetic patients after adjusting the other factors. This study aims to examine the regulatory roles of serum adiponectin level in a homogeneous Type 2 diabetic cohort. METHOD Study Population The trial was conducted from July 2005 through June 2006 in Taipei Hospital, Taiwan County, Taiwan. A total of *Address correspondence to this author at the Institute of Public Health, National Yang-Ming University, Taipei, Taiwan, 155, Li-Nong St, Sec 2, Peitou, Taipei, Taiwan; Tel: 886-2-2826-7050; Fax: 886-2-28201461; E-mail: pschou@ym.edu.tw 1256 registered diabetic patients were screened, among which 136 met the inclusion /exclusion criteria (Table 1). A letter explaining the purpose of the study were sent to the 136 patients inviting their participation, and 116 accepted the invitation and were enrolled with informed consent. The protocol was approved by the Human Ethics Committee of Taipei Hospital. Table 1. Inclusion and Exclusion Criteria

The Correlation of Traditional Chinese Medicine Deficiency Syndromes, Cancer Related Fatigue, and Quality of Life in Breast Cancer Patients

Background: To evaluate the correlation between the different traditional chinese medicine (TCM) deficiency syndromes, cancer related fatigue (CRF), and quality of life (QoL) in breast cancer patients. Patients and methods: Ninety-five breast cancer patients were categorized into different qi (氣 qì), blood (血 xuè), yin (陰 yin), and yang (陽 yáng) TCM deficiency syndrome groups (DSGs). We used the ICD-10 for diagnosing CRF. The QoL was assessed by the WHO-BREF and Short Form Health Survey (SF12) questionnaires. The major outcome was to compare the QoL scores between the different TCM DSGs. The second outcome was the intergroup analysis between the CRF and different TCM DSGs in breast cancer patients. Results: The patients with qi deficiency (氣虛 qì xu) had a higher correlation with CRF (p=0.001) and poorer QoL both in the WHO-BREF and SF12 survey (p<0.001), whereas the patients with yin deficiency (陰虛 yin xu) had poorer QoL in the psychological (p=0.02) and social aspects (p=0.04). The qi deficiency (氣虛 qì xu) syndrome was closely associated with yin deficiency syndrome (陰虛 yin xu). (p=0.03). Conclusion: Our study confirmed the concept of Qi-deficiency (氣虛 qì xu) in TCM was associated with CRF as identified in cancer care in western medicine. The breast cancer patients with qi deficiency (氣虛 qì xu) have poorer QoL. Treatment of CRF and improving QoL by supplying qi (氣 qì) may warrant further investigation.

An Evaluation of the Additive Effect of Natural Herbal Medicine on SARS or SARS-Like Infectious Diseases in 2003: A Randomized, Double-Blind, and Controlled Pilot Study

Natural herbal medicine (NHM) has been used to control infectious diseases for thousands of years. In view of the possible beneficial effect of NHM on SARS, we conducted this study to examine whether NHM is of any benefit as a supplementary treatment of SARS or SARS-like infectious disease. This was a randomized, double-blind, placebo-controlled trial. Twenty-eight patients fulfilled the WHO inclusion criteria and our exclusion criteria. All enrolled patients received routine western-medicine treatment. Patients were randomly allocated to one of the three supplementary treatment groups: NHM A (Group A, n = 9) NHM B (Group B, n = 9) or placebo (Group C, n = 10). Chest X-ray was done every 1 or 2 days for every patient. Reading radiologists use a standard 0–3 scoring system (0: no infiltration; 1: focal haziness or even small patchy lesion; 2: ground glass picture; 3: lobar consolidation) according to the severity of infiltration in each lung field (three lung fields in both right and left lungs). The main outcome measurements were the improving chest radiographic scores (IRS) and the duration (days) till improvement (DI). One patient from the placebo group passed away. Patients from NHM A took less days before showing improvement (6.7 ± 1.8) compared with placebo group (11.2 ± 4.9), which showed statistical significance (P = 0.04). The cases were too few to be conclusive, the initial observations seem to indicate NHM appears to be safe in non-criticallly ill patients and clinical trials are feasible in the setting of pandemic outbreaks.

Screening to Identify Commonly Used Chinese Herbs That Affect ERBB2 and ESR1 Gene Expression Using the Human Breast Cancer MCF-7 Cell Line

Aim. Our aim the was to screen the commonly used Chinese herbs in order to detect changes in ERBB2 and ESR1 gene expression using MCF-7 cells. Methods. Using the MCF-7 human breast cancer cell line, cell cytotoxicity and proliferation were evaluated by MTT and trypan blue exclusion assays, respectively. A luciferase reporter assay was established by transient transfecting MCF-7 cells with plasmids containing either the ERBB2 or the ESR1 promoter region linked to the luciferase gene. Chinese herbal extracts were used to treat the cells at 24 h after transfection, followed by measurement of their luciferase activity. The screening results were verified by Western blotting to measure HER2 and ERα protein expression. Results. At concentrations that induced little cytotoxicity, thirteen single herbal extracts and five compound recipes were found to increase either ERBB2 or ESR1 luciferase activity. By Western blotting, Si-Wu-Tang, Kuan-Shin-Yin, and Suan-Tsao-Ren-Tang were found to increase either HER2 or ERα protein expression. In addition, Ligusticum chuanxiong was shown to have a great effect on ERBB2 gene expression and synergistically with estrogen to stimulate MCF-7 cell growth. Conclusion. Our results provide important information that should affect clinical treatment strategies among breast cancer patients who are receiving hormonal or targeted therapies.