Ping-tang Recipe(平糖方) Improves Insulin Resistance and Attenuates Hepatic Steatosis in High-Fat Diet-Induced Obese Rats

Objective： To investigate the therapeutic effects of Ping-tang Recipe （平糖方, PTR） on highfat diet （HFD）-induced insulin resistance and non-alcoholic fatty liver disease （NAFLD）, and to elucidate the underlying mechanisms. Methods： Forty male SD rats were included in the study. Ten rats were fed on normal diet as normal control, and thirty rats were fed on HFD for 8 weeks to induce obesity, followed with low dose （0.42 g/kg） or high dose （0.84 g/kg） of PTR or vehicle for 8 weeks with 10 animals for each group. Glucose metabolism and insulin sensitivity were evaluated by oral glucose tolerance test and insulin tolerance test. Hepatic steatosis was measured by immunohistochemistry. Liver lipid metabolic genes were analyzed by quantitative real-time polyrnerase chain reaction, while AMP-activated protein kinase （AMPK） expression was examined by Western blot. Results： Rats fed on HFD developed abdominal obesity, insulin resistance and NAFLD. PTR treatment reduced visceral fat （peri-epididymal and peri-renal） accumulation, improved glucose metabolism, and attenuated hepatic steatosis. The expressions of the key lipolytic regulating genes, including peroxisome proliferators-activated receptor γ co-activator 1 α （PGC-1 α）, peroxisome proliferator-activated receptor γ, （PRAR-γ） and γ （PRAR-α）, were up-regulated （P〈0.05 or P〈0.01）, while the expressions of lipogenic genes such as sterol regulatory element-binding protein lc （SREBP-lc）, fatty acid synthase （FAS） and liver fatty acid-binding protein （L-FABP） were down-regulated （P〈0.05 or P〈0.01）. In addition, PTR activated AMPK and promoted acetyI-CoA carboxylase phosphorylation in the liver. Conclusions： PTR improves insulin resistance and reverse hepatic steatosis in the rat model of HFD-induced obesity through promotion of lipolysis and reduction of lipogenesis, which involves the AMPK signaling pathway, thus representing a new therapeutic intervention for obesity related insulin resistance and NAFLD.

Effect of Chinese Herbal Medicine Jinlida Granule in Treatment of Patients with Impaired Glucose Tolerance

Background：Diabetes mellitus （DM） remains a major health problem worldwide.Several clinical trials have shown the superiority of the Traditional Chinese Medicine in delaying or reversing the development and progression of DM.This study aimed to evaluate the efficacy of Jinlida （JLD） granule,a Chinese herbal recipe,in the treatment of impaired glucose tolerance （IGT） and its effect on the prevention of DM.Methods：Sixty-five IGT patients were randomized to receive one bag of JLD granules three times daily （JLD group,n =34） or no drug intervention （control group,n =31） for 12 weeks.Oral glucose tolerance test,glycated hemoglobin A1c （HbA1c）,body mass index,blood lipids levels,fasting insulin,and insulin resistance calculated using homeostatic model assessment （HOMA-IR） of all the patients were observed and compared before and after the treatment.Results：Sixty-one participants completed the trial （32 in JLD group and 29 in the control group）.There were statistically significant decreases in HbA1c （P 〈 0.001）,2-h plasma glucose （P 〈 0.001）,and HOMA-IR （P =0.029） in JLD group compared with the control group after 12 weeks of treatment.After 12 weeks of treatment,two （6.9%） patients returned to normal blood glucose,and five （17.2%） patients turned into DM in control group,while in the JLD group,14 （43.8%） returned to normal blood glucose and 2 （6.2%） turned into DM.There was a significant difference in the number of subjects who had normal glucose at the end of the study between two groups （P =0.001）.Conclusions：JLD granule effectively improved glucose control,increased the conversion of IGT to normal glucose,and improved the insulin resistance in patients with IGT.This Chinese herbal medicine may have a clinical value for IGT.