| ANTIOXIDANT
PROPERTY OF GINGER IN PATIENTS WITH CORONARY ARTERY
DISEASE |
| SK Verma, A Bordia,
P Jain, KC Srivastava* |
 |
Indigenous Drug
Research Centre, Department of Medicine, R.N.T.
Medical College, Udaipur. India |
|
Department of
Environmental Medicine*, Odense University,
Odense, Denmark. |
|
| |
 ABSTRACT |
| |
| Background: Ginger contains
components with strong antiplatelet, prostanoid
synthesis inhibitory activity and antioxidant potential,
prompted us to study its antioxidant effect in healthy
subjects and in patients with coronary artery disease. |
| |
| Study Design: Randomised, double
blinded, placebo controlled study. |
| |
| Material and Methods: Twenty
healthy individuals (Group-A) and twenty patients
with coronary artery disease (Group-B) were selected.
Both the groups were randomly assigned either dry
ginger (5gm) or matched placebo (Lactose powder)
for four weeks. Blood lipids and lipoprotein oxidation
susceptibility were estimated initially and at the
end of the study and the results were analysed using
paired t-test. |
| |
| Results: Ginger administration
significantly (P<0.001) decreased lipoprotein
oxidation susceptibility in healthy subjects as
well as in patients with coronary artery disease
without any effect on blood lipids. No adverse effects
were observed. |
| |
| Conclusion: Ginger appears
to have strong free radical scavenging property.
This antioxidant potential along with other beneficial
effects of ginger merits strong consideration of
its use in patients with ischemic heart disease. |
| |
|
INTRODUCTION |
| |
| Ginger (Zingiber officinale) is a
popular food spice, and occupies an important place
in Ayurvedic and Graeco-Arabic systems of medicine
to treat various ailments, from time immemorial
1. It has attracted
much scientific attention during past few years.
Several pharmacological activities including antiemetic,
antithrombotic, antimicrobial, anticancer, antioxidant
and anti-inflammatory properties have been documented
for preparations of ginger in vitro and / or animal
studies 2. In many
human studies it has been evaluated regarding, its
effects on blood lipids3,4
fibrinolysis 5, and
platelet aggregation 6
both in healthy individuals 4,5
and patients of coronary artery disease (CAD) 3.
Its antioxidant property has been observed in animal
studies. However, its effect on lipoprotein oxidation
susceptibility (LOS) has not been studied in man.
The present study therefore was envisaged to observe
the effect of dry ginger on LOS in healthy individuals
and patients with CAD. |
| |
|
MATERIAL AND METHODS |
| |
| After approval from the institutional
ethical committee the study was conducted on 20
healthy individuals (Group A) and 20 patients with
CAD (Group B). CAD patients were of old healed myocardial
infarction (> 6 months) and were stable in their
symptoms. They were receiving isosorbide dinitrate
(20 mg twice daily) and aspirin 150 mg daily. In
both the groups half (n=10) were randomly assigned
ginger powder (5gm) in gelatin capsules or placebo
in matched gelatin capsules for a period of 4 weeks.
The blood samples were collected initially and after
4 weeks of ginger administration. Samples were subjected
for estimation of blood lipids enzymatically using
standard kits and lipid peroxidation employing lipoprotein
oxidation susceptibility (LOS) test7. |
| |
| Statistical
analysis: The data's were expressed as mean
± standard error (SE). The results were analyzed
with student 't' test for paired data (paired 't'
test). A p value less than 0.05 was considered significant. |
| |
| Preparation
of ginger capsules: Dry ginger rhizomes were
powdered in an electric grinder. The dry powder
was filled in gelatin capsules. Each capsule contained
625 mg of dry ginger powder. Four capsules were
administered twice daily with meals. Placebo capsules
contained same amount of lactose powder. |
| |
| RESULTS |
| |
| The administration of ginger produced
a significant (P<0.001) decrease in lipoprotein
oxidation susceptibility both in healthy individuals
and patients with CAD. Lipoprotein oxidation susceptibility
decreased by 18 percent and 23 percent in healthy
individuals and patient of CAD respectively at the
end 4 weeks. The control subjects (placebo group)
in both the groups however did not show any significant
alteration in LOS (Table-1). Moreover, the blood
lipid levels were not altered to any significant
extent by ginger administration (Table-2). |
| |
| Table 1: -Effect of Ginger on
Lipoprotein Oxidation Susceptibility (in mol MDA/mg
of non-HDL-C) |
| |
| |
Initial |
After 4 weeks |
| Healthy Subjects |
|
|
| Treated (N=10) |
58.40±4.62 |
47.90±3.87* |
| Control (N=10) |
55.80±3.95 |
57.20±3.71** |
| |
|
|
| CAD Patients |
|
|
| Treated (N=10) |
72.10±3.72 |
55.40±3.16* |
| Control (N=10) |
69.90±4.62 |
67.60±4.31** |
|
| |
| Values are mean ± SE.
* p<0.001, as compared with initial. ** P=NS
(not significant) as compared with initial. |
| |
| DISCUSSION |
| |
| In the present study there has been
a definite decrease in lipoprotein oxidation susceptibility
after 5 gm of ginger administration daily in both
healthy subjects and patients with CAD (Table-1)
without any significant alteration in lipid levels
(Table-2). In our most of previous studies on ginger3-5,
we used 5gm dosage, as lesser amounts gives inconsistent
results. Therefore, the same dose (5 gm) has been
used in the present study also. No side effects
were observed even in this dose when administered
for 4 weeks. |
| |
| The free radical damaging reaction
has been proposed to be a significant contributor
to the process of atherosclerosis, inflammation,
cancer and aging. Increasing evidences indicate
an inverse correlation between consumption of certain
food (containing antioxidants) and incidence of
ischemic heart disease (IHD) and Cancer
8. Sizeable randomized trials of antioxidant
vitamins have shown equivocal results in patients
with IHD 9. More
importantly, a potential harmful effect of synthetic
antioxidant vitamins in patients with known or suspected
CAD has also been observed 10.
In this context, the antioxidant property of ginger
merits special consideration, which is a widely
used food spice and can be consumed by all. It has
added advantage of being a natural antioxidant,
which might prove more useful by providing flavenoids
and other antioxidant compounds not present in standard
oral synthetic antioxidant vitamin supplements 9. |
| |
| Table 2: - Effect of ginger
on blood lipids |
| |
| |
Total Cholesterol |
Triglycerides |
HDL-Cholesterol |
| |
Initial |
4 Weeks |
Initial |
4 Weeks |
Initial |
4 Weeks |
| Healthy Subjects |
|
| Treated (N=10) |
201.70 ±
7.54 |
205.06 ±
8.34* |
125.0 ±
6.50 |
120.50 ±
6.10* |
51.64 ±
2.40 |
59.09 ±
3.35* |
| Control (N=10) |
208.60 ±
7.87 |
201.7 ±
8.25* |
121.10 ±
7.10 |
124.60 ±
6.50* |
52.12 ±
1.73 |
51.31 ±
1.33* |
| |
| Cad Patients |
|
| Treated (N=10) |
247.48 ±
9.47 |
245.81 ±
8.42* |
160.5 ±
12.20 |
156.20 ±
11.60* |
44.90 ±
3.26 |
42.50 ±
3.20* |
| Control (N=10) |
237.75 ±
11.29 |
232.15 ±
10.80* |
158.20 ±
11.80 |
162.45 ±
12.80* |
41.62 ±
1.81 |
42.99 ±
1.97* |
|
| |
| Values (mg %) are means ±
SE. * P = NS (not significant) as compared with
initial. |
| |
| Chemically, ginger contains several
classes of compounds including starch (40-60%),
proteins (10%), fats (10%), fibers (5%), inorganic
material (6%), moisture (10%) and essential oil
(1-4%) 1. The essential
oil (oleoresin) of ginger contains various terpins
and sesquiterpenes (Zingiberene). In all, more than
200 different volatile substances have been characterized
in the essential oil fraction. The characteristic
pungent odour is due to its oleoresin content, which
is an oily liquid containing oxymethyl phenols like
shagoal, zingerone and gingerol, which are probably
responsible for its antioxidant property11.
Various animal studies have documented antioxidant
property of ginger11-12.
An ethanolic ginger extract standardized to contain
40mg/gm gingerols, shagoals and zingerone and 90mg/gm
total polyphenols, have been reported to inhibit
low density lipoprotein oxidation and to reduce
the development of atherosclerosis in atherosclerotic
mice when compared to control 11.The
antioxidant property of ginger has also been demonstrated
in vitro 13. |
| |
| Ginger has been a popular food spice
possessing many medicinal properties 1-2.
Recently it has drawn a lot of scientific attention.
It has been reported to have components (gingerol,
shagoal), which are potent inhibitor of platelet
aggregation, and inhibits platelet aggregation in
vitro6 and in healthy
individuals as well as patients with CAD ex vivo3-4.
It has also shown amelioration in pain and inflammation
in patients with rheumatism, musculoskeletal disorders
and migraine 14.However,
it does not alter blood lipids, blood sugar and
fibrinogen in patients with CAD 3.
|
| |
| We have earlier reported that ginger
neutralizes altered fibrinolytic state, induced
by fatty meals in healthy individuals 5.
The antioxidant property further adds to its therapeutic
potential. Recently, a preliminary study using a
'living cell' flow-cytometric approach to membrane
protection has demonstrated that ginger contains
antioxidant component(s) that act with in the cell
membrane and slow lipid peroxidation in situ 15.
In view of the above observations, ginger deserves
serious thought regarding its therapeutic application
in patients with IHD because of its potential beneficial
properties of inhibiting platelet aggregation, enhancing
fibrinolysis and preventing lipoprotein oxidation
susceptibility in man with and without IHD. |
| |
| ACKNOWLEDGEMENT |
| |
| The authors thank the Danish International
Development Agency (DANIDA) for the financial support
(grant No. 104 Dan. 8/808). |
| |
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| |
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