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Review
. 2021 Mar;24(3):280-292.
doi: 10.22038/ijbms.2021.48965.11218.

The protective effect of Azadirachta indica (neem) against metabolic syndrome: A review

Fatemeh Yarmohammadi  1   2 , Soghra Mehri  3   2 , Nahid Najafi  1   2 , Sanaz Salar Amoli  1   4 , Hossein Hosseinzadeh  3   2
Affiliations
Review

The protective effect of Azadirachta indica (neem) against metabolic syndrome: A review

Fatemeh Yarmohammadi et al. Iran J Basic Med Sci. 2021 Mar.

Abstract

Metabolic syndrome is a condition associated with obesity, diabetes, dyslipidemia, and high blood pressure. Recently, the use of phytochemicals is suggested in the control and treatment of metabolic syndrome. The Azadirachta indica (neem) is an evergreen tree belonging to the family of Meliaceae. Multiple studies have been confirmed the anti-diabetic and anti-hypertension, anti-hyperlipidemia, and anti-obesity effects of neem. In this review, we reported the protective effects of neem against the complications of metabolic syndrome with a special focus on mechanisms that are involved. It has been shown that neem can control hyperglycemia and hypertension through over-expression of transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2) and anti-oxidant effects. Neem also reduced the glucose uptake through up-regulation of glucose transporter 4 (GLUT4) and inhibition of key intestinal enzymes such as glucosidases. Moreover, neem showed anti-hypertensive effects possibility via the block of calcium channels, up-regulation of endothelial nitric oxide synthase (eNOS), and extracellular signal-regulated kinases 1/2 (ERK1/2) signaling pathway. Anti-oxidant effects play an important role in protective mechanisms of neem against metabolic syndrome and its complications.

Keywords: Azadirachta indica; Diabetes; Hyperlipidemia; Hypertension; Metabolic syndrome; Neem; Obesity.

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Figures

Figure 1
Figure 1
Main mechanisms of neem on high blood pressure. Mechanisms underlying the protective effect of neem against high BP are including the block of calcium channels, up-regulation of ERK 1/2 and Nrf2 gene expression, and normalize serum of NO bioavailability. ARE: Anti-oxidant response element; eNOS: endothelial nitric oxide synthase; ERKs: extracellular-regulated kinases; GPX: glutathione peroxidase; GST: glutathione S-transferases, Nrf2: nuclear factor erythroid-2-related factor 2; NO: nitric oxide; ROS: reactive oxygen species; SOD: superoxide dismutase
Figure 2
Figure 2
Main mechanisms of neem on hyperlipidemia. Neem has been shown protective effects against hyperlipidemia via improvement of the function of anti-oxidant markers and inhibition of oxidative damage of lipoproteins
Figure 3
Figure 3
Main mechanisms of neem on diabetes. Neem has been shown protective effects against diabetes via inhibition of the mitochondrial/oxidative stress pathways
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