Effect of Korean Red Ginseng on metabolic syndrome

Abstract

Metabolic syndrome (MS) refers to a clustering of at least three of the following medical conditions: high blood pressure, abdominal obesity, hyperglycemia, low high-density lipoprotein level, and high serum triglycerides. MS is related to a wide range of diseases which includes obesity, diabetes, insulin resistance, cardiovascular disease, dyslipidemia, or non-alcoholic fatty liver disease. There remains an ongoing need for improved treatment strategies for MS. The most important risk factors are dietary pattern, genetics, old age, lack of exercise, disrupted biology, medication usage, and excessive alcohol consumption, but pathophysiology of MS has not been completely identified. Korean Red Ginseng (KRG) refers to steamed/dried ginseng, traditionally associated with beneficial effects such as anti-inflammation, anti-fatigue, anti-obesity, anti-oxidant, and anti-cancer effects. KRG has been often used in traditional medicine to treat multiple metabolic conditions. This paper summarizes the effects of KRG in MS and related diseases such as obesity, cardiovascular disease, insulin resistance, diabetes, dyslipidemia, or non-alcoholic fatty liver disease based on experimental research and clinical studies.

Keywords: ACC, Acetyl-Coenzyme A carboxylase; ADP, adenosine diphosphate; AG, American ginseng extract; AGE, advanced glycation end product; ALT, alanine aminotransferase; AMPK, AMP-activated protein kinase; AST, aspartate aminotransferase; Akt, protein kinase B; BMI, body mass index; C/EBPα, CCAAT/enhancer-binding protein alpha; COX-2, cyclooxygenase-2; CPT, current perception threshold; CPT-1, carnitine palmitoyl transferase 1; CRP, C-reactive protein; CVD, Cardiovascular disease; DBP, diastolic blood pressure; DEN, diethyl nitrosamine; EAT, epididymis adipose tissue; EF, ejection fraction; FABP4, fatty acid binding protein 4; FAS, Fatty acid synthase; FFA, free fatty acid; FR, fine root concentration; FS, fractional shortening; GBHT, ginseng-plus-Bai-Hu-Tang; GLUT, glucose transporter type; GPx, glutathione peroxidase; GS, ginsenoside; GST, glutathione S-transferase; GST-P, glutathione S-transferase placental form; GTT, glucose tolerance test; HCC, hepatocellular carcinoma; HCEF-RG, hypotensive components-enriched fraction of red ginseng; HDL, high-density lipoprotein; HFD, High fat diet; HOMA-IR, homeostasis model assessment of insulin resistance index; HbA1c, glycosylated hemoglobin; I.P., intraperitoneal injection; IL, interleukin; IR, insulin resistance; ITT, insulin tolerance test; Insulin resistance; KRG, Korean Red Ginseng; LDL, low-density lipoprotein; LPL, lipoprotein lipase; Lex, lower extremities; MDA, malondialdehyde; MMP, Matrix metallopeptidases; MS, Metabolic syndrome; Metabolic syndrome; NAFLD, Non-alcoholic fatty liver disease; NF-кB, nuclear factor kappa-light-chain-enhancer of activated B cells; NK cell, Natural killer cell; NMDA-NR1, N-methyl-D-aspartate NR1; NO, nitric oxide; NRF1, Nuclear respiratory factor 1; Non-alcoholic fatty liver disease; Nrf2, Nuclear factor erythroid 2-related factor 2; OLETF rat, Otsuka Long-Evans Tokushima fatty rat; PCG-1α, PPAR-γ coactivator-1α; PI3K, phosphoinositide 3-kinase; PPAR, peroxisome proliferator-activated receptors; PPD, protopanaxadiol; PPT, protopanaxatriol; Panax ginseng; REKRG, Rg3-enriched KRG; ROS, Reactive oxygen species; Rg3-KGE, Rg3-enriched KRG extract; SBP, systolic blood pressure; SCD, Stearoyl-Coenzyme A desaturase; SHR, spontaneously hypertensive rat; SREBP-1C, Sterol regulatory element-binding protein 1; STAT5, Signal transducer and activator of transcription 5; STZ, streptozotocin; TBARS, thiobarbituric acid reactive substances; TC, total cholesterol; TG, triglyceride; TNF, tumor necrosis factor; UCP, Mitochondrial uncoupling proteins; VLDL, very low-density lipoprotein; iNOS, inducible nitric oxide synthase; t-BHP, tert-butyl hyperoxide; tGST, total glutathione.

Graphical abstract

Fig. 1

Metabolic syndrome associated diseases.

Fig. 2

The constituent parts of Korean Red Ginseng.