Endocrine Abstracts

Introduction: Metabolic syndrome (MetS) is a cluster of interconnected factors that directly increase the risk of DM2 and CVD. Stevia rebaudiana (a low calorie natural sweetener) and its compounds are known for anti-hyperglycemic, anti-inflammatory, anti-oxidant, anti-hypertensive effects.

Methods: Thirty-eight patients (age 47.3±10.3 years) (n_males=14, n_females=24) with MetS (NCEP/ATPIII criteria) were included. MetS patients were following the same low calorie diet and were randomly assigned to consume either a Stevia snack (n=19) four times/week (Stevia group) or a sweet of their choice (n=19) once a week (control group), for 4 months. BMI, W/H ratio, systolic and diastolic blood pressure (sBP, dBP) were measured before and after intervention. Glucose, triglycerides, cholesterol (LDL, HDL), uric acid, renal and liver functions were determined. Insulin was measured with CLIA, and HOMA-IR was calculated. leptin, plasminogen activator inhibitor 1 (PAI1), IL-6,ox-LDL, suPAR were measured with ELISA, HbA1c in DCA BAYER analyzer and total oxidant status: (Perox) photometrically.

Results: After 4 months dietary intervention, a decrease in BMI (P=0.01) sBP (P=0.02), SGOT (P=0.004), γGT (P=0.035), alk.phospatase (P=0.008) was observed in the control group while Patients in the Stevia group presented significantly lower levels in TCHOL (P=0.022), SGOT (P<0.001), γ-GT (P<0.001), ox-LDL(P=0.016), BMI (P<0.001), sBP (P<0.001), dBP (P<0.001) and W/H (P=0.001). A marginally significant decrease in suPAR (P=0.078), as well as in HbA1c (P=0.07), LDL (P=0.072), and leptin (P=0.071) was also observed. Comparing the changes in serum values, BMI, W/H, BP and HOMA-IR between the two groups over the 4 months period, patients in Stevia group presented significantly lower levels of ox-LDL (P=0.01) and sBP (P=0.003) and marginally significant decrease in fasting Glu (P=0.058) and leptin (P=0.054) compared to control group.

Conclusion: The introduction of low glycemic load snacks based on Stevia in a low calorie diet in patients with MetS is safe and can lead to a further reduction in BP, fasting glucose, ox-LDL and leptin compared to a hypocaloric diet alone.