Yu Jui-Ting, Li Chen-Pi, Hsiao Yao, Cheng Kuan-Po, Tsai Ru-Yin
Division of Hematology/Medical Oncology, Department of Medicine, Tung's Taichung MetroHarbor Hospital, Taichung 43503, Taiwan.
Department of Nursing, Tung's Taichung MetroHarbor Hospital, Taichung 43503, Taiwan.
Int J Mol Sci. 2025 Aug 28;26(17):8380. doi: 10.3390/ijms26178380.
Metabolic syndrome refers to a group of conditions that commonly occur together, including abdominal obesity, high blood pressure, elevated blood sugar, high triglyceride levels, and low high-density lipoprotein cholesterol (HDL). These factors collectively increase the risk of cardiovascular disease, diabetes, and cognitive impairment. Recent research has identified a connection between metabolic syndrome and cognitive disorders such as mild cognitive impairment and vascular dementia (VaD). Mulberry ( L.) is a natural source of bioactive compounds with antioxidant, anti-inflammatory, and lipid-regulating properties. This meta-analysis assessed the potential of mulberry extract as an adjunctive treatment for metabolic risk factors linked to vascular dementia. We systematically reviewed randomized controlled trials (RCTs) published up to May 2025 that compared mulberry extract to placebo or standard care in adults with metabolic disorders. Fifteen trials including 1202 participants met the inclusion criteria. The primary outcomes were fasting glucose, fasting insulin, liver enzyme levels, lipid profiles, and inflammatory markers such as tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP). The pooled results indicated that mulberry supplementation improved blood sugar control and lowered total cholesterol, low-density lipoprotein cholesterol (LDL), triglycerides, fasting blood glucose, glycosylated hemoglobin (HbA1c), homeostasis model assessment for insulin resistance (HOMA-IR), and inflammatory markers. Aspartate aminotransferase (AST) improved, whereas alanine aminotransferase (ALT) showed no significant change. Subgroup analyses revealed that greater benefits were associated with shorter treatment durations and doses below 500 milligrams per day. Furthermore, extracts from different parts of the mulberry plant showed varying effects on lipid and glucose metabolism. None of the included trials directly measured cognitive or neurovascular outcomes, so any potential neurovascular protection is inferred from changes in metabolic and inflammatory markers rather than demonstrated. In summary, these findings suggest that mulberry extract may be a promising complementary approach for managing metabolic risk factors in people at risk for VaD. However, further large-scale and rigorously designed studies are required to confirm its clinical benefits and to identify the most effective preparations.
代谢综合征是指一组通常同时出现的病症，包括腹部肥胖、高血压、血糖升高、甘油三酯水平升高以及高密度脂蛋白胆固醇（HDL）降低。这些因素共同增加了心血管疾病、糖尿病和认知障碍的风险。最近的研究发现了代谢综合征与轻度认知障碍和血管性痴呆（VaD）等认知障碍之间的联系。桑（L.）是具有抗氧化、抗炎和脂质调节特性的生物活性化合物的天然来源。这项荟萃分析评估了桑提取物作为与血管性痴呆相关的代谢危险因素辅助治疗的潜力。我们系统回顾了截至2025年5月发表的随机对照试验（RCT），这些试验比较了桑提取物与安慰剂或标准护理对患有代谢紊乱的成年人的效果。15项试验包括1202名参与者符合纳入标准。主要结果是空腹血糖、空腹胰岛素、肝酶水平、血脂谱以及炎症标志物，如肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和高敏C反应蛋白（hs-CRP）。汇总结果表明，补充桑提取物可改善血糖控制，降低总胆固醇、低密度脂蛋白胆固醇（LDL）、甘油三酯、空腹血糖、糖化血红蛋白（HbA1c）、胰岛素抵抗的稳态模型评估（HOMA-IR）和炎症标志物。天冬氨酸转氨酶（AST）有所改善，而丙氨酸转氨酶（ALT）无显著变化。亚组分析显示，较短的治疗持续时间和每天低于500毫克的剂量带来的益处更大。此外，桑植物不同部位的提取物对脂质和葡萄糖代谢的影响各不相同。纳入的试验均未直接测量认知或神经血管结果，因此任何潜在的神经血管保护作用都是从代谢和炎症标志物的变化推断出来的，而非得到证实。总之，这些发现表明，桑提取物可能是一种有前景的辅助方法，用于管理有VaD风险人群的代谢危险因素。然而，需要进一步开展大规模且设计严谨的研究来证实其临床益处，并确定最有效的制剂。
