Mechanistic and therapeutic insight into the effects of cinnamon in polycystic ovary syndrome: a systematic review

Abstract

Polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases in the women at their reproductive age. Nowadays, the use of herbal compounds for lesser side effects, as compared to drug treatments, has become popular for the prevention and reduction of the complications of this disease. Evidence suggests that cinnamon, given its antioxidant and anti-inflammatory properties, can be associated with reduced metabolic complications from chronic non-communicable diseases. This systematic review aimed to determine the potential effect of cinnamon on the metabolic status in the PCOS. PICO framework for current systematic review was Population (P): subjects with PCOS; Intervention (I): oral cinnamon supplement; Comparison (C): the group as control or administered placebo; and Outcome (O): changed inflammatory, oxidative stress, lipid profile, glycemic, hormonal and anthropometric parameters and ovarian function. PubMed, Scopus, EMBASE, ProQuest and Google Scholar were searched from their very inception until January, 2020, considering specific keywords to explore the related studies. Out of 266 studies retrieved by the search strategy, only nine were eligible for evaluation. All clinical trials, animal studies, and published English-language journal studies were eligible for this review. The results showed that increased high-density lipoprotein and insulin sensitivity were increased by the cinnamon supplementation while low-density lipoprotein, triglyceride, and blood glucose were decreased in patients with PCOS. However, the results related to the potential effects of cinnamon on body weight and body mass index were inconsistent, thus calling for further studies. Also, despite improved results regarding the effect of cinnamon on oxidative stress and ovarian function, further studies are required to explore the precise mechanisms. Overall, the effects of cinnamon on the improvement of metabolic status in PCOS were promising. However, to observe clinical changes following cinnamon supplementation in PCOS, more clinical trials with higher doses of cinnamon and a longer duration of intervention are needed.

A comparison of the effects of cinnamon, ginger, and metformin consumption on metabolic health, anthropometric indices, and sexual hormone levels in women with poly cystic ovary syndrome: A randomized double-blinded placebo-controlled clinical trial

“…As a result, cinnamon seems to be as effective as metformin in increasing the Insulin sensitivity. In line with this study, Maleki et al showed that HDL and insulin sensitivity were increased by the cinnamon supplementation while LDL, TG, and blood glucose were decreased in patients with PCOS ( 17 ). Supplementation with cinnamon has direct connection with lowering oxidative stress, leptin, total energy expenditure and liver enzymes, factors that may lead to an improvement in HOMA-IR ( 37 ).…”

“…The final sample was estimated including a 20% probable drop-out for each group. A minimum detectable effect size (i.e., of lab endpoints) of 0.3 was considered clinically plausible using data from previous investigations utilizing ginger and cinnamon supplementations (9,11,(16)(17)(18). Our calculated sample size was 80 participants (20 participants per group).…”

The effect of cinnamon supplementation on glycemic control in patients with type 2 diabetes mellitus: An updated systematic review and dose‐response meta‐analysis of randomized controlled trials

“…(iii) decrease in phosphoenolpyruvate carboxykinase (PEPCK) and the glucose-6-phosphatase activity and subsequent gluconeogenesis in the liver (Silva et al, 2022). It seems that bioactive compounds of cinnamon exert these actions by activating insulin signaling pathways (Maleki et al, 2021). The AMP-activated protein kinase (AMPK) plays a mediating role between cinnamon and insulin signaling pathways.…”

“…In summary, cinnamon can regulate glycemic responses by three endogenous pathways, including (i) increase in glucose transporter 4 (GLUT4) production and translocation and subsequent glucose uptake in muscle and adipose tissue, (ii) decrease in glycogen synthase kinase 3 (GSK3) activity and subsequent promotion of glycogen synthase activity, and (iii) decrease in phosphoenolpyruvate carboxykinase (PEPCK) and the glucose‐6‐phosphatase activity and subsequent gluconeogenesis in the liver (Silva et al, 2022). It seems that bioactive compounds of cinnamon exert these actions by activating insulin signaling pathways (Maleki et al, 2021). The AMP‐activated protein kinase (AMPK) plays a mediating role between cinnamon and insulin signaling pathways.…”

The Role of Bioactive Compounds from Dietary Spices in the Management of Metabolic Syndrome: An Overview

“…There is evidence to suggest that cinnamon has the capacity to improve glucose control in humans [ 99 ]. Indeed, a study examined the effects of cinnamon in people living with diabetes at three different doses: 1, 3, and 6 g/day for 40 days, finding it decreased FBG levels significantly [ 72 ].…”