Mini review Open Access
Knowledgebase Development and Review for the Function of Omega-3 Polyunsaturated Fatty Acid and Polysaccharide in Diabetes
Jing Li1, Teng Liu2, Fangli Ma3, Renhuai Cong3, Xiangliang Yang1, Hai Yang1*, An-Yuan Guo2*
1National Engineering Research Center for Nano medicine, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan 430074, P. R. China
2Department of Bioinformatics and Systems Biology, Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei 430074, PR. China.
3Functional Oil Laboratory Associated by Oil Crops Research Institute, Chinese Academy of Agricultural Sciences and Infinitus (China) Company Ltd.
*Corresponding author: Hai Yang, National Engineering Research Center for Nano medicine, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan 430074, P. R. China @

An-Yuan Guo, Department of Bioinformatics and Systems Biology, Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei 430074, PR. China, @
Received: December 02, 2016; Accepted: December 24, 2016;; Published:January 02, 2017
Citation: Li J, Liu T, MaF, Yang H, Guo AY (2017) Knowledgebase Development and Review for the Function of Omega-3 Polyunsaturated Fatty Acid and Polysaccharide in Diabetes. Int J Pharmacovigil 2(1): 6.
It was well studied that omega-3 polyunsaturated fatty acid (PUFA) or polysaccharides have beneficial effects on the prevention and amelioration of human diseases including diabetes mellitus (DM). However, the effect of combination of these two components on DM has seldom been reported. Our aim was to study the research progress and discuss the potential synergistic effect of omega-3 PUFA and polysaccharides on DM. Based on the literature review, we developed a database named Database of Omega-3 PUFA and Polysaccharide in Diabetes (DOPD), which was freely available at http://bioinfo.life.hust.edu.cn/DOPD/. Users can browse and search the studies and their reported information about Omega-3 and polysaccharide in diabetes. Then we proposed some potential combinations of omega-3 PUFA and polysaccharide which would be better for DM based on their specific functions. The database and the potential combinations will provide useful resource for further studies on diabetes.
Diabetes Mellitus (DM) is a chronic disease characterized by the absolute or relative shortage of insulin, leading to chronic hyperglycemia [1, 2]. There were 366 million people with DM in 2011 [3], and a lower life expectancy by approximately 12 years has been expected in people with DM [4]. Type 2 Diabetes Mellitus (T2DM) causes macro vascular and micro vascular complication such as cardiovascular, cerebrovascular, retinopathy, nephropathy and neuropathy diseases [5]. It is well known that both environmental and genetic factors led to DM. The predominant cause of T2DM is due to lifestyle factors including diet, insufficient physical activity, overweight and stress [2]. The genetic susceptibility to T2DM has been demonstrated with at least 36 diabetes-associated genes identified, yet only about 10% of the heritability of T2DM can be explained [6]. Medical nutrition therapy, physical activity and education have an important contribution to the general management of patients with DM [7]. Diets with specific foods and nutrients have been shown to exert a protective effect on T2DM [8].

Omega-3 Poly Unsaturated Fatty Acid (PUFA) has potential beneficial impacts on the prevention of cognitive disorders and Cardio Vascular Disease (CVD), and synergistically improves metabolic parameters associated with weight loss [9-12]. Omega-3 PUFA decreases blood triglyceride levels and improves insulin sensitivity in humans [13-15]. Also, regular intake of omega-3 may reduce the DM complications [16, 17]. Similarly, polysaccharides, such as Astragalus Polysaccharide (APS) [18, 19], β-D-fructan polysaccharide (MDG-1) [20], Ganoderma lucidum polysaccharide (GL-PS/PSG-l) [21], levan polysaccharide [22], can also inhibit hyperglycemia and oxidative stress, and improve insulin sensitivity.

Although there have been many studies on omega-3 PUFA and polysaccharides, there were no studies on their combinatorial effects on DM. The aim of this article was to discuss whether the combination of omega-3 FUFA and polysaccharide has the potential synergistic effects on DM. Firstly, the research of omega-3 FUFA and polysaccharide on the prevention and amelioration of DM were simply summarized. Then the database of Omega-3 PUFA and Polysaccharide in Diabetes (DOPD, http:// bioinfo.life.hust.edu.cn/DOPD/) was developed and discussed. Then combinations of omega-3 PUFA and polysaccharide such as the combination of APS and each of α-linolenic acid (ALA), Eicosapentaenoic (EPA) and Docosahexanoic Acids (DHA) were proposed by the specific function, which were increasing insulin secretion, hypoglycemic activity, and anti-inflammatory activity or improving lipid metabolism.
Material and Methods
Data source and database content
The Database of Omega-3 PUFA and Polysaccharide in Diabetes (DOPD) were built from articles collected in PubMed (http://www.ncbi.nlm.nih.gov/pubmed). We extracted the omega-3 PUFA or polysaccharide components that were effective in preventing or ameliorating DM. The current version of DOPD contained 197 articles related to omega-3 PUFA and 76 articles related to polysaccharides. The data were categorized with Pubmed ID, purpose, study object, component, method, study process, results and conclusion [Figure 1].
Database function and interface
DOPD was built on Apache server 2.2.22 (http://www. apa-che.org/) with PHP scripts (http://www.php.net/) and the data were stored in My SQL relational database. My SQL and PHP technologies were preferred due to the open source of the software and the platform-independent characteristics.
Results and Discussion
Omega-3 PUFA on DM
The most important components of omega-3 PUFA are ALA, EPA and DHA. ALA has a plant origin and is the precursor of EPA and DHA [23]. The consumption of omega-3 PUFA has been shown to reduce risk factors for CVD and T2DM, such as hypertension, hyperlipidaemia, insulin resistance and inflammation [24-26].

Omega-3 PUFA Ameliorate the Insulin Resistance

Insulin resistance is a sign of diabetes, and its development involves several adipokines, including leptin, tumor necrosis factor-α (TNF-α), interleukin-6, adiponectin, and resistin [27]. Adiponectin regulates the lipid and glucose metabolism, increases insulin sensitivity, and protects against a chronic inflammation [28]. Leptin is an adipokine involved in the regulation of satiety and energy intake [29]. Haugen [30] reported that ALA could reduce resistin mRNA levels in 3T3-L1 adipocytes. Thus omega-3 PUFA could make the levels of adipokines increase or decrease, which all contributed to ameliorate insulin resistance. Kazemian [31] proposed that omega-3 PUFA could bind to a G-protein coupled receptor, resulting in reduced cytokine production and thus improving signaling in adipocytes, leading to a reduction in insulin resistance.
Omega-3 PUFA Can Exert Anti-Inflammatory Effects
T2DM is considered as an inflammatory disease [32]. Increasing evidences have demonstrated that EPA and DHA can suppress inflammation and have a beneficial role in a variety of inflammatory diseases including diabetes, atherosclerosis, and arthritis [33]. It has been reported that stimulation of macrophages with omega-3 PUFA abolished NLRP3 inflammasome activation and reduced the production of interleukin-1/ 2/ 6 (IL-1/ 2/ 6) and TNF-α [34, 35]. EPA and DHAderived resolvins and protectins are key inflammation resolution agonists [36]. It also has been demonstrated that EPA and DHA exert anti-inflammatory effects through several mechanisms, including activation of AMPK [37] and PPARG [38], as well as suppression of toll-like receptors (TLRs) and NF-κB pathway [39, 40]. Omega-3 also can reduce blood pressure and oxidative stress in T2DM patients [41, 42].

As discussed above, omega-3 PUFA can prevent or ameliorate DM and its complications through multiple mechanisms, such as increasing insulin secretion, improving lipid or glucose metabolism. Omega-3 PUFA also can exert anti-oxidant and antiinflammatory activity in DM and its complications. The number of publications on the effects of omega-3 PUFA on DM was summarized in Figure 2a, which showed a gradually increasing trend in last fifteen years. The allocation of publications for different omega-3 PUFA components was shown in Figure 2b.
Polysaccharide on DM
Polysaccharides such as APS and Lycium barbarum polysaccharide (LBP) can not only inhibit hyperglycemia and oxidative stress, but also improve insulin sensitivity. Here, we focused on the two polysaccharide components which have beneficial effects on DM.

The Beneficial Effects of LBP on DM

LBP as one of the traditional oriental medicines can significantly reduce the blood glucose levels and serum total cholesterol and thyroglobulin concentrations in alloxan-induced diabetic animals [43, 44]. The effects of LBP on the improvement of insulin resistance were investigated in a rat model of Non-Insulin Dependent Diabetes Mellitus (NIDDM) [45]. The mechanism involved was that LBP increased the level of Glucose Transporter 4 (GLUT4), improving GLUT4 trafficking and intracellular insulin signal. Additional study also indicated LBP could control the blood glucose levels and modulate the metabolism of glucose, leading to significant decrease of Malonaldehyde (MDA) and increase of SOD (Superoxide Dismutase). Furthermore, LBP could decrease levels of DNA damage possibly through decreasing in oxidative stress levels in rats with NIDDM [46].

The Beneficial Effects of APS on DM

Protein tyrosine phosphatase 1B (PTP1B) was a key negative
Figure 1: The schematic representation of architecture of database DOPD
regulator of insulin signaling and emerged as an attractive target for therapeutic intervention of T2DM [47]. APS increased the insulin sensitivity by decreasing the expression of PTP1B [48, 49] and two other pathways including ROS-ERK-NF-κB [50] and PKB/GLUT4 [51]. APS exerted anti-inflammatory effects by inducing IL-10 gene expression and inhibiting IL-1β protein production and most of the pro-inflammatory genes expression [52]. APS showed beneficial effects to lower body weight, blood glucose and triglyceride levels in mice with insulin resistance and DM [53]. Besides, APS partially improved myocardial glucose and lipid metabolism disorders in diabetic hamsters and protected myocardium [54].

Thus, polysaccharides exert anti-diabetes effect or have beneficial effects on DM complications through different ways. The number of publications on the effects of polysaccharides on DM was summarized in Figure 2c, which showed a gradually increasing trend in recent years. The allocation of publications for different polysaccharide components was shown in Figure 2d.
The development of DOPD database
The database interface includes the following sections: HOME, SEARCH, SUMMARY 1, SUMMARY 2, SUMMARY 3, and HELP.
Figure 2: The number of articles of different years and components of omega-3 PUFA and polysaccharides on DM
a. The number of annual articles for omega-3 PUFA on DM after 2000.The number of the year 2014 is only for the first two months.
b. The number of publications for different omega-3 PUFA components on DM. Omega-3 column means the article only mentioned omega-3 and no specific components.
c. The number of annual article for polysaccharides on DM after 2000. (The number of 2014 is only for the first two months)
d. The number of publications for different polysaccharide components on DM. e. The number of articles correlated with different functions.
In the search interface, there are three methods for search: 1) search by a specific omega-3 PUFA and polysaccharide components; 2) search by one or two functions which both omega-3 PUFA and polysaccharide have; and 3) search by article information, such as PMID, title, publication time and so on. Furthermore, a combination search of the components and functions can also be carried out.

To better understand the function and mechanism of omega-3 PUFA and polysaccharide on DM, we categorized the potential functions into 7 types [Figure 2e]. The SUMMARY 1 section includes some basic statistics of the publications in the database [Figure 2]. The SUMMARY 2 and SUMMARY 3 sections are the combined article information of both PUFA and polysaccharide in each function category showed in different way [Figure 2e], which may indicate the study trend and status of omega-3 PUFA and polysaccharides on DM and its complications intuitively. Users can click the article number to browse the detail information. On SUMMARY 2 page, users can filter by keywords or rank each column by the number.
The prediction of combined effects of omega-3 PUFA and polysaccharide
Amir Abdolahi [55] reported that the ingestion of fish oil, both alone and in combination with aspirin, reduced Lysophosphatidylcholine (LPC) and Lysophosphatidic Acids (LPA) plasma concentrations, which may reduce cardiovascular disease risk in diabetic adults. Canetti [56] demonstrated that Essential Fatty Acids (EFA) mainly concluding Linoleic Acid (LA) and ALA can not only reduce pancreas damage, insulin and glucose plasma levels, but also restore the Delta6 desaturase activity in streptozotocin-induced diabetes mice. Iancu [57] pointed out that only the diet supplemented with both flaxseed (which was very rich in omega-3 PUFA) and vitamin E resulted in the significant reduction of platelet aggregation and adhesiveness as compared to diabetic animals fed with control diet in diabetic hamsters. You-Gui Li [58] reported that Deoxynojirimycin- Polysaccharide Mixture (DPM) decreased blood glucose and reversed the damage to pancreatic β-cells in diabetic mice, thus the anti-hyperglycemic efficacy of this combination was better than that of 1-Deoxynojirimycin (DNJ) or polysaccharide alone. However, whether the combination of omega-3 PUFA and polysaccharides can exert synergistic effects on DM is unknown. Thus, based on our developed DOPD database, we predicted the potential synergistic effects on DM combining omega-3 PUFA and polysvaccharides.

In our database, SUMMARY 2 and SUMMARY 3 both show the potential effects on preventing and ameliorating DM and its complications by combining omega-3 PUFA and polysaccharide but with different strategies. Take SUMMARY 3 for an example [Figure 3], each row of the form represents the component of polysaccharides while each column is different components of omega-3 PUFA. In the cross-cell, A, B, C, D, E, F, G represent seven different functions [Figure 2e], numbers in brackets represent the articles number that omega PUFA and polysaccharide have effects on DM respectively. In the cross-cell of EPA and APS, “A” represents function “Increase insulin secretion”, so there are 7 articles about EPA and 9 articles about APS on “Increase insulin secretion” in DM, others are as the same principle. Also the numbers take on different color, it is set up according to the number of omega-3 PUFA which the gradient is 10, followed by gray, green, bright green and red. If the number is gray, it indicates that omega-3 PUFA and polysaccharide has no same function. Furthermore, the number can link to related articles.

On the basis of database, several potential combinations of omega-3 PUFA and polysaccharides were suggested to prevent and ameliorate DM [Figure 3]. First, the combination of APS with EPA, DHA or ALA: APS was the most studied polysaccharide on DM, and it shared at least four same functions with EPA, DHA and ALA, including increasing insulin secretion, hypoglycemic activity, and anti-inflammatory activity and decreasing endothelial dysfunction as well as decreasing myocardial injury. Furthermore, APS and EPA, DHA as well as ALA can regulate NF- κB, AMPK, PPAR-ˠ or other translational factors or proteins that involved in DM. Second, the combination of Ganoderma lucidum polysaccharide (PSG-1) and each of EPA, ALA and DHA: PSG- 1 had the most same functions with EPA, DHA as well as ALA, which could reach to seven functions with EPA and ALA. Third, the combinations of MDG-1 with EPA, both of them had four same functions. All the suggested combinations of omega-3 PUFA and polysaccharides have not been proposed and reported. It was worth pointing out that the database has the capability to find out whether both omega-3 PUFA and polysaccharide can regulate the same genes and the related signal pathways in DM if the deposited sources contain genetic information that omega-3 PUFA or polysaccharide regulated in DM.
Figure 3: The combination of omega-3 PUFA and polysaccharide connected by functions The rectangle colored with red is an example of the supported article number of APS and EPA in each function.
The authors wish to thank Prof. Qibing Zhou for reviewing the manuscript and thank Miss Changhan Gao for some data checking.

This work is supported by the open fund of Functional Oil Laboratory Associated by Oil Crops Research Institute, Chinese Academy of Agricultural Sciences and Infinitus (China) Company Ltd.
The authors declare that there is no conflict of interest regarding the publication of this paper.
  1. Lu J, Xie G, Jia W, Jia W. Metabolomic in human type 2 diabetes research. Front Med. 2013;7(1):4-13. doi: 10.1007/s11684-013-0248-4.
  2. Friedrich N. Metabolomic in diabetes research. J Endocrinol. 2012;215(1):29-42. doi: 10.1530/JOE-12-0120.
  3. Whiting DR, Guariguata L, Weil C, Shaw J. IDF Diabetes Atlas: Global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract. 2011;94(3):311-321. doi: 10.1016/j.diabres.2011.10.029.
  4. Manuel DG, Schultz SE. Health-related quality of life and health-adjusted life expectancy of people with diabetes in Ontario, Canada, 1996-1997. Diabetes Care. 2004;27(2):407-414.
  5. American Diabetes Association. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 2010; 33(1): S62–S69. doi:  10.2337/dc10-S062.
  6. Herder C, Roden M. Genetics of type 2 diabetes: pathophysiologic and clinical relevance. Eur J Clin Invest. 2011;41(6):679-692. doi: 10.1111/j.1365-2362.2010.02454.x.
  7. Nyenwe EA, Jerkins TW, Umpierrez GE, Kitabchi AE. Management of type 2 diabetes: evolving strategies for the treatment of patients with type 2 diabetes. Metabolism. 2011;60(1):1-23. doi: 10.1016/j.metabol.2010.09.010.
  8. Mursu J, Virtanen JK, Tuomainen TP, Nurmi T, Voutilainen S. Intake of fruit, berries, and vegetables and risk of type 2 diabetes in Finnish men: the Kuopio Ischaemic Heart Disease Risk Factor Study. Am J Clin Nutr. 2014;99(2):328-333. doi: 10.3945/​ajcn.113.069641.
  9. Tommy Cederholm, Norman Salem Jr, Palmblad J. omega-3 fatty acids in the prevention of cognitive decline in humans. Advances in nutrition. 2013;4:672-676. doi:10.3945/an.113.004556.
  10. Saremi A, Arora R. The utility of omega-3 fatty acids in cardiovascular disease. Am J Ther. 2009;16(5):421-36. doi: 10.1097/MJT.0b013e3180a5f0bb.
  11. Mori TA, Bao DQ, Burke V, Puddey IB, Watts GF, Beilin LJ. Dietary fish as a major component of a weight-loss diet: effect on serum lipids, glucose, and insulin metabolism in overweight hypertensive subjects. Am J Clin Nutr. 1999;70(5):817-25.
  12. Siddiqui RA, Harvey KA, Zaloga GP. Modulation of enzymatic activities by n-3 polyunsaturated fatty acids to support cardiovascular health. J Nutr Biochem. 2008;19(7):417-37. doi: 10.1016/j.jnutbio.2007.07.001.
  13. T.A. Sanders, F.R. Oakley, G.J. Miller, K.A. Mitropoulos, D. Crook, M.F. Oliver. Influence of n-6 versus n-3 polyunsaturated fatty acids in diets low in saturated fatty acids on plasma lipoproteins and hemostatic factors. Arteriosclerosis, thrombosis, and vascular biology. 1997;3449-3460.
  14. D.S. Im. Omega-3 fatty acids in anti-inflammation (pro-resolution) and GPCRs. Prog Lipid Res. 2012;51(3):232-7. doi: 10.1016/j.plipres.2012.02.003.
  15. A. Stirban, S. Nandrean, C. Gotting, B. Stratmann, D. Tschoepe. Effects of n-3 Polyunsaturated Fatty Acids (PUFAs) on Circulating Adiponectin and Leptin in Subjects with Type 2 Diabetes Mellitus, Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme. 2014;46:490-492.
  16. H.C. Bucher, P. Hengstler, C. Schindler, G. Meier. N-3 polyunsaturated fatty acids in coronary heart disease: a meta-analysis of randomized controlled trials. Am J Med. 2002;112(4):298-304.
  17. N.J. Stone. Fish consumption, fish oil, lipids, and coronary heart disease. Am J Clin Nutr. 1997;65(4):1083-6.
  18. J. Liu, J.F. Zhang, J.Z. Lu, D.L. Zhang, K. Li, K. Su, et al. Astragalus polysaccharide stimulates glucose uptake in L6 myotubes through AMPK activation and AS160/TBC1D4 phosphorylation, Acta Pharmacol Sin. 2013;34(1):137-45. doi: 10.1038/aps.2012.133.
  19. F. Zou, X.Q. Mao, N. Wang, J. Liu, J.P. Ou-Yang. Astragalus polysaccharides alleviates glucose toxicity and restores glucose homeostasis in diabetic states via activation of AMPK. Acta Pharmacol Sin. 2009;30(12):1607-15. doi: 10.1038/aps.2009.168.
  20. Zhu Y, Cong W, Shen L, Wei H, Wang Y, Wang L, et al. Fecal metabonomic study of a polysaccharide, MDG-1 from Ophiopogon japonicus on diabetic mice based on gas chromatography/time-of-flight mass spectrometry (GC TOF/MS). Mol Biosyst. 2014;10(2):304-12. doi: 10.1039/c3mb70392d.
  21. C. Xiao, Q.P. Wu, W. Cai, J.B. Tan, X.B. Yang, J.M. Zhang. Hypoglycemic effects of Ganoderma lucidum polysaccharides in type 2 diabetic mice. Arch Pharm Res. 2012;35(10):1793-801. doi: 10.1007/s12272-012-1012-z.
  22. I. Dahech, K.S. Belghith, K. Hamden, A. Feki, H. Belghith, H. Mejdoub. Antidiabetic activity of levan polysaccharide in alloxan-induced diabetic rats. Int J Biol Macromol. 2011;49(4):742-6. doi: 10.1016/j.ijbiomac.2011.07.007.
  23. Burdge GC, Wootton SA. Conversion of alpha-linolenic acid to eicosa-pentaenoic, docosapentaenoic and docosahexaenoic acids in young women. Br J Nutr. 2002;88(4):411-20.
  24. F.B. Hu, E. Cho, K.M. Rexrode, C.M. Albert, J.E. Manson. Fish and long-chain omega-3 fatty acid intake and risk of coronary heart disease and total mortality in diabetic women. Circulation. 2003;107(14):1852-7.
  25. J.A. Nettleton, R. Katz. n-3 long-chain polyunsaturated fatty acids in type 2 diabetes: a review. J Am Diet Assoc. 2005;105(3):428-40.
  26. I. Thorsdottir, J. Hill, A. Ramel, Omega-3 fatty acid supply from milk associates with lower type 2 diabetes in men and coronary heart disease in women. Prev Med. 2004;39(3):630-4.
  27. B. Antuna-Puente, B. Feve, S. Fellahi, J.P. Bastard. Adipokines: the missing link between insulin resistance and obesity. Diabetes Metab. 2008;34(1):2-11.
  28. M. Liu, F. Liu. Transcriptional and post-translational regulation of adiponectin. Biochem J. 2009;425(1):41-52. doi: 10.1042/BJ20091045.
  29. Lau DC, Dhillon B, Yan H, Szmitko PE, Verma S. Adipokines: molecular links between obesity and atheroslcerosis. Am J Physiol Heart Circ Physiol. 2005;288(5):H2031-41.
  30. F. Haugen, N. Zahid, K.T. Dalen, K. Hollung, H.I. Nebb, C.A. Drevon. Resistin expression in 3T3-L1 adipocytes is reduced by arachidonic acid. J Lipid Res. 2005;46(1):143-53.
  31. P. Kazemian, S.M. Kazemi-Bajestani, A. Alherbish, J. Steed, G.Y. Oudit. The use of omega-3 poly-unsaturated fatty acids in heart failure: a preferential role in patients with diabetes. Cardiovasc Drugs Ther. 2012;26(4):311-20. doi: 10.1007/s10557-012-6397-x.
  32. M.Y. Donath, S.E. Shoelson. Type 2 diabetes as an inflammatory disease. Nat Rev Immunol. 2011;11(2):98-107. doi: 10.1038/nri2925.
  33. K. Fritsche. Fatty acids as modulators of the immune response. Annu Rev Nutr. 2006;26:45-73.
  34. Y. Yan, W. Jiang, T. Spinetti, A. Tardivel, R. Castillo, C. Bourquin, et al. Omega-3 fatty acids prevent inflammation and metabolic disorder through inhibition of NLRP3 inflammasome activation. Immunity. 2013;38(6):1154-63. doi: 10.1016/j.immuni.2013.05.015.
  35. A. Mullen, C.E. Loscher, H.M. Roche. Anti-inflammatory effects of EPA and DHA are dependent upon time and dose-response elements associated with LPS stimulation in THP-1-derived macrophages. J Nutr Biochem. 2010;21(5):444-50. doi: 10.1016/j.jnutbio.2009.02.008.
  36. J.M. Schwab, N. Chiang, M. Arita, C.N. Serhan. Resolvin E1 and protectin D1 activate inflammation-resolution programmes. Nature. 2007;447(7146):869-74.
  37. M. Figueras, M. Olivan, S. Busquets, F.J. Lopez-Soriano, J.M. Argiles. Effects of eicosapentaenoic acid (EPA) treatment on insulin sensitivity in an animal model of diabetes: improvement of the inflammatory status. Obesity (Silver Spring). 2011;19(2):362-9. doi: 10.1038/oby.2010.194.
  38. S. Neschen, K. Morino, J.C. Rossbacher, R.L. Pongratz, G.W. Cline, S. Sono, et al. Fish oil regulates adiponectin secretion by a peroxisome proliferator-activated receptor-gamma-dependent mechanism in mice. Diabetes. 2006;55(4):924-8.
  39. D.Y. Oh, S. Talukdar, E.J. Bae, T. Imamura, H. Morinaga, W.Q. Fan, et al. GPR120 Is an Omega-3 Fatty Acid Receptor Mediating Potent Anti-inflammatory and Insulin-Sensitizing Effects. Cell. 2010;142(5):687-98. doi: 10.1016/j.cell.2010.07.041.
  40. H.W. Hsueh, Z. Zhou, J. Whelan, K.G.D. Allen, N. Moustaid-Moussa, H. Kim, K.J. Claycombe. Stearidonic and Eicosapentaenoic acids Inhibit Interleukin-6 Expression in ob/ob Mouse Adipose Stem Cells via Toll-Like receptor-2-Mediated Pathways. J Nutr. 2011;141(7):1260-6. doi: 10.3945/jn.110.132571.
  41. M.J. Hosseinzadeh Atar, H. Hajianfar, A. Bahonar. The effects of omega-3 on blood pressure and the relationship between serum visfatin level and blood pressure in patients with type II diabetes. ARYA Atheroscler. 2012 Spring;8(1):27-31.
  42. M.M. Mahmoudabadi, A.R. Rahbar. Effect of EPA and vitamin C on superoxide dismutase, glutathione peroxidase, total antioxidant capacity and malondialdehyde in type 2 diabetic patients. Oman Med J. 2014;29(1):39-45. doi: 10.5001/omj.2014.09.
  43. Q. Luo, Y. Cai, J. Yan, M. Sun, H. Corke. Hypoglycemic and hypolipidemic effects and antioxidant activity of fruit extracts from Lycium barbarum. Life Sci. 2004;76(2):137-49.
  44. L. Jing, G. Cui, Q. Feng, Y. Xiao. Evaluation of hypoglycemic activity of the polysaccharides extracted from Lycium barbarum. Afr J Tradit Complement Altern Med. 2009;6(4):579-84.
  45. R. Zhao, Q. Li, B. Xiao. Effect of Lycium barbarum polysaccharide on the improvement of insulin resistance in NIDDM rats. Yakugaku Zasshi. 2005;125(12):981-8.
  46. H. Wu, H. Guo, R. Zhao. Effect of Lycium barbarum polysaccharide on the improvement of antioxidant ability and DNA damage in NIDDM rats. Yakugaku Zasshi. 2006;126(5):365-71.
  47. E. Asante-Appiah, B.P. Kennedy. Protein tyrosine phosphatases: the quest for negative regulators of insulin action. American journal of physiology. Endocrinology and metabolism. 2003; 284:E663-670.
  48. N. Wang, D. Zhang, X. Mao, F. Zou, H. Jin, J. Ouyang. Astragalus polysaccharides decreased the expression of PTP1B through relieving ER stress induced activation of ATF6 in a rat model of type 2 diabetes. Mol Cell Endocrinol. 2009;307(1-2):89-98. doi: 10.1016/j.mce.2009.03.001.
  49. Y. Wu, J.P. Ou-Yang, K. Wu, Y. Wang, Y.F. Zhou, C.Y. Wen. Hypoglycemic effect of Astragalus polysaccharide and its effect on PTP1B. Acta Pharmacol Sin. 2005;26(3):345-52.
  50. M. Liu, J. Qin, Y. Hao, M. Liu, J. Luo, T. Luo, L. Wei. Astragalus polysaccharide suppresses skeletal muscle myostatin expression in diabetes: involvement of ROS-ERK and NF-kappaB pathways. Oxidative medicine and cellular longevity.2013;782497.
  51. M. Liu, K. Wu, X. Mao, Y. Wu, J. Ouyang. Astragalus polysaccharide improves insulin sensitivity in KKAy mice: regulation of PKB/GLUT4 signaling in skeletal muscle. J Ethnopharmacol. 2010;127(1):32-7. doi: 10.1016/j.jep.2009.09.055.
  52. J. Lu, X. Chen, Y. Zhang, J. Xu, L. Zhang, Z. Li, W. Liu, J. Ouyang, S. Han, X. He. Astragalus polysaccharide induces anti-inflammatory effects dependent on AMPK activity in palmitate-treated RAW264.7 cells. Int J Mol Med. 2013;31(6):1463-70. doi: 10.3892/ijmm.2013.1335.
  53. Y. Ye, T. Deng, X.Y. Wan, J.P. Ouyang, M. Liu, X.Q. Mao. The role of quantitative changes in the epxression of insulin receptor substrate-1 and nuclear ubiquitin in abnormal glycometabolism in the livers of KKay mice and the relative therapeutic mechanisms of Astragalus polysaccharide. Int J Mol Med. 2014;33(2):341-50. doi: 10.3892/ijmm.2013.1580.
  54. W. Chen, Y.P. Xia, W.J. Chen, M.H. Yu, Y.M. Li, H.Y. Ye. Improvement of myocardial glycolipid metabolic disorder in diabetic hamster with Astragalus polysaccharides treatment. Mol Biol Rep. 2012;39(7):7609-15. doi: 10.1007/s11033-012-1595-y.
  55. A. Abdolahi, S.N. Georas, J.T. Brenna, X. Cai, K. Thevenet-Morrison, R.P. Phipps, et al. The effects of aspirin and fish oil consumption on lysophosphatidylcholines and lysophosphatidic acids and their correlates with platelet aggregation in adults with diabetes mellitus. Prostaglandins Leukot Essent Fatty Acids. 2014;90(2-3):61-8. doi: 10.1016/j.plefa.2013.12.004.
  56. L. Canetti, H. Werner, A. Leikin-Frenkel. Linoleic and alpha linolenic acids ameliorate streptozotocin-induced diabetes in mice. Arch Physiol Biochem. 2014;120(1):34-9. doi: 10.3109/13813455.2013.868002.
  57. R.I. Iancu, R. Haliga, V. Luca, P.A. Stitt, V. Mocanu. Modulation of the platelet function by diet supplemented with flaxseed and vitamin E in diabetic hamsters. Rev Med Chir Soc Med Nat Iasi. 2006;110(4):962-7.
  58. Y.G. Li, D.F. Ji, S. Zhong, Z.Q. Lv, T.B. Lin. Cooperative anti-diabetic effects of deoxynojirimycin-polysaccharide by inhibiting glucose absorption and modulating glucose metabolism in streptozotocin-induced diabetic mice. PLoS One. 2013;8(6):e65892. doi: 10.1371/journal.pone.0065892.
Listing : ICMJE   

Creative Commons License Open Access by Symbiosis is licensed under a Creative Commons Attribution 3.0 Unported License