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Stevia rebaudiana Bertoni A Natural Alternative for Treating Diseases Associated with Metabolic Syndrome
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REVIEW Stevia rebaudiana Bertoni: A Natural Alternative for Treating Diseases Associated with Metabolic Syndrome Areli Carrera-Lanestosa, 1 Yolanda Moguel-Ordo ´n ˜ez, 2 and Maira Segura-Campos1 1Faculty of Chemical Engineering, Autonomous University of Yucatan, Merida, Mexico. 2National Institute for Forest, Agronomic, and Livestock Research, Mococha Experimental Field, Yucatan, Mexico. ABSTRACTStevia rebaudiana (SR) is often used by the food industry due to its steviol glycoside content, which is a suitable calorie-free sweetener. Further, both in vitro and in vivo studies indicate that these glycosides and the extracts from SR have pharmacologicalandtherapeuticproperties, includingantioxidant, antimicrobial, antihypertensive,antidiabetic, andanticancer. This work reviews the antiobesity, antihyperglycemic, antihypertensive, and antihyperlipidemic effects of the majority of glycosides and aqueous/alcoholic extracts from the leaves, f l owers, and roots of the SR. These compounds can serve as a natural and alternative treatment for diseases that are associated with metabolic syndrome, thus contributing to health promotion. KEYWORDS: diabetes ? dyslipidemia ? hypertension ? metabolic syndrome ? obesity ? Stevia rebaudiana INTRODUCTION M etabolic syndrome is a set of cardiometabolic fac- tors that have insulin resistance (IR) and oxidative stress, leading to an increase in the risk of suffering car- diovascular diseases. These factors include abdominal obe- sity (AO), arterial hypertension (AHT), diabetes mellitus (DM), inf l ammation, hepatic steatosis, and dyslipidemia. Further, people with metabolic syndrome have a constant risk of getting cerebrovascular disease (CVD) and ischemic cardiomyopathy in the short term.1,2 Cardiovascular disease is the f i rst cause of morbidity and mortality in Mexico, where endocrines diseases such as AO, DM, and AHT, along with an abnormal lipid metabolism, are risk factors for CVD. Moreover, CVD is currently among the f i rst 10 causes of death worldwide.3,4Currently, there are several chemically synthesized pharmaceuticals for treating these diseases. However, many of them have secondary un- desirable effects such as lactic acidosis, metallic taste, and vitamin B12def i ciency. Therefore, there is a demand for new natural-basedmedicinalcompounds,4,5withSteviarebaudiana (SR) Bertoni being a potential source for these compounds. SR is native to the Amambay Mountains, which are lo- cated between southern Brazil and northern Paraguay. Guaranı ´ Indians live there and since ancient times have consumed SR as a sweetener and a medicinal plant that they call ka’a he’e ¨ or sweet herb.6The presence of steviol gly- cosides in SR is responsible for its sweet taste. These compounds are 200–300 times sweeter than saccharose- based candies and get advantage for not containing calo- ries.7Besides containing natural sweeteners, SR has also a complex mixture of other compounds, including terpenes, tannins, sterols, volatile acids, vitamins, carotenes, f l avonoids, enzymes, organic acids, polysaccharides, hormones, and mi- croelements.8Further, interesting biofunctional properties have been found in phytochemicals that are present in SR, which encourages the study of its properties. Thus, this work aims at reviewing the antiobesity, antihyperglycemic, anti- hypertensive, and antihyperlipidemic effects of the majority glycosides and aqueous/alcoholic extracts from the leaves, f l owers, and roots of SR. These glycosides and extracts can serve as a natural and alternative treatment for the diseases that are associated with metabolic syndrome. METABOLIC SYNDROME Metabolic syndrome is a set of risk factors that are characterized by the presence of AO, high arterial pressure (AP), and disorder inthe carbohydrate and lipid metabolism. Under AO, the functionality of adipose tissues (AT) de- creases, causing a misbalance of reactive oxygen species and proinf l ammatory cytokines such as tumor necrosis factor-a (TNF-a), interleukin 6 (IL-6), adiponectin, leptin, and plasminogen activator inhibitor (PAI1). This system- atically triggers inf l ammatory processes that will eventu- ally increase the risk of developing cardiovascular diseases (Fig. 1).1,2,9–11Metabolic syndrome has other names, in- cluding IR syndrome, plurimetabolic syndrome, and deadly quartet. However, in 1998, the World Health Organization Manuscript received 26 November 2016. Revision accepted 26 April 2017. Address correspondence to: Maira Segura-Campos, PhD, Facultad de Ingenierı ´a Quı´mica, Universidad Auto ´noma de Yucata ´n, Perife ´rico Norte, Km. 33.5, Tablaje catastral 13615, Col. Chuburna ´ de Hidalgo Inn, Me ´rida CP. 97203, Yucata ´n, Me ´xico, E-mail: maira .segura@correo.uady.mx JOURNAL OF MEDICINAL FOOD J Med Food 00 (0) 2017, 1–11 # Mary Ann Liebert, Inc., and Korean Society of Food Science and Nutrition DOI: 10.1089/jmf.2016.0171 1 Downloaded by 221.1.106.228 from online.liebertpub.com at 10/09/17. For personal use only.

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