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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">JHHR</journal-id>
      <journal-title-group>
        <journal-title>Journal of Human Health Research</journal-title>
      </journal-title-group>
      <issn pub-type="epub">2576-9383</issn>
      <publisher>
        <publisher-name>Open Access Pub</publisher-name>
        <publisher-loc>United States</publisher-loc>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id">JHHR-17-1816</article-id>
      <article-id pub-id-type="doi">10.14302/issn.2576-9383.jhhr-17-1816</article-id>
      <article-categories>
        <subj-group>
          <subject>research-article</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Comparative Study of Hypolipidemic Effects of Momordica Charantia (Karela) with Atorvastatin in Fat Fed Rats</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Sharmin</surname>
            <given-names>Zinat Rehana</given-names>
          </name>
          <xref ref-type="aff" rid="idm1809296892">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Akter</surname>
            <given-names>Muqbula Tasrin</given-names>
          </name>
          <xref ref-type="aff" rid="idm1809294660">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Rahman</surname>
            <given-names>Rifayet</given-names>
          </name>
          <xref ref-type="aff" rid="idm1809196684">3</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Hoque</surname>
            <given-names>Mahbubul</given-names>
          </name>
          <xref ref-type="aff" rid="idm1809196180">4</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Khan</surname>
            <given-names>Ismail</given-names>
          </name>
          <xref ref-type="aff" rid="idm1809197980">5</xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Mosaddek</surname>
            <given-names>Abu Syed Md.</given-names>
          </name>
          <xref ref-type="aff" rid="idm1809198556">6</xref>
          <xref ref-type="aff" rid="idm1809314284">*</xref>
        </contrib>
      </contrib-group>
      <aff id="idm1809296892">
        <label>1</label>
        <addr-line>Department of Pharmacology, Uttara Adhunik Medical College, Dhaka, Bangladesh , Email: zinatrehana050@gmail.com </addr-line>
      </aff>
      <aff id="idm1809294660">
        <label>2</label>
        <addr-line>Department of Pharmacology, Shaheed Tajuddin Medical College, Gajipur, Bangladesh, Email-dr.mtaktar@yahoo.com </addr-line>
      </aff>
      <aff id="idm1809196684">
        <label>3</label>
        <addr-line>Department of Pharmacology, Green Life Medical College, Dhaka, Bangladesh, Email-rifayetrahman@yahoo.com </addr-line>
      </aff>
      <aff id="idm1809196180">
        <label>4</label>
        <addr-line>Department of Pharmacology, Popular Medical College, Dhaka, Bangladesh, Email- mahbubhoque75@yahoo.com</addr-line>
      </aff>
      <aff id="idm1809197980">
        <label>5</label>
        <addr-line>Chittagong Medical University, Chittagong. Bangladesh</addr-line>
      </aff>
      <aff id="idm1809198556">
        <label>6</label>
        <addr-line>Department of Pharmacology, Uttara Adhunik Medical College, Dhaka, Bangladesh, Email: Drmosaddek25@gmail.com </addr-line>
      </aff>
      <aff id="idm1809314284">
        <label>*</label>
        <addr-line>Corresponding author</addr-line>
      </aff>
      <contrib-group>
        <contrib contrib-type="editor">
          <name>
            <surname>Jong</surname>
            <given-names>In Kim</given-names>
          </name>
          <xref ref-type="aff" rid="idm1809031924">1</xref>
        </contrib>
      </contrib-group>
      <aff id="idm1809031924">
        <label>1</label>
        <addr-line>Wonkwang University</addr-line>
      </aff>
      <author-notes>
        <corresp>Corresponding author: Abu Syed Md. Mosaddek, Department of Pharmacology, Uttara Adhunik Medical College, Dhaka, Bangladesh. Email: <email>Drmosaddek25@gmail.com</email></corresp>
        <fn fn-type="conflict" id="idm1817114060">
          <p>The authors have declared that no competing interests exist.</p>
        </fn>
      </author-notes>
      <pub-date pub-type="epub" iso-8601-date="2017-11-11">
        <day>11</day>
        <month>11</month>
        <year>2017</year>
      </pub-date>
      <volume>1</volume>
      <issue>1</issue>
      <fpage>11</fpage>
      <lpage>15</lpage>
      <history>
        <date date-type="received">
          <day>16</day>
          <month>10</month>
          <year>2017</year>
        </date>
        <date date-type="accepted">
          <day>05</day>
          <month>11</month>
          <year>2017</year>
        </date>
        <date date-type="online">
          <day>11</day>
          <month>11</month>
          <year>2017</year>
        </date>
      </history>
      <permissions>
        <copyright-statement>© </copyright-statement>
        <copyright-year>2017</copyright-year>
        <copyright-holder>Zinat Rehana Sharmin, et al.</copyright-holder>
        <license xlink:href="http://creativecommons.org/licenses/by/4.0/" xlink:type="simple">
          <license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
        </license>
      </permissions>
      <self-uri xlink:href="http://openaccesspub.org//jhhr/article/626">This article is available from http://openaccesspub.org//jhhr/article/626</self-uri>
      <abstract>
        <sec id="idm1809038620">
          <title>Background: </title>
          <p>Disorders of lipid metabolism are manifested by elevation of the plasma concentration of the various lipid and lipoprotein fractions and the result, predominantly cardiovascular diseases. Lipid research clinic’s coronary primary prevention trial has provided useful information on the reduction of plasma cholesterol level in hyperlipidemic subjects by diet and drug therapy and thus the reduction in risk of myocardial infarction and death. Conventional lipid lowering drugs are used for lowering lipid level. But in the last few years’ herbal drugs are gaining popularity in the management of hyperlipidemia. In this study we compare the hypolipidemic effect of <italic>Momordica</italic><italic>Charantia</italic> (MC) with atorvastatin, a commonly used hypolipidemic drug.</p>
        </sec>
        <sec id="idm1809038332">
          <title>Methods: </title>
          <p>The present experimental study was done in the pharmacology department of Dhaka Medical College during the period of July, 2011 to June, 2012. For this study a total number of 30 Norwegian rats of either sex were selected. They were divided into 5 groups each comprises of 6 rats. In  the experiment   group A was given normal diet with high fatty diet (1.5 ml olive oil plus 1% cholesterol) which was control group and other experimental groups (B,C,D,) were allowed to feed a high fatty diet along with fresh juice of <italic>Momordica</italic><italic>Charantia</italic> (in different doses) for 10 days. Another experimental group, E was given high fatty diet along with atorvastatin (0.14mg/kg/day) for 10 days. Rats were sacrificed on 11<sup>th</sup> day and blood was collected by cardiac puncture for estimation of serum lipid profile.</p>
        </sec>
        <sec id="idm1809028780">
          <title>Results: </title>
          <p>After administration of fatty diet in group A for 10 days, there was significant increased total cholesterol (TCL), low density lipoprotein (LDL) and triglyceride (TG) levels. Concomitant administration of fatty diet and fresh juice of MC (in different doses) daily  for 10 days in group B,C,D reduced serum TCL, LDL and TG levels which was more significant in higher doses in comparison to  atorvastatin given group E.</p>
        </sec>
        <sec id="idm1809029356">
          <title>Conclusion: </title>
          <p>The present study provides a rationale for use a new herbal medicine much needed for the reduction of serum lipid levels.<italic>Momordica</italic><italic>Charantia</italic> could be useful in hyperlipidemic conditions. They are as effective as a standard lipid lowering agent- atorvastatin.</p>
        </sec>
      </abstract>
      <kwd-group>
        <kwd>Momordica Charantia</kwd>
        <kwd>Total cholesterol</kwd>
        <kwd>Low density lipoprotein</kwd>
        <kwd>High density lipoprotein</kwd>
        <kwd>Triglyceride.</kwd>
      </kwd-group>
      <counts>
        <fig-count count="15"/>
        <table-count count="1"/>
      </counts>
    </article-meta>
  </front>
  <body>
    <sec id="idm1809028204" sec-type="intro">
      <title>Introduction: </title>
      <p>Disorders of lipid metabolism are manifested by elevation of the plasma concentration of the various lipid and lipoprotein fractions (total cholesterol, low density lipoprotein, very low density lipoprotein and triglyceride) and they result predominantly cardiovascular diseases<xref ref-type="bibr" rid="ridm1808761044">1</xref>. Coronary heart disease is the commonest form of heart disease and the single most important cause of premature death in the developed world. The death rates from CHD in the United Kingdom are among the highest in the world. Unfortunately the incidence of the condition is increasing rapidly in Eastern Europe and many developing countries like Bangladesh<xref ref-type="bibr" rid="ridm1808758308">2</xref>. Lipid research clinic’s coronary primary prevention trial has provided useful information on the reduction of plasma cholesterol level in hyperlipidemic subjects by diet and drug therapy and thus the reduction in risk of myocardial infarction and death<xref ref-type="bibr" rid="ridm1808825068">3</xref>. Reductase inhibitor, niacin, fibrate are the drugs used for lowering the lipid level. But these drugs are costly and toxic. Therefore studies are still going on in search of more potent, less toxic, cheaper and easily available hypolipidemic agent. Plants have been used as source of medicine throughout human history and they continue to serve as the basis for many pharmaceuticals used today<xref ref-type="bibr" rid="ridm1808837668">4</xref>. So  many research works have been done on various herbal agents such as <italic>Momordica</italic><italic>Charantia</italic> (karela), garlic oil, onion, chatharanthus roseus, etc<xref ref-type="bibr" rid="ridm1808867332">5</xref>. Among these we choose <italic>Momordica</italic><italic>Charantia</italic>   to compare its hypolipidemic effects with that  of atorvastatin.<italic>Momordica</italic><italic>Charantia</italic>   is called bitter melon, bitter gourd in English, is a tropical and subtropical vine of the family cucurbitaceae, widely grown in Asia, Africa and the Caribbean. It is commonly known as karela in our country<xref ref-type="bibr" rid="ridm1808621132">6</xref>. In addition to culinary usage bitter melon is also used in folklore medicine. The seeds, fruits, leaves and root of the plant have been used in traditional medicine for microbial infections, sluggish digestion and intestinal gas, menstrual stimulation, wound healing and inflammation<xref ref-type="bibr" rid="ridm1808616524">7</xref>. Documentation has found that <italic>Momordica</italic><italic>Charantia</italic> possess blood glucose lowering effect<xref ref-type="bibr" rid="ridm1808614220">8</xref>,<xref ref-type="bibr" rid="ridm1808608028">9</xref>, hypolipidemic effect<xref ref-type="bibr" rid="ridm1808604716">10</xref>,antiviral effect<xref ref-type="bibr" rid="ridm1808602700">11</xref>, anti helminthic<xref ref-type="bibr" rid="ridm1808594388">12</xref> ,antioxidant<xref ref-type="bibr" rid="ridm1808599356">13</xref>and anticancer effect<xref ref-type="bibr" rid="ridm1808595972">14</xref>. The recent research focus has shifted to explore the hypolipidemic effect of<italic>Momordica</italic><italic>Charantia</italic> in comparison to atorvastatin, a hypolipidemic drug.</p>
    </sec>
    <sec id="idm1809012460" sec-type="materials">
      <title>Materials and Methods:</title>
      <p>A total number of 30 Norwegian rats of either sex and weighting 150-200g were selected for the experimental study performed in pharmacology department of Dhaka Medical College (DMC) from July, 2011 to June, 2012.</p>
      <p> They were divided into 5 groups with each group comprising of 6 rats. They were treated for 10 days and sacrificed on 11<sup>th</sup> day.</p>
      <sec id="idm1809013108">
        <title>Preparation of <italic>Momordica</italic><italic>Charantia</italic> Juice</title>
        <p>Fresh fruits were bought from the local market. Fruits were authenticated from National Herbarium, Mirpur, Dhaka. The DACB accession number is 36525. The fruits were crushed through a shell and mortar. After removal of the seeds the juice were filtered through fine cloths to remove debris.</p>
      </sec>
    </sec>
    <sec id="idm1809011524">
      <title>Procedure:</title>
      <p>In the experiment, 30 rats were equally divided into group A, B, C, D, E. Group A served as fat fed control group who received normal diet and fatty diet (1.5 ml olive oil plus 1% cholesterol<xref ref-type="bibr" rid="ridm1808579460">15</xref>) for 10 days.  Group B, C, D served as fat fed experimental group where they received fatty diet along with fresh juice of <italic>Momordica</italic><italic>Charantia</italic> for 10 days at different doses. Group B received 0.5 ml/kg MC juice, group C received 1.0 ml/kg MC juice and group D received 1.5 ml/kg MC juice per day. Group E is the fat fed experimental group which received fatty diet along with atorvastatin (0.14mg/kg/day).  After treating those for 10 days rats were sacrificed on the 11<sup>th</sup> day and blood was collected by cardiac puncture for estimation of serum lipid profile. The doses were adjusted according to previous work<xref ref-type="bibr" rid="ridm1808579964">16</xref>.</p>
      <sec id="idm1809018580">
        <title>Measurements</title>
        <p>Sera were obtained. Subsequently, serum total cholesterol, HDL, LDL and triglyceride levels were measured by enzymatic colorimetric method in the department of pharmacology and therapeutics, Dhaka Medical College, using lipid profile kits.</p>
      </sec>
      <sec id="idm1809017572">
        <title>Data Collection and Analysis</title>
        <p>All relevant information of each rat was recorded in a predesigned data collection sheet. Collected data were screened, complied and appropriate statistical analysis, unpaired student’s ‘t’ tests, was applied using computer based software. P value &lt; 0.05 was taken as minimum level of significance.</p>
      </sec>
    </sec>
    <sec id="idm1809016852" sec-type="results">
      <title>Results</title>
      <p>Here the effects of extract of <italic>M.Charantia</italic>at different doses in group B, C and D on lipid levels of fat fed rats were observed.</p>
      <p>The mean TCL in group A,B,C,D,E were 141.50 ± 2.66, 139.50 ± 3.39, 135.50 ± 4.64, 65.83 ± 29.23 mg/dl, 63.67 ± 3.78 respectively.  Serum TCL decreased significantly in group C, D, E. </p>
      <p>The   mean LDL   in group A,B,C,D,E were 79.83 ± 2.40, 74.50 ± 4.64, 76.00 ± 3.46, 32.00 ± 3.29 and 27.50 ± 1.76mg/dl respectively.</p>
      <p>The mean HDL in group A,B,C,D,E were 30.83 ± 1.47, 31.33 ± 2.25, 30.50 ± 2.66, 31.17 ± 2.99 mg/dl and 37.00±3.03, respectively.</p>
      <p>The mean triglyceride levels in group A, B,C,D,E were 109.00 ± 3.22, 103.50 ± 3.27, 94.67 ± 4.27, 95.67 ± 4.41 mg/dl and 84.67 ± 4.89, respectively. </p>
      <table-wrap id="idm1808618572">
        <label>Table 1.</label>
        <caption>
          <title> Mean lipid profile of different groups of rats </title>
        </caption>
        <table rules="all" frame="box">
          <tbody>
            <tr>
              <th>
                <bold>Group N=6</bold>
              </th>
              <td>
                <bold>TCL (mg/dl)</bold>
              </td>
              <td>
                <bold>LDL (mg/dl)</bold>
              </td>
              <td>
                <bold>HDL (mg/dl)</bold>
              </td>
              <td>
                <bold>TG (mg/dl)</bold>
              </td>
            </tr>
            <tr>
              <td>Group A</td>
              <td>141.50  ±  2.66</td>
              <td>79.83 ± 2.40</td>
              <td>30.83 ± 1.47</td>
              <td>109.00 ± 3.22</td>
            </tr>
            <tr>
              <td>Group B</td>
              <td>139.50 ± 3.39<sup>ns</sup></td>
              <td>74.50 ± 4.64<xref ref-type="table-fn" rid="idm1808999348">*</xref></td>
              <td>31.33 ± 2.25<xref ref-type="table-fn" rid="idm1808999348">*</xref></td>
              <td>103.50 ± 3.27<xref ref-type="table-fn" rid="idm1808999348">*</xref></td>
            </tr>
            <tr>
              <td>Group C</td>
              <td>135.50 ± 4.64<xref ref-type="table-fn" rid="idm1808999348">*</xref></td>
              <td>76.00 ± 3.46<sup>ns</sup></td>
              <td>30.50  ± 2.66<sup>ns</sup></td>
              <td>94.67 ± 4.27<xref ref-type="table-fn" rid="idm1809000356">***</xref></td>
            </tr>
            <tr>
              <td>Group D</td>
              <td>65.83 ± 29.23<xref ref-type="table-fn" rid="idm1809000356">***</xref></td>
              <td>32.00 ± 3.29<xref ref-type="table-fn" rid="idm1809000356">***</xref></td>
              <td>31.17 ± 2.99<sup>ns</sup></td>
              <td>95.67 ±  4.41<xref ref-type="table-fn" rid="idm1809000356">***</xref></td>
            </tr>
            <tr>
              <td>Group E</td>
              <td>63.67 ± 3.78<xref ref-type="table-fn" rid="idm1809000356">***</xref></td>
              <td>27.50 ± 1.76<xref ref-type="table-fn" rid="idm1809000356">***</xref></td>
              <td>37.00 ± 3.03<xref ref-type="table-fn" rid="idm1809000356">***</xref></td>
              <td>84.67 ± 4.89<xref ref-type="table-fn" rid="idm1809000356">***</xref></td>
            </tr>
          </tbody>
        </table>
        <table-wrap-foot>
          <fn id="idm1808998916">
            <label/>
            <p>Data expressed as mean ± SD</p>
          </fn>
          <fn id="idm1808999348">
            <label>*</label>
            <p>P &lt; 0.05 is significant </p>
          </fn>
          <fn id="idm1809000356">
            <label>***</label>
            <p>P &lt; 0.001 taken as highly significant </p>
          </fn>
        </table-wrap-foot>
      </table-wrap>
    </sec>
    <sec id="idm1808999780" sec-type="discussion">
      <title>Discussion:</title>
      <p>The present study was carried out to evaluate the effect of <italic>Momordica</italic><italic>Charantia</italic> on serum lipid levels in comparison to atorvastatin. In the present work hyperlipidemia was induced in rats by administration of 1.5 ml olive oil with 1% cholesterol for 10 days. The hyperlipidemia was evidenced by significant increase in serum TCL, LDL and TG levels. Similar observations were made by a number of researchers, who demonstrated hyperlipidemia by administering 1.5 ml olive oil solution containing vitamin D<sub>3</sub> and cholesterol for consecutive 5 days. In their studies they got the similar results. Serum TCL, LDL and TG levels increased significantly (P &lt;0.05)<xref ref-type="bibr" rid="ridm1808577660">17</xref>. In another study they demonstrated hyperlipidemia in adult long evans rats by administering 1.5 ml olive oil and 1% cholesterol for 10 days. They showed that fatty diet increased total serum cholesterol, LDL and VLDL significantly (P&lt; 0.001)<xref ref-type="bibr" rid="ridm1808579460">15</xref>.</p>
      <p>In this study concomitant administration of fresh juice of<italic>Momordica</italic><italic>Charantia</italic> and fatty diet (olive oil plus cholesterol) daily orally for 10 days reduced serum TCL, LDL and TG levels. The reduction was highly significant in comparison to hyperlipidemic control group, which   was best observed at the higher doses (1.0 ml/kg/day and 1.5 ml/kg/day) of MC and atorvastatin treated group. It was observed that the serum TCL levels significantly decreased in group C (P &lt;0.05), D (P &lt; 0.001) and E (P&lt;0.001) compared to group A and the serum LDL levels significantly reduced in group B (P &lt; 0.05), D (P &lt; 0.001) and E (P&lt;0.001) compared to group A. No significant change of serum HDL levels was observed in group C and D but significantly increased in group B (P &lt; 0.05) and group E (P&lt;0.001). The serum TG levels reduced significantly  in group B (P &lt; 0.05), C (P &lt; 0.001), D (P &lt; 0.001) and E (P&lt;0.001).</p>
      <fig id="idm1808567372">
        <label>Figure 1.</label>
        <caption>
          <title> Bar diagram showing serum lipid levels in different groups of rats </title>
        </caption>
        <graphic xlink:href="images/image1.jpg" mime-subtype="jpg"/>
      </fig>
      <p>The reduction of serum TCL, LDL and TG by higher doses of <italic>Momordica</italic><italic>Charantia</italic> (1.0ml/kg and 1.5ml/kg) were almost similar to that of atorvastatin. As far as our knowledge goes, no other work has been carried out on this aspect of <italic>M.Charantia</italic> in our country. Further investigations identify the hypolipidemic active principles and elucidate their mechanism of action. The present study provides an initial step in demonstrating juice of <italic>M.Charantia</italic> as effective as atorvastatin in hyperlipidemic states. Thus it could be a new agent in reducing morbidity and mortality resulting from dyslipidemia. </p>
    </sec>
    <sec id="idm1808971924" sec-type="conclusions">
      <title>Conclusion:</title>
      <p>Inpresent study we compared the hypolipidemic effects of <italic>M.Charantia</italic> with a standard known hypolipidemic agent atorvastatin. Thus it could be useful in hyperlipidemic conditions. <bold>Purpose of this study is to introduce herbal agents instead of costly and toxic drugs.</bold> But before stablising <italic>M.Charantia</italic> juice as a therapeutically effective hypolipidemic agent, further studied should be carried out to determine the active principles responsible for hypolipidemic effect and its cellular mechanism of action.</p>
    </sec>
  </body>
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