Metabolic syndrome (MetS) is a group of risk factors, including abdominal obesity, a disorder of lipid metabolism, glucose intolerance, and hypertension that lead to cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). An unbalanced diet, stress, reduced physical activity, and genetic factors may lead to abdominal obesity and are the main causes of MetS. Adipose tissue releases adipocytokines, which may increase insulin resistance and blood pressure, cause oxidative stress, and disturb lipid metabolism. “Population studies have shown that the Mediterranean diet rich in fruits, vegetables, legumes, and grains is inversely associated with the incidence of MetS.” Fruits and vegetables are rich in polyphenolic compounds. Black chokeberry (Aronia melanocarpa, Rosaceae) is rich in polyphenols. Another study showed that black chokeberry juice had high antioxidant potential.
Cholinesterase is part of a group of enzymes that hydrolyze acetylcholine and other choline esters, including acetylcholinesterase (AChE) and butyrylcholinesterase (BChE). AChE has been shown to bind with erythrocytes in adults diagnosed with MetS. Studies have shown that BChE may act as a scavenger for toxic molecules. The purpose of this study was to determine cholinesterase activities in the blood of adolescents diagnosed with MetS and compare those effects to changes in AChE and BChE in adolescents receiving black chokeberry extract.
Participants in the study included  Patients diagnosed with MetS (MetS group) of the Clinic of Endocrinology and Metabolic Diseases at Polish Mother’s Memorial Research Institute and the Medical University of Łódź. Patients were both male (n=32) and female (n=34), aged 13-19 years with a body mass index (BMI) ³ 95th percentile for age and sex. Exclusion criteria included other chronic diseases, infections during the study and four weeks preceding the study, and the use of other medications. A control group of 11 adolescents (n=5, male; n=6, female) aged 14-18 years was recruited from a school in Łódź. Inclusion and exclusion criteria for the control group was the same as the study group. All participants in the study had normal fasting glucose levels. The MetS group received black chokeberry extract at a dose of 100 mg three times a day for two months. This group was instructed to maintain their usual diet and lifestyle. The commercial product Aronox (Agropharm, Poland) was used. According to the manufacturer, 100 mg of Aronox, an extract from the fruits of black chokeberry, contains 50 mg of polyphenols and at least 20 mg of anthocyanins.
The MetS group reported higher lipid peroxidation (P<0.001), higher total cholesterol (P<0.001), higher low-density lipoprotein cholesterol (LDL-c) (P<0.005), higher triacylglycerol (P<0.01), and lower high-density lipoprotein cholesterol (HDL-c) (P<0.01) compared to the control group. After treatment with black chokeberry significant reductions in lipid peroxidation (P=0.05), total cholesterol (P=0.05), LDL-c (P=0.05), and an increase in HDL-c (P=0.05) were observed. The observed lipid peroxidation level post-treatment was similar between the two groups. However, total cholesterol and LDL-c remained higher in the MetS versus the control group and HDL-c remained lower in the MetS group. The MetS group reported significantly higher lipid peroxidation and higher cholesterol in erythrocyte membranes than the control (P=0.05 and P=0.001, respectively). Both lipid peroxidation and cholesterol in erythrocyte membranes significantly decreased after treatment with chokeberry (P=0.001 and P=0.05, respectively).
No significant differences were observed between the groups for total antioxidant capacity rapidly reacting antioxidants (TAC “fast”). After the study, the MetS TAC “fast” levels increased significantly over the control group (P<0.05). TAC long reacting antioxidants (TAC “slow”) were significantly lower in the MetS group (P<0.005).
BChE activity in the MetS group was significantly higher at baseline compared to the control (P<0.001). No significant changes were observed in BChE activity after treatment with black chokeberry in the MetS group. AChE activity was significantly higher at baseline compared to the control (P<0.001). However, after treatment with black chokeberry, AChE activity was significantly lower than the control group (P<0.05).
The authors state that black chokeberry may play a role in decreasing lipid peroxidation and cholesterol content in the erythrocyte membranes as well as decreasing AChE activity. They suggest that the decrease in lipid peroxidation and cholesterol caused a decrease in AChE activity. Conversely, black chokeberry had no effect on BChE activity. The authors suggest BChE activity is affected by cholesterol rather than oxidative stress. An increase in BChE activity was observed with an increase in oxidative stress and impaired lipid metabolism. The authors suggest this “may play a significant role in lipid disorders.”
The authors declare no conflicts of interest.
Duchnowicz P, Ziobro A, Rapacka E, Koter-Michalak M, Bukowska B. Changes in cholinesterase activity in the blood of adolescent[s] with metabolic syndrome after supplementation with an extract from Aronia melanocarpa. Biomed Res Int. March 2018; 5670145:8. doi: 10.1155/2018/5670145.