Abstract

Protracted periods of increased cortisol production, as may be seen in an acute illness, may lead to transient hyperglycemia. Increasing evidence suggests that cortisol may then mediate the development of insulin resistance and potentially lead to the development of overt diabetes. Evidence in animal studies also suggests that under conditions of stress Ginkgo biloba extract could reduce plasma cortisol production and so the primary aim of this study was to determine the effect of Ginkgo biloba extract ingestion on plasma cortisol production during an acute period of glucose challenge. Healthy non-diabetic, glucose tolerant volunteers (n = 30, (10/20, M/F); age, 45.7 ± 9.9 years old) completed a randomized, double-blind, placebo-controlled crossover study when they ingested Ginkgo biloba extract (120 mg/day as a single dose) and placebo during each 3-month arm. A standard 75 g oral glucose tolerance test was performed at the end of each cycle and blood was collected and used to measure plasma glucose, insulin, c-peptide and cortisol. Fasting plasma cortisol was significantly lower after the Ginkgo biloba cycle than the placebo cycle (326 ± 149 vs. 268 ± 121 nmol/L, respectively; p = 019). The plasma cortisol area under the curve during the 2-hour test (AUC0-2) was also significantly lower after ingestion of the Ginkgo biloba cycle compared to the placebo (668 ± 265 vs. 530 ± 213 nmol/L/h, respectively; p Ginkgo biloba extract has effect on the hypothalamic-pituitary-adrenal axis leading to reduced basal cortisol levels and reduced cortisol production in response to acute hyperglycemic challenge.

Highlights

  • The hypothalamic-pituitary (HPA) axis is characterized by a circadian rhythm with a maximum cortisol production in early morning (8 - 10 am) and the lowest levels found in the evening [1]

  • We have studied the effect of Ginkgo biloba extract on several parameters including pancreatic β-cell function and whole body insulin sensitivity in normal glucose tolerant individuals, those with impaired glucose tolerance and people suffering from type 2 diabetes mellitus (T2DM) [11]-[13]

  • Because there are already studies showing that Ginkgo biloba extract regulates adrenal cortical hormone production in cell culture [14] and in intact stress-induced rats [15] the driving hypothesis was that the feeling of wellbeing reported by volunteers after ingesting Ginkgo biloba extract was due to reduced cortisol production

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Summary

Introduction

The hypothalamic-pituitary (HPA) axis is characterized by a circadian rhythm with a maximum cortisol production in early morning (8 - 10 am) and the lowest levels found in the evening [1]. We have studied the effect of Ginkgo biloba extract on several parameters including pancreatic β-cell function and whole body insulin sensitivity in normal glucose tolerant individuals, those with impaired glucose tolerance and people suffering from type 2 diabetes mellitus (T2DM) [11]-[13]. During these studies the volunteers completed monthly questionnaires and were encouraged to provide other general comments about how they felt after ingesting the Ginkgo biloba extract. It was further hypothesized that the ingestion of Ginkgo biloba extract would significantly protect the HPA axis even after an acute glucose challenge

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