Proceedings S.Z.M.C. Vol: 38(1):

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3URFHHGLQJV6=0&9RO  pp. 31-36, 2024. 
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Hepatoprotective Effect ofLavage

Extra Virgin Olive Oil and


Intraoperative Peritoneal
,V&RYLG9DFFLQH+HVLWDQF\8QIRXQGHG"$/RFDO
2XWFRPHRI/RQJHU/HYHU$UP3ODWHVZLWK0LQLPDOO\
0HGLFDO6WXGHQWV¶3HUFHSWLRQRQ/HDUQLQJ$QDWRP\ in Peritonitis: Normal
Apple Cider
Saline Vinegar in Type-2 Diabetic Rat Model
&RPSDUDWLYH6WXG\RQ6KRUW7HUP6LGH(IIHFWVRI'LIIHUHQW
,QYDVLYH3ODWH
vs Metronidazole
2VWHRV\QWKHVLVLQ$27\SH&'LVWDO
2QOLQH'XULQJ&29,'3DQGHPLFLQDQ,QWHJUDWHG
Ruqaiyya
1
Nazir, Muniza Saeed,
2
Ghulam Mustafa, Seher Naeem,
3
Hifza Qureshi,
Noor, Sehrish Ijaz 4 5 6
 
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Hira Aslam, Muhammad Khurram Jameel, Pir Muneeb,

Aneeqa Nasir Fawad
1 2 2 1 2
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Hameed, Muhammad Ammar, Maham Qazi, Abrar ul Hassan Pirzada
3 2 4 
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KEMU,ABSTRACT
1
Department of Surgery, Hospital, Lahore
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2 0XKDPPDG8PDLU.KDQ
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Department of Surgery, ANMC / Chaudhary Muhammad Akram Hospital, Lahore

1
6LEJKD)DWLPD
Department
Introduction:
3

+XPDLUD*XOQD]
ofType-2
Orthopedics,
Public Health,THQ,
diabetes Health 
a6\HG+XVVDLQ5D]D=DLGL
Khanewal
mellitus, Services Academy,
major public problem,6DED6DOHHP

healthIslamabad.

=DKUD)DWLPD
is caused by insulin resistance. In diabetics,
2Department of Urology, Chaudhary Muhammad Akram Hospital, Lahore
4 1DELOD.DXNDE
Department
chronic of Orthopedics,
Management
hyperglycemia results inLGH,
Sciences,Lahore
formation Riphah
of Int
reactive University,
oxygen species.Islamabad.
Oxidative stress in diabetic patients is responsible
13Department of Plastic Surgery, ANMC / Chaudhary Muhammad Akram Hospital, Lahore, Pakistan
Department
for of Anatomy,
hepatic damage because itUCMD,
Department of Medicine,
Orthopedics, Universityofofseveral
causes activation
THQ,Islamabad.
IHITC, Ferozwala Lahore, Lahore
pro-inflammatory mediators in liver. Hepatic complications of
4
2diabetes include
Department offatty liver disease,
Anatomy,
Department of Orthopedics, Punjabnecrosis,
Rheumatology, Medicalcirrhosis,
CMH,
PIMS, College,carcinoma
Lahore
Islamabad. and
Faisalabad liver failure.
Medical University, Faisalabad
Aims
35 & Objectives:
Department of Medicine,To
Medical determine
Education, and
Pakcompare
Red theABSTRACT
hepatoprotective effect of College,
extra virgin olive oil and apple cider
Hand & Upper
Dow Limb of Crescent
Surgery,
University MedicalKarachi.
CMH,Sciences,
Health Lahore and Dental Lahore
vinegar
6 in streptozotocin
Department of induced
Orthopedics, Type-2 diabetic rat
Al-Rehmatperitonitis
Benevolentmodel.
Trust
Introduction: Globally,
Place and Duration of acute
Study:generalized ranks
This experimental study among
was the top surgical
conducted at Animalemergencies.
House of Different studies
Postgraduate have
Medical
been conducted to show the amplitude of peritonitis
Institute, Lahore, Pakistan from May 2021 to June 2021. $%675$&7
worldwide
$%675$&7 eliciting a huge impact on overall patient morbidity and
mortality. Largely peritonitis is caused by a $%675$&7
gastrointestinal perforation or anastomotic leak. In peritonitis,
Material & Methods: In this study, 40 male Sprague Dawley rats were divided into 4 groups i.e., Group I was NC anaerobes &
,QWURGXFWLRQ6LGH(IIHFWVRI&RYLG9DFFLQDWLRQVKDYHEHHQUHVSRQVLEOHIRU
gram-negative organisms are mostly responsible forGroup
sepsis andEVOO morbidity 9DFFLQHKHVLWDQF\
duevirgin
to theolive
overactive 9+ZDVZKLFKLVGHILQHG
,QWURGXFWLRQ
(negative 7KHGroup
control), &29,' II PC SDQGHPLF
(positive LQIOXHQFHG
control), HGXFDWLRQ
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(ExtraZRUOGZLGH 7KLVoil) andinflammatory
FKDQJH Group XQXVXDO cascade
IV (Apple IRUciderby
ERWK
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,QWURGXFWLRQ7KHODUJHVW
endotoxins which is amenable VWURQJHVWERQHLQWKHERG\LVWKHIHPXUZLWKDQHTXLYDOHQWO\JRRGEORRGVXSSO\)UDFWXUHV
vinegar), each group having 10torats. timely intervention.
VWXGHQWVDQGDQDWRPLVWV7KHSUHVHQWVWXG\LVFRQGXFWHGWRSHUFHLYHRQOLQHOHDUQLQJH[SHULHQFHRI
Diabetes was induced in all rats except the rats of NC group at the VW
QG\HDU0%%6
start of the study
$LPV & 2EMHFWLYHV 7R HYDOXDWH DQG was
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LQWKH\RXQJVWHUV VKRUWsaline
WHUP VLGHmetronidazole
HIIHFWV RI GLIIHUHQW
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Aims Objectives: The study'sofaim
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by intraperitoneal administration injectiontonicotinamide,
evaluate whether usingbynormal
OHFWXUHVZLWKIDFHWRIDFH
followed injection STZorafter 15 minutes.solutionGroup III was
during
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0HWDSK\VHDO
intraoperative DQG LQWUDDUWLFXODU
peritoneal lavage FRPPLQXWLRQ
(IOPL), results LV
in
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a FKDOOHQJH
lower rate WR
of FRQYHQWLRQDO
postoperative SODWH
wound IL[DWLRQ
infection. 0LQLPDOO\LQYDVLYHSODWH
WKH H[SHULHQFHRIOHDUQLQJ$QDWRP\
given 1ml/100gBW/ day EVOO and Group IV was given 2ml/kgBW/day diluted ACV with distilled water in 1:5 orally
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and GXUDWLRQ
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sampling
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study was \HDUVZDV
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undertaken WUHDW DW 6SHFLDOLVW
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for 4 weeks. Terminal performed at the end ofatthe
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week Ward,
for estimation Mayo
of 6*'
liver Hospital
enzymes Lahore
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months 6WDELOL]DWLRQ
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2nd, 2021, /,66
to  7KH
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1st, GLIILFXOW
2021. IUDFWXUHV IRU RUWKRSHGLF VXUJHRQV WR WUHDW DUH LQWUDDUWLFXODU
and AST) in serum. Data were entered and analyzed in SPSS version 26. p value of ” 0.05 was considered significant.
0DWHULDO & Methods:
0HWKRGVConsecutive
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Material
Results: On comparison with PC VGLVWDOHQG
sampling
group, bothstrategy followed
the treatment groups randomized
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showed significantcontrolled trial
decrease in serum induct
ALT and
levels
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$LPV
provide  2EMHFWLYHV
intervention to 907R GHWHUPLQH
patients aged WKH
15-65UDGLRORJLFDO
years with  IXQFWLRQDO
peritonitis
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by hollowRI ORQJHU
viscus OHYHU
perforation.DUP SODWHV
The ZLWK
patients
with p values 0.026 for EVOO and < 0.001 for ACV. Serum ALP levels were also decreased significantly in both the
LQGLYLGXDOV
0,32
were DJHGintop\HDUV DQGA&DERYH ZKRKDG HLWKHU FRPSOHWHG
0LQLPDOO\LQYDVLYHSODWHRVWHRV\QWKHVLVLQIUDFWXUHVRI'LVWDOIHPXU$2W\SH&
subdivided 2value
groups RU SDUWLDOO\ FRPSOHWHGWKHLU YDFFLQDWLRQGRVDJH DW DQ\
0DWHULDO
treated groups < 0.001B(n=45 each).Two
as wellliters
as forofthe normal
ACVsaline
group.were
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with for EVOO used forreduction
However, peritoneal in lavage
serum in AST group
levelsA,
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whilenonsignificant
two liters of with 
normal ,%0 $UPRQN 1HZ <RUN 86$  ZDV XVHG IRU GDWD
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saline0.082
were and combined with 200 and
mL ACV of metronidazole
PHGLFDOHGXFDWLRQLVWV7KHVDPSOLQJZDVGRQHE\QRQSUREDELOLW\FRQYHQLHQFHWHFKQLTXH)RUDFRQILGHQFHOHYHORI DQDO\VLV 3YDOXH
solution and administered to group B. ZDV WDNHQ DV
was p values 0.058 in EVOO groups respectively.
VLJQLILFDQW
WR
intraoperatively.Baseline physiological
VDPSOHVL]HZDV$WRWDORIVWXGHQWVIURP parameters VWsuch QGas age, sex, BMI , intra operative surgical parameters
  \HDU0%%6ZHUHDVNHGWRILOOLQD4XHVWLRQQDLUHZLWK/LNHUW as
Conclusion: Both EVOO and ACV have hepatoprotective effect in Type-2 diabetic rats. However, ACV is more
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0DWHULDO
duration of operation and post-operative course were recorded till discharge.
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POD, patients 
returned 
to OPD ZHUH
for
effective.
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further 6*'
RQOLQH monitoring. An
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DQG ,QWHUDFWLYHinfection ZHUHRIDJHJURXS\HDUVZKHUHDV
was ZLWK
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diagnosedIDFHWRIDFH OHDUQLQJ post-operative
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if the patient had symptoms
&29,'SDQGHPLF such as ZDV
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increased
Keywords: TLC, wound discharge, redness, 
or
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Apple cider vinegar, Extra virgin 6366YHUVLRQZDVXVHGWRUHFRUGDQGHYDOXDWHDOOWKHGDWD$SYDOXHRI
pain.
olive Data
oil, was
Type-2 entered
diabetes and analyzed using SPSS version 23.
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Results: A majority of the patients adults. Mean age of
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 UHVSRQGHQWVFRQILUPHGWKDWWKH\FRPSOHWHGWKHWZRGRVHYDFFLQDWLRQSURFHVV6KRUWWHUPDGYHUVHHYHQWVZHUH
years of patients in the
\HDU
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metronidazole ,Q WKLV
ZKLOHZHUHIURP VWXG\
group QG 
was comparable SDWLHQWV
to ZHUH
mean PDOH
age ZKLOH
40.04 ±  
11.96 
yearsSDWLHQWV
in the ZHUH
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saline group, 7KH PHDQ
difference $PHULFDQ
was not
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.QHH 6RFLHW\ 6FRUH $.66  RI WKH
significant
VWXGHQW (p=0.067).
UHVSRQVHV IRUMale/female
PLVVLQJ GDWD WKHSDWLHQWV
ratio in ZDV ZHUH
Metronidazole
SHUFHQWDJHV “
and 7KH
Saline groups
FDOFXODWHG IURPH[FHOOHQW
were
WRWDO 17/25 IXQFWLRQDO
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UHVSRQVHV WR ZDV
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respectively. Patients
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V\PSWRPV

who
received INTRODUCTION
SDWLHQWVDQGDIWHUUGPRQWKXQLRQZDVQRWHGLQSDWLHQWV
intraperitoneal lavage with normal saline were more dyslipidemia 1
likely to develop. Type-2 wound diabetes
infections mellitus
(17/45)has come
(37.78%),
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while only 3/45)
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those who WKDW YDFFLQHV
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metronidazole out
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a global
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did YLUXV
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so epidemic
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the results of this experiment, using posing
metronidazole a huge
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Conclusion: Based on solution
&RQFOXVLRQ2XUSUHVHQWVWXG\FRQFOXGHVWKDWOHDUQLQJDQDWRP\RQOLQHLVFKDOOHQJLQJ2YHUDOOVWXGHQWVGLGQRWYDOXHRQOLQH health for burden .
intraoperative According
peritoneal to one
lavage
iabetes
instead ofPRUH Mellitus
normal saline (DM)
reduces isthea chronic
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OHDUQLQJ occurrence metabolic
of postoperative estimation
wound there
infection. were 451
WKDQ IDFHWRIDFH OHDUQLQJ LQ WHUPV RI IOH[LELOLW\ IUHHGRP LQWHUDFWLRQ ZLWK WHDFKHUV ODFN RI KDQGVRQ million people with
disorder which is characterized by hyperglycemia,
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Keywords:
caused by peritonitis,
WLPH impairedpostoperative
insulin secretion wound infection,
or insulin intraoperative peritoneal
are expected to lavage
have this disorder by the year 20453.

 resistance. Type-2 diabetes mellitus is characterized About 26.3% of the adult local population is
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by insulin insensitivity of the insulin receptors and
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31
 Hepatoprotective Effect of Extra Virgin Olive Oil and Apple Cider Vinegar in Type-2 Diabetic Rat Model

also occur7. Although, oral hypoglycemic agents are acclimatized. They were housed in labeled cages of
most commonly used drugs for the management of appropriate size at room temperature (22-24ºC) with
diabetes, but they have some adverse effects such as proper ventilation. They were fed on rat chow and
hypoglycemia, gastrointestinal disturbances, weight water ad-libitum. After acclimatization, rats were
gain, lactic acidosis and retention of fluid8. divided into four groups by lottery method (10 rats
Inconvenience in use of insulin and side effects of in each group) i.e., Group I negative control (NC)
oral hypoglycemic agents are leading to an increase group, Group II PC positive control, Group III extra
in usage of natural remedies for diabetes9. These virgin olive oil group (EVOO) and Group IV apple
remedies include phenolic compounds because they cider vinegar group (ACV).
are known to have hypoglycemic and antioxidant Induction of Diabetes
effects. There are many plant derived foods which Type-2 diabetes mellitus was induced at the start of
have phenolic compounds for example extra virgin study in all rats by administration of intraperitoneal
olive oil (EVOO)10 and apple cider vinegar injection of nicotinamide in a dose of 100mg/kg BW
(ACV)11. Olive oil is obtained by mechanical by 26 gauge needle followed by injection STZ
extraction of the olive fruits and has abundant (prepared in citrate buffer with pH of 4.5) in a dose
polyphenols. Composition of olive oil depends on of 55 mg/kg BW after 15 minutes, except the rats of
harvest conditions, processing and preservation NC group. Rats with blood glucose level
methods. Extra virgin olive oil is the richest in >200mg/dL (checked by hand held gluco-meter,
phenolic compounds as compared to all other forms manufactured by SD Biosensor, Korea), 72 hours
of olive oil10. Apples undergo two step fermentation after injection of STZ were considered diabetic14.
process for the production of ACV, which contains Dosage and Experimental Study Program
5-6% acetic acid12. Phenolic compounds present in Both the control groups i.e., Group I (NC) and
it have antioxidant and glucose lowering effects11. Group II (PC) were given 1ml/100gBW/day
Apple cider vinegar has hepato-protective effect as distilled water orally. Group III (EVOO) was given
phloretin present in it plays vital roles in the non- 1ml/100gBW/day extra virgin olive oil (Rafael
enzymatic protection against oxidative stress Salgado, Spain)15, Group IV (ACV) was given
induced hepatic injury13. The aim of the current 2ml/kgBW/day diluted apple cider vinegar (Bragg
study was to determine and compare the hepato- Live Food Products) with distilled water in 1:5 for 4
protective effects of extra virgin olive oil and apple weeks16.
cider vinegar to identify which one of them may be Measurement of Serum Biochemical Indexes
more effective and potent in treating or reversing Light anesthesia with chloroform was done after
progression of hepatic damage in diabetics so that overnight fast at the end of 4th week to collect
that these natural substances could be added as samples using a syringe of 26-gauge needle through
adjuvant therapy for diabetes. cardiac puncture and remains were disposed off in
accordance with the ethical principles and
MATERIAL AND METHODS guidelines laid down by World Medical Association
(WMA) declaration of Helsinki. Four ml blood of
This experimental study, with a duration of 40 days, each rat was collected and sampling tubes were kept
was conducted at the Animal House of Postgraduate straight in standing position for half an hour at room
Medical Institute, Lahore from May to June, 2021. temperature and then centrifuged at 3000 rpm for 10
Research was started after the official approval of minutes for separation of serum. The serum was
synopsis by Ethical Committee of Postgraduate then poured into pre labeled serum holders. Liver
Medical Institute, Lahore (00-20-5-2019). Sample enzymes (ALT, AST, ALP) were measured in
size was calculated using values of serum ALT serum samples by semi-automated chemistry
levels in the following formula; analyzer by standard kinetic method. Data were
entered and analyzed in SPSS version 26. Normality
of distribution of data was checked by Shapiro Wilk
test. The median (Inter Quartile Range) for
quantitative variables were calculated. Differences
Animals in results among groups were compared and
Forty adult healthy male Sprague Dawley rats of checked by applying Kruskal Wallis H test. Results
weight 180-200 gram were bought from local among individual groups were analyzed by Mann
market of Lahore for this study. Rats showing signs Whitney U test.
of any ailment were excluded. Prior to the
experimentation, the rats were given one week to be


32
 Hepatoprotective Effect of Extra Virgin Olive Oil and Apple Cider Vinegar in Type-2 Diabetic Rat Model

RESULTS

A very highly significant difference in ALT levels

(p= 0.000) as well as in ALP (p=0.000) levels were
found among all the study groups, when comparison
was done by Kruskal Wallis H test at the end of the
study. Serum AST levels were significantly
different among all the groups with p value 0.011,
whereby the diabetic rats displayed highest values
of ALT, AST and ALP (Table-1, Fig-1, Fig-2, Fig-
3). Pair wise comparison was done by Mann
Whitney U test that also revealed highest increase of
serum ALT levels in PC group. Serum ALT levels
of EVOO (p=0.026) & ACV (p<0.001) groups were
significantly lower than PC group. On comparison
with NC, EVOO group showed significant Fig-1: Serum Alanine aminotransferase levels
difference with p value of 0.006 while there was no {median (IQR)} ofrats in all groups at the end
significant difference of ALT levels of NC & ACV of 4 weeks study period.
groups with p value of 0.649 (Table-2). Pair wise
comparison of serum ALP levels revealed that
serum ALP levels of EVOO & ACV groups were
very highly significantly lower than PC i.e., p <
0.001. However, comparison of serum AST levels
of both the treatment groups (EVOO & ACV) with
PC group showed statistically non-significant
difference with the p-values of 0.082 and 0.058
respectively (Table-2).

Alanine Aspartate Alkaline

amino- amino- phospha
Groups
transferase transferase tase
(U/L) (U/L) (U/L)
58.50 98.50 581.50
Group- Median
I (NC) (IQR)
(49.75- (83.00- (493.75-
66.25) 107.25) 740.00)
92.00 117.50 1520.00 Fig-2: Serum Aspartate aminotransferase of levels
Group- Median {median (IQR)} of rats in all groups at the
II (PC) (IQR)
(79.75- (108.50- (1293.25-
119.75) 122.00) 1783.75) end of 4 weeks.
Group- 76.00 112.50 850.00
III Median
(EVO (IQR)
(66.75- (94.75- (818.75-
O) 91.50) 115.25) 912.75)
Group- 54.50 105.50 454.00
Median
IV
(IQR)
(48.50- (98.50- (350.75-
(ACV) 64.75) 113.50) 474.75)
P value 0.000*** 0.011* 0.000***
Table-1: Comparison of serum liver enzymes
(alanine amino-transferase, aspartate,
aminotransferase and alkaline phosphatase)
levels among all groups at the end of the
study by Kruskal Wallis H test
*p value significant,
***p value very highly significant.

Fig-3: Serum Alkaline phosphatase levels {median

(IQR)} of rats in all groups at the end of 4
weeks.

33
 Hepatoprotective Effect of Extra Virgin Olive Oil and Apple Cider Vinegar in Type-2 Diabetic Rat Model

Alanine Aspartate
Alkaline decrease in serum ALT levels (p values 0.026 and
amino- amino- <0.001 respectively) and serum ALP levels (p
Groups phosphatase
transferase transferase
(U/L) (U/L)
(U/L) values <0.001) in current study. However, reduction
58.50 98.50 581.50 of serum AST levels was with p values 0.082 and
Group Median (49.75- (83.00- (493.75- 0.058 in EVOO and ACV groups respectively.
I (NC) (IQR) 66.25) 107.25) 740.00)
²p<0.001*** ²p=0.004** ²p < 0.001***
Results of some previous studies confirm our
92.00 117.50 1520.00 findings. Kauka et al. attributed the improvement in
Group Median
II (PC) (IQR)
(79.75- (108.50- (1293.25- liver enzymes by consumption of EVOO to the
119.75) 122.00) 1783.75)
76.00 112.50 850.00 presence of hydroxytyrosol a phenolic component
Group
III Median
(66.75- (94.75- (818.75- which prevents inflammation by inhibiting
(EVO (IQR)
91.50) 115.25) 912.75) expression and activation of endothelial and
¹p=0.006** ¹p=0.064 ¹p=0.001**
O)
²p=0.026* ²p=0.082 ²p<0.001*** intercellular adhesion molecules17.
54.50 105.50 454.00 Amirnahavandirahbar and Nasirzadeh proved in
Group (48.50- (98.50- (350.75- their study that oleuropein (an important component
Median
IV 64.75) 113.50) 474.75)
(ACV)
(IQR)
¹p=0.649 ¹p=0.074 ¹p=0.005** of EVOO) causes decline in elevated liver enzymes
²p<0.001*** ²p=0.058 ²p<0.001*** as oleuropein inhibits cyclooxygenase-2 enzymeto
Table-2: Multiple comparison of serum liver enzymes bring about its anti-inflammatory action18. Liver
(alanine aminotransferase, aminotransferase enzymes are increased in diabetes due to
and alkaline phosphatase) levels among hepatocellular inflammation. Polyphenols, present
groups at the end of study by Mann Whitney
in olives have anti-inflammatory activity that’s why
U test
p¹= significance versus NC, they were reported to help in regulation of hepatic
p²=significance versus PC enzymes in diabetics19,20. However, contrary to our
*p value significant, results, Sila et al. noted that consumption of olive
**p value highly significant, oil has no effect on elevated liver enzymes (ALT,
***p value very highly significant AST and ALP) in diabetic rats21.
Apple cider vinegar also has hepatoprotective effect
DISCUSSION due to the presence of biologically active
ingredients like flavonoids. Reduction of liver
Diabetes mellitus is considered as a great public enzymes in our study by administration of ACV is
health issue worldwide whose risk is increased by in accordance with some previous studies. Halima et
adopting sedentary lifestyle i.e., decreased physical al., 2017 noted elevated hepatic biomarkers in
activity and unhealthy dietary habits2. Hepatic diabetic group of their study, which were
damage is one of the complications of diabetes9. significantly decreased in the group treated by
This study was designed to determine the administration of ACV due to constructive effects of
hepatoprotective effect of EVOO and ACV in Type- Quercetin (flavonoid present in ACV) on liver,
2 diabetic rats. suggesting that ACV plays an important role in
Hepatic enzymes (ALT, AST and ALP) were improving hepatic function22. Bukhari et al., 2021
estimated in serum samples of all rat groups at the noted marked reduction in liver enzymes (ALT,
termination of this study. The diabetic group AST, ALP) in high fat fed rats, by oral
developed a significant raise in serum ALT, AST administration of ACV23. Bouazza et al., 2016
and ALP) as compared to NC group. These findings attributed improvement in liver functions and
are in accordance with previous literature which reduction in liver enzymes (ALT, AST, ALP) in
state that long term hyperglycemia induces serum by administration of ACV in their study to
oxidative stress, resulting in hepatic tissue injury7,15. the presence of phenolic compounds in ACV24.
Intake of EVOO has hepato-protective effect. Mohammad Ghasemi et al., 2018 indicated
Different bioactive molecules present in olives such improvement in symptoms of NAFLD, reduction in
as MUFA (oleic acid) and phenolic compounds i.e., grade of steatosis from moderate to mild along with
HT and oleuropein turn on several signaling improvement of liver enzymes levels by intake of
cascades in hepatic cells for prevention of oxidative ACV25.
stress, inflammation, endoplasmic reticulum stress,
mitochondrial dysfunction and insulin insensitivity CONCLUSION
resulting in resolution or prevention of hepatic
injury15 This study concludes that extra virgin olive oil and
On comparison with PC group, both the treatment apple cider vinegar have a hepatoprotective effect in
groups (EVOO and ACV) showed significant Type-2 diabetic rats as both were successful in

34
 Hepatoprotective Effect of Extra Virgin Olive Oil and Apple Cider Vinegar in Type-2 Diabetic Rat Model

lowering hepatic enzymes. Hepatoprotective effect 12. Morgan J, Mosawy S. The potential of apple cider
of apple cider vinegar was more pronounced. vinegar in the management of type 2 diabetes.
International Journal of Diabetes Research.
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The Authors:

Dr. Ruqaiyya Nazir

Demonstrator,
Department of Physiology,
Islamic International Medical College, Rawalpindi.
Dr. Muniza Saeed,
Professor,
Department of Physiology,
Postgraduate Medical Institute Lahore.
Dr. Ghulam Mustafa,
FCPS-II Trainee,
Department of Nephrology,
Armed Forces Institute of Urology, Rawalpindi.
Dr. Seher Naeem,
Senior Demonstrator,
CMH Lahore Medical College and Institute of
Dentistry Lahore, Pakistan.
Dr. Hifza Noor,
Associate Professor,
Department of Physiology,
Rashid Latif Khan University, Lahore
Dr. Sehrish Ijaz,
Senior Demonstrator,
Department of Pharmacology,
Multan Medical and Dental College.

Authorship:

RN: Conceptualization, Methodology, Writing

Original draft
MS: Supervision
GM: Data collection
SN: Data collection and analysis
HN: Review
SI: Data collection

36