Anti-Hyperglycaemic Effect of Aegle marmelos ( L .) in Animal Experiments-PRISMA based Systematic Review and Meta-analysis

Aegle marmelos is a folklore medicine which is widely consumed as an anti-hyperglycaemic drug, its properties are known since prehistoric times. Plenty of cell line as well as animal research have reported the anti-hyperglycaemic activity of the drug. Even though quality researches are necessary to fulfil further human studies and marketing, no quality assessments for these studies have been undertaken till date. The aim was to critically analyse the quality standards and evaluate the anti-hyperglycaemic potential of A. marmelos in rodent model researches. The search strategy was done using the key words ‘Aegle marmelos, along with ‘Diabetes or Hyperglycaemia,’ in different databases like PubMed (n = 45), Google Scholar (n = 43) and Science Direct (n = 46). However, the filter used during the search was ‘Animal experimentation’. All animal experimentations collected with the keyword search was analysed for the inclusion criteria like serum glucose estimation as primary outcome, timeline of publication 1997 to 2017 in English and treatments containing any part and any form of A. marmelos in single or in combination. Based on the inclusion criteria, 11 articles were selected for the review. Data extraction underwent a blind procedure independently by two reviewers. If full texts were not available, communicating the authors was also tried and all the four authors responded. All the studies selected after screening were given unique codes, to ensure blind review. Result observed indicated higher reduction of serum glucose levels in hyperglycaemia-induced rodent models. After administering the drug, significant changes were observed in total cholesterol as well as triglycerides. Rest of the LDL, HDL, SOD and serum insulin were an in-significant find. Sample size calculation was not mentioned in any of the studies. Only 9% of the studies reported on blinding and 18% reported on randomisation. This might have affected the internal validity of the studies. It can be concluded that A. marmelos is effective in lowering the serum glucose levels in experimental hyperglycaemia. Further research has to be conducted to explore its target specific mode of action. This may lead to the development of an effective anti-hyperglycaemic drug with minimal side effects.