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Al Refaie A, Baldassini L, Mondillo C, De Vita M, Giglio E, Tarquini R, Gonnelli S, Caffarelli C. Vitamin D and Dyslipidemia: Is There Really a Link? A Narrative Review. Nutrients 2024; 16:1144. [PMID: 38674837 PMCID: PMC11053479 DOI: 10.3390/nu16081144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 04/04/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Nowadays, the interest in the extraskeletal effects of vitamin D is growing. In the literature, its several possible actions have been confirmed. Vitamin D seems to have a regulatory role in many different fields-inflammation, immunity, and the endocrine system-and many studies would demonstrate a possible correlation between vitamin D and cardiovascular disease. In this paper, we deepened the relationship between vitamin D and dyslipidemia by reviewing the available literature. The results are not entirely clear-cut: on the one hand, numerous observational studies suggest a link between higher serum vitamin D levels and a beneficial lipid profile, while on the other hand, interventional studies do not demonstrate a significant effect. Understanding the possible relationship between vitamin D and dyslipidemia may represent a turning point: another link between vitamin D and the cardiovascular system.
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Affiliation(s)
- Antonella Al Refaie
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy (S.G.)
- Division of Internal Medicine I, San Giuseppe Hospital, 50053 Tuscany, Italy
| | - Leonardo Baldassini
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy (S.G.)
| | - Caterina Mondillo
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy (S.G.)
| | - Michela De Vita
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy (S.G.)
| | - Elisa Giglio
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy (S.G.)
| | - Roberto Tarquini
- Division of Internal Medicine I, San Giuseppe Hospital, 50053 Tuscany, Italy
| | - Stefano Gonnelli
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy (S.G.)
| | - Carla Caffarelli
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy (S.G.)
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Du H, Li D, Molive LM, Wu N. Advances in free fatty acid profiles in gestational diabetes mellitus. J Transl Med 2024; 22:180. [PMID: 38374136 PMCID: PMC10875910 DOI: 10.1186/s12967-024-04922-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 01/21/2024] [Indexed: 02/21/2024] Open
Abstract
The morbidity of gestational diabetes mellitus (GDM) is increasing and is associated with adverse perinatal outcomes and long-term maternal and infant health. The exact mechanism underlying changes in plasma free fatty acid (FFA) profiles in patients with GDM is unknown. However, it is believed that changes in diet and lipid metabolism may play a role. Fatty acids contain many specific FFAs, and the type of FFA has different impacts on physiological processes; hence, determining changes in FFAs in individual plasma is essential. Alterations in FFA concentration or profile may facilitate insulin resistance. Additionally, some FFAs show potential to predict GDM in early pregnancy and are strongly associated with the growth and development of the fetus and occurrence of macrosomia. Here, we aimed to review changes in FFAs in women with GDM and discuss the relationship of FFAs with GDM incidence and adverse outcomes.
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Affiliation(s)
- Haoyi Du
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Danyang Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Laura Monjowa Molive
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Na Wu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China.
- Medical Department, Shengjing Hospital of China Medical University, Liaoning Province, Shenyang, People's Republic of China.
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Silveira JM, Ribeiro TS, Guilarducci MJ, Reis MG, Vieira RAL, Guimarães NS, Gomes JMG. Effect of fish-oil supplementation on the glycemic and lipidemic profiles of pregnant women: a systematic review and meta-analysis. Nutr Rev 2024:nuad158. [PMID: 38318725 DOI: 10.1093/nutrit/nuad158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Abstract
CONTEXT Pregnant women have physiological metabolic changes in glycemic and lipid profiles that are essential for fetal development. OBJECTIVE The aim of this systematic review was to analyze the effects of fish-oil-capsule supplementation on the glycemic and lipid profiles of pregnant women. DATA SOURCES A systematic search was conducted of the MEDLINE (by PubMed), Embase, Cochrane Library (CENTRAL) databases and gray literature, including preprints for all relevant studies published in English, with no date restrictions. DATA EXTRACTION The estimated pooled results were analyzed using a random-effects model and represented by mean differences (MDs) and corresponding 95% confidence intervals (CIs). The analyses were performed with R software, version 4.2.1, using the "Meta" packages, versions 6.0-0. DATA ANALYSIS Fifteen eligible studies were included after screening. In a pooled analysis, overall fish-oil supplementation had no effect on parameters compared with placebo. In the subgroup analysis, fish-oil supplementation may be beneficial in insulin (MD: -2.11 IU/mL; 95% CI: -3.86, -0.36) and homeostasis model assessment of insulin resistance (HOMA-IR) (MD: -0.71; 95% CI: -1.14, -0.29) indices, with heterogeneity (I2 =0%) among pregnant women with diabetes mellitus. In the subgroup with doses of eicosapentaenoic acid (EPA) below 200 mg, there was a reduction in HOMA-IR in the intervention group (MD: -0.60; 95% CI: -1.14, -0.06). CONCLUSION Pregnant women taking fish-oil capsules showed significant beneficial changes in the subgroups of type 2 diabetes and EPA dosages below 200 mg for insulin and HOMA-IR.
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Affiliation(s)
- Julie M Silveira
- Instituto Federal do Sudeste de Minas Gerais, Campus Barbacena, Brazil
| | - Thassia S Ribeiro
- Instituto Federal do Sudeste de Minas Gerais, Campus Barbacena, Brazil
| | | | | | | | - Nathalia S Guimarães
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
- Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Júnia M G Gomes
- Instituto Federal do Sudeste de Minas Gerais, Campus Barbacena, Brazil
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Jiang Y, Chen Y, Wei L, Zhang H, Zhang J, Zhou X, Zhu S, Du Y, Su R, Fang C, Ding W, Feng L. DHA supplementation and pregnancy complications. J Transl Med 2023; 21:394. [PMID: 37330569 PMCID: PMC10276458 DOI: 10.1186/s12967-023-04239-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/31/2023] [Indexed: 06/19/2023] Open
Abstract
Docosahexaenoic acid (DHA) supplementation is recommended for women during pregnancy because of its neurological, visual, and cognitive effects. Previous studies have suggested that DHA supplementation during pregnancy may prevent and treat certain pregnancy complications. However, there are contradictions in the current related studies, and the specific mechanism by which DHA acts remains unclear. This review summarizes the research on the relationship between DHA intake during pregnancy and preeclampsia, gestational diabetes mellitus, preterm birth, intrauterine growth restriction, and postpartum depression. Furthermore, we explore the impact of DHA intake during pregnancy on the prediction, prevention, and treatment of pregnancy complications as well as its impact on offspring neurodevelopment. Our results suggest that there is limited and controversial evidence for the protective effect of DHA intake on pregnancy complications, with the exception of preterm birth and gestational diabetes mellitus. However, additional DHA supplementation may improve long-term neurodevelopmental outcomes in the offspring of women with pregnancy complications.
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Affiliation(s)
- Yi Jiang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Yuting Chen
- Department of Obstetrics and Gynecology Ultrasound, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Lijie Wei
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Huiting Zhang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Jingyi Zhang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Xuan Zhou
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Shenglan Zhu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Yuanyuan Du
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Rui Su
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Chenyun Fang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China
| | - Wencheng Ding
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China.
| | - Ling Feng
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Avenue, Wuhan, 430030, Hubei, China.
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Ma S, Yin W, Wang P, Wang H, Zhang L, Tao R, Hu H, Jiang X, Zhang Y, Tao F, Zhu P. Effect of vitamin D supplementation on glucose control in mid-late gestation: A randomized controlled trial. Clin Nutr 2023; 42:929-936. [PMID: 37087832 DOI: 10.1016/j.clnu.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/07/2023] [Accepted: 04/11/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND & AIMS It is unclear whether vitamin D supplementation contributes to gestational glucose control and whether the specific effects vary in individuals with diverse genetic and metabolic contexts. The study aimed to assess the effect of vitamin D supplementation during pregnancy on subsequent glucose levels and to identify factors modulating the response to vitamin D3 intake. METHODS We conducted a multicenter randomized controlled trial, 1720 pregnant women recruited from the three antenatal clinics of Hefei city, China, who were allocated to receive either 1600 IU/d vitamin D3 (n = 858) or 400 IU/d vitamin D3 (n = 862) for 2 months at 24-28 weeks' gestation. Outcomes were changes in serum 25-hydroxyvitamin D (25(OH)D) and fasting plasma glucose (FPG) levels from baseline, 32-36 weeks' gestation to delivery (37-41 weeks) quantified using a linear mixed model. RESULTS After 2 months, FPG levels of the control group significantly increased by 0.22 mmol/L (from 4.6 [0.4] mmol/L to 4.8 [1.2] mmol/L, P < 0.001) at delivery, but that of the intervention group had no significant variation (from 4.6 [0.4] mmol/L to 4.7 [1.1] mmol/L; between-group difference in changes, -0.2 mmol/L, 95% CI, -0.3 to -0.08, P = 0.015). And differences in FPG variation were found in participants with the ApaI SNP CC genotype, or BsmI-CC, TaqI-AA, FokI-AA, respectively. Pregnant women with basal 25(OH)D concentrations higher than 50 nmol/L subgroup showed the greatest decline in FPG levels (between-group difference, -0.3 mmol/L; 95% CI, -0.5 to -0.1, P < 0.001). Moreover, pregnant women with GDM, multiple pregnancies or who were overweight were more likely to have FPG decline from vitamin D treatment. CONCLUSIONS Vitamin D supplementation significantly protected glucose homeostasis in mid-late gestation, and glycemic response to vitamin D may be dependent on basal 25(OH)D status, VDR gene polymorphism or their metabolic profiles. TRIAL REGISTRATION NUMBER ChiCTR2100051914. URL OF REGISTRATION: http://www.chictr.org.cn/showproj.aspx?proj=134700.
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Affiliation(s)
- Shuangshuang Ma
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China
| | - Wanjun Yin
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China; MOE Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China
| | - Peng Wang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China; MOE Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China
| | - Haixia Wang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China; MOE Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China
| | - Lei Zhang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China; MOE Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China
| | - Ruixue Tao
- Department of Obstetrics and Gynecology, Hefei First People's Hospital, No 390 Huai-he Road, Hefei, 230031, Anhui, China
| | - Honglin Hu
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, No 218 Ji-xi Road, Hefei, 230022, Anhui, China
| | - Xiaomin Jiang
- Department of Obstetrics and Gynecology, Anhui Women and Child Health Care Hospital, No 15 Yi-min Street, Hefei, 230001, Anhui, China
| | - Ying Zhang
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Anhui Medical University, No 218 Ji-xi Road, Hefei, 230022, Anhui, China
| | - Fangbiao Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China; MOE Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China
| | - Peng Zhu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China; MOE Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Mei-Shan Road, Hefei, Anhui, 230032, China.
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Mehdawi A, Mohammad BA, Mosleh I, Khader HA, Habash M, Nassar RI, Awwad S, Hasoun L, Abu-Samak MS. Combined Effect of Omega-3 Fatty Acid and Vitamin D 3 on Oxidized LDL-C and Non-HDL-C Levels in People With Vitamin D Deficiency: A Randomized Controlled Trial. J Cardiovasc Pharmacol 2023; 81:251-258. [PMID: 36630694 DOI: 10.1097/fjc.0000000000001398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023]
Abstract
ABSTRACT The present randomized clinical trial (RCT) was conducted on Jordanian participants with vitamin D deficiency (VDD) with no other medical conditions, to evaluate the combined effect of 1,25-dihydroxy vitamin D 3 (Vit.D 3 ) and omega-3 fatty acid (n-3FA) supplements (D+) on oxidized low-density lipoprotein (Ox-LDL) and non-high-density lipoprotein cholesterol (non-HDL-C) levels as common predictors of cardiovascular diseases (CVDs). Participants were randomized into 4 groups as follows: a control group (C) that received no supplementations, a Vit.D 3 group that received 50,000 IU of Vit.D 3 every week, an n-3FA group that received 300 mg of omega-3 fatty acid every day, and a D+ group that received a combination of both supplements, with the same dosage administered by the previous groups but with a 4-6-hour time interval between Vit.D 3 and n-3FA administration to avoid any possible interaction. All supplementations were administered orally for 8 weeks. Forty-seven participants were allocated to each group. Twenty-six in the control group, 37 participants in the Vit.D 3 group, 37 participants in the n-3FA group, and 46 participants in the D+ group completed the study to the end. The D+ supplementations significantly increased non-HDL-C (118.99 ± 60.98 to 155.26 ± 43.36 mg/dL, P << 0.05) but decreased Ox-LDL-C levels (69.29 ± 37.69 to 52.81 ± 17.30 pg/mL, P = 0.03). The stepwise regression showed that the serum LDL-C level was the main independent variable involved in the elevation of non-HDL levels (R 2 = 0.837) observed at the end of the trial in the D+ group. The groups that were supplemented with either Vit.D 3 alone or n-3FA alone had an insignificant decrease in the level of Ox-LDL-C. In conclusion, despite the observed hyperlipidemic effect, the combination treatment is recommended by the research team because the decrease in Ox-LDL may offset the hyperlipidemic effect.
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Affiliation(s)
- Amani Mehdawi
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Beisan A Mohammad
- Department of Pharmaceutical Sciences, Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia
| | - Ibrahim Mosleh
- Department of Medical Laboratory Sciences, University of Jordan, Amman, Jordan
| | - Heba A Khader
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, The Hashemite University,, Zarqa, Jordan
| | - Maha Habash
- Michael Sayegh Faculty of Pharmacy, Aqaba University of Technology, Aqaba, Jordan; and
| | - Razan I Nassar
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Shady Awwad
- Department of Pharmaceutical Chemistry & Pharmacognosy, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Luai Hasoun
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Mahmoud S Abu-Samak
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
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Liu W, Gao M, Yang S, Sun C, Bi Y, Li Y, Wang J, Yuan X. Effects of omega-3 supplementation on glucose and lipid metabolism in patients with gestational diabetes: A meta-analysis of randomized controlled trials. J Diabetes Complications 2023; 37:108451. [PMID: 36913875 DOI: 10.1016/j.jdiacomp.2023.108451] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/09/2023]
Abstract
AIM We assessed whether omega-3 supplementation could improve glucose and lipid metabolism, insulin resistance, and inflammatory factors in individuals with gestational diabetes mellitus (GDM). METHODS In this meta-study, we used a random-effects or fixed-effects meta-analysis model to analyze the mean differences (MD) and corresponding 95 % confidence intervals (CI) before and after omega-3 and placebo supplementation, thus evaluating the effects of omega-3 on glucose and lipid metabolism, insulin resistance, and inflammatory factors. RESULTS Six randomized controlled trials (331 participants) were included in the meta-analysis. The levels of fasting plasma glucose (FPG) (WMD = -0.25 mmol/L; 95 % CI: -0.38, -0.12), fasting insulin (WMD = -17.13 pmol/L; 95 % CI: -27.95, -6.30), and homeostasis model of assessment-insulin resistance (WMD = -0.51; 95 % CI: -0.89, -0.12) were lower in the omega-3 group compared to their levels in the placebo group. The results of the analysis of lipid metabolism showed that triglycerides (WMD = -0.18 mmol/L; 95 % CI: -0.29, -0.08) and very low-density lipoprotein cholesterol (WMD = -0.1 mmol/L; 95 % CI: -0.16, -0.03) decreased in the omega-3 group, while high-density lipoproteins (WMD = 0.06 mmol/L; 95 % CI: 0.02, 0.10) increased. Compared to the placebo group, inflammatory factor serum C-reactive protein (SMD = -0.68 mmol/L; 95 % CI: -0.96, -0.39) decreased in the omega-3 group. CONCLUSION Omega-3 supplementation can decrease the levels of FPG and inflammatory factors, enhance blood lipid metabolism, and reduce insulin resistance in patients with GDM.
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Affiliation(s)
- Weixia Liu
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, Jilin, China
| | - Menghan Gao
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, Jilin, China
| | - Shuo Yang
- Department of Clinical Nutrition, First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, Jilin, China
| | - Chenglin Sun
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, Jilin, China; Department of Clinical Nutrition, First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, Jilin, China
| | - Yaru Bi
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, Jilin, China
| | - Yuting Li
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, Jilin, China
| | - Jiping Wang
- Department of Clinical Nutrition, First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, Jilin, China.
| | - Xiaojie Yuan
- Department of Clinical Nutrition, First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, Jilin, China.
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Wu C, Song Y, Wang X. Vitamin D Supplementation for the Outcomes of Patients with Gestational Diabetes Mellitus and Neonates: A Meta-Analysis and Systematic Review. Int J Clin Pract 2023; 2023:1907222. [PMID: 36713951 PMCID: PMC9867594 DOI: 10.1155/2023/1907222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/29/2022] [Accepted: 09/07/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Prevention and timely treatment of gestational diabetes mellitus (GDM) are important to the prognosis of pregnant women and neonates. We aimed to conduct a meta-analysis to evaluate the effects and safety of vitamin D supplementation on GDM patients and neonates, to provide insights into clinical GDM treatment. METHODS Two authors searched the Medline, PubMed, Cochrane Library, Web of Science, Embase, CNKI, and Wanfang databases for randomized controlled trials (RCTs) on the effects and safety of vitamin D supplementation in GDM patients. The quality of the included RCTs was evaluated according to Cochrane handbook. RevMan 5.3 software was used for statistical analysis. RESULTS A total of 20 RCTs involving 1682 GDM patients were finally included, of whom 837 received vitamin D supplementation. Vitamin D supplementation in GDM patients increased the serum 25(OH)D level (SMD = 4.07, 95% CI: (2.73, 5.41)) and HDL level (SMD = 0.41, 95% CI: (0.23, 0.58)) and reduced serum LDL (SMD = -0.49, 95% CI: (-0.68, -0.29)), TG (SMD = -0.59, 95% CI: (-1.01, -0.17)), and TC (SMD = -0.67, 95% CI: (-1.19, -0.14)) levels in GDM patients (all P < 0.05). Besides, vitamin D supplementation reduced the risk of premature birth (OR = 0.37, 95% CI: (0.22, 0.62)), hyperbilirubinemia (OR = 0.38, 95% CI: (0.25, 0.58)), and neonatal hospitalization (OR = 0.38, 95% CI: (0.25, 0.58)) of neonates (all P < 0.05). No significant publication bias in synthesized results was found (all P > 0.05). CONCLUSIONS Vitamin D supplementation improves the blood lipid level in GDM patients and reduces adverse neonatal outcomes. The dose and duration of vitamin D supplementation for safety need to be further investigated in future high-quality studies.
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Affiliation(s)
- Chunfeng Wu
- Department of Obstetrics, Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen 51800, China
| | - Yang Song
- Department of Obstetrics, Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen 51800, China
| | - Xueying Wang
- Department of Obstetrics, Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen 51800, China
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Shaikh SR, Virk R, Van Dyke TE. Potential Mechanisms by Which Hydroxyeicosapentaenoic Acids Regulate Glucose Homeostasis in Obesity. Adv Nutr 2022; 13:2316-2328. [PMID: 35709423 PMCID: PMC9776734 DOI: 10.1093/advances/nmac073] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/16/2022] [Accepted: 06/13/2022] [Indexed: 01/29/2023] Open
Abstract
Dysregulation of glucose metabolism in response to diet-induced obesity contributes toward numerous complications, such as insulin resistance and hepatic steatosis. Therefore, there is a need to develop effective strategies to improve glucose homeostasis. In this review, we first discuss emerging evidence from epidemiological studies and rodent experiments that increased consumption of EPA (either as oily fish, or dietary/pharmacological supplements) may have a role in preventing impairments in insulin and glucose homeostasis. We then review the current evidence on how EPA-derived metabolites known as hydroxyeicosapentaenoic acids (HEPEs) may be a major mode of action by which EPA exerts its beneficial effects on glucose and lipid metabolism. Notably, cell culture and rodent studies show that HEPEs prevent fat accumulation in metabolic tissues through peroxisome proliferator activated receptor (PPAR)-mediated mechanisms. In addition, activation of the resolvin E1 pathway, either by administration of EPA in the diet or via intraperitoneal administration of resolvin E1, improves hyperglycemia, hyperinsulinemia, and liver steatosis through multiple mechanisms. These mechanisms include shifting immune cell phenotypes toward resolution of inflammation and preventing dysbiosis of the gut microbiome. Finally, we present the next steps for this line of research that will drive future precision randomized clinical trials with EPA and its downstream metabolites. These include dissecting the variables that drive heterogeneity in the response to EPA, such as the baseline microbiome profile and fatty acid status, circadian rhythm, genetic variation, sex, and age. In addition, there is a critical need to further investigate mechanisms of action for HEPEs and to establish the concentration of HEPEs in differing tissues, particularly in response to consumption of oily fish and EPA-enriched supplements.
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Affiliation(s)
- Saame Raza Shaikh
- Department of Nutrition, Gillings School of Global Public Health and School
of Medicine, The University of North Carolina at Chapel Hill, Chapel
Hill, NC, USA
| | - Rafia Virk
- Department of Nutrition, Gillings School of Global Public Health and School
of Medicine, The University of North Carolina at Chapel Hill, Chapel
Hill, NC, USA
| | - Thomas E Van Dyke
- Center for Clinical and Translational Research, The Forsyth
Institute, Cambridge, MA, USA
- Department of Oral Medicine, Infection, and Immunity, Harvard School of
Dental Medicine, Harvard Medical School, Boston, MA, USA
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10
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Fuller H, Iles M, Moore JB, Zulyniak MA. Unique Metabolic Profiles Associate with Gestational Diabetes and Ethnicity in Low- and High-Risk Women Living in the UK. J Nutr 2022; 152:2186-2197. [PMID: 35883228 PMCID: PMC9535440 DOI: 10.1093/jn/nxac163] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/28/2022] [Accepted: 07/20/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is the most common global pregnancy complication; however, prevalence varies substantially between ethnicities, with South Asians (SAs) experiencing up to 3 times the risk of the disease compared with white Europeans (WEs). Factors driving this discrepancy are unclear, although the metabolome is of great interest as GDM is known to be characterized by metabolic dysregulation. OBJECTIVES The primary aim was to characterize and compare the metabolic profiles of GDM in SA and WE women (at <28 wk of gestation) from the Born in Bradford (BIB) prospective birth cohort in the United Kingdom. METHODS In total, 146 fasting serum metabolites, from 2,668 pregnant WE and 2,671 pregnant SA women (average BMI 26.2 kg/m2, average age 27.3 y) were analyzed using partial least squares discriminatory analyses to characterize GDM status. Linear associations between metabolite values and post-oral glucose tolerance test measures of dysglycemia (fasting glucose and 2 h postglucose) were also examined. RESULTS Seven metabolites associated with GDM status in both ethnicities (variable importance in projection ≥1), whereas 6 additional metabolites associated with GDM only in WE women. Unique metabolic profiles were observed in healthy-weight women who later developed GDM, with distinct metabolite patterns identified by ethnicity and BMI status. Of the metabolite values analyzed in relation to dysglycemia, lactate, histidine, apolipoprotein A1, HDL cholesterol, and HDL2 cholesterol associated with decreased glucose concentration, whereas DHA and the diameter of very low-density lipoprotein particles (nm) associated with increased glucose concertation in WE women, and in SAs, albumin alone associated with decreased glucose concentration. CONCLUSIONS This study shows that the metabolic risk profile for GDM differs between WE and SA women enrolled in BiB in the United Kingdom. This suggests that etiology of the disease differs between ethnic groups and that ethnic-appropriate prevention strategies may be beneficial.
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Affiliation(s)
- Harriett Fuller
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Mark Iles
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| | - J Bernadette Moore
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Michael A Zulyniak
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
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11
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Saha S, Saha S. Participant attrition and perinatal outcomes in prenatal vitamin D-supplemented gestational diabetes mellitus patients in Asia: A meta-analysis. World J Methodol 2022; 12:164-178. [PMID: 35721245 PMCID: PMC9157628 DOI: 10.5662/wjm.v12.i3.164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/20/2022] [Accepted: 03/27/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The role of vitamin D supplementation in gestational diabetes mellitus (GDM) patients is unclear.
AIM To determine the burden and risk of post-randomization GDM patient attrition from vitamin D-supplemented arms of randomized controlled trials (RCTs). The auxiliary aim was to compare the effects of nutritional supplements on their fasting blood glucose (FPG) levels and perinatal outcomes.
METHODS RCTs were searched in the PubMed, Embase, and Scopus databases. Random-effect prevalence and pairwise meta-analysis were performed for the primary objective. The auxiliary aim was to compare the effects of nutritional supplements on their fasting blood glucose (FPG) levels and perinatal outcomes. Fixed-effect network meta-analyses were undertaken for the secondary goals. All analyses were performed using Stata software, and statistical significance was determined at P < 0.05.
RESULTS Thirteen RCTs from Iran and China were reviewed. The participant attrition burden in vitamin D recipients was 6% [95% confidence interval (CI): 0.03, 0.10], and its risk did not vary from non-recipients. Vitamin D and calcium co-supplementation reduced the cesarean section incidence in GDM patients [risk ratio (RR): 0.37; 95%CI: 0.18, 0.74]. The hyperbilirubinemia or hospitalization risk in their newborns decreased with vitamin D supplementation (RR: 0.47; 95%CI: 0.27, 0.83) and co-supplementation with calcium (RR: 0.35; 95%CI: 0.16, 0.77) or omega-3 fatty acids (RR: 0.25; 95%CI: 0.08, 0.77). Vitamin D and probiotics co-supplementation decreased newborn hyperbilirubinemia risk (RR: 0.28; 95%CI: 0.09, 0.91). FPG levels and macrosomia risk did not vary across interventions.
CONCLUSION In RCTs, vitamin D supplementation or co-supplementation in GDM patients showed a low participant attrition burden and low risk of cesarean section, newborn hyperbilirubinemia, and newborn hospitalization.
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Affiliation(s)
- Sumanta Saha
- Department of Community Medicine, R. G. Kar Medical College, Kolkata 700004, West Bengal, India
| | - Sujata Saha
- Department of Mathematics, Mankar College, Mankar 713144, West Bengal, India
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12
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Saha S, Saha S. The effects of prenatal dietary supplements on blood glucose and lipid metabolism in gestational diabetes mellitus patients: A systematic review and network meta-analysis protocol of randomized controlled trials. PLoS One 2022; 17:e0267854. [PMID: 35503790 PMCID: PMC9064104 DOI: 10.1371/journal.pone.0267854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 04/16/2022] [Indexed: 12/12/2022] Open
Abstract
Background Several randomized controlled trials (RCT) investigated antenatal dietary supplements’ effect on gestational diabetes mellitus patients’ fasting plasma glucose levels, glycated hemoglobin levels, homeostasis model assessment of- insulin resistance and β-cell function, quantitative insulin sensitivity check index for glucose, high-, low-, and very-low-density lipoprotein cholesterol levels, total cholesterol levels, triglyceride levels, and triglyceride to high-density lipoprotein ratio. However, an efficacy comparison across various dietary supplements and their co-supplements are unavailable for these outcomes. Therefore, a systematic review protocol is proposed here to make a network meta-analysis (NMA)-based juxtaposition across the following dietary supplements- vitamins, Myo-inositol, choline, minerals, probiotics, prebiotics, synbiotics, and omega-3 fatty acids. Materials and methods A database search will ensue in the PubMed, Embase, and Scopus databases for RCTs testing the above, irrespective of their geographical origin. Data on population characteristics, compared interventions, and outcomes of interest will get abstracted from the studies included in the proposed review. Each of the reviewed studies will get appraised using the revised Cochrane tool. For each outcome, the comparative efficacy across interventions will be estimated in weighted or standardized mean difference using the frequentist method NMA and presented with their 95% confidence interval using league tables. By constructing network maps and comparison-adjusted funnel plots, a visual assessment of the inter-interventional relation and publication bias in each NMA model will happen, respectively. The best-ranked intervention prediction for respective outcomes will transpire using the surface under the cumulative ranking curve values. The Stata statistical software (version 16) will be used for analysis, and statistical significance will be determined at p<0.05 and 95% confidence interval. Trial registration PROSPERO registration number:CRD42020214378.
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Affiliation(s)
- Sumanta Saha
- Department of Community Medicine, R. G. Kar Medical College, Kolkata, West Bengal, India
- * E-mail:
| | - Sujata Saha
- Department of Mathematics, Mankar College, Mankar, West Bengal, India
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13
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Ibrahim I, Bashir M, Singh P, Al Khodor S, Abdullahi H. The Impact of Nutritional Supplementation During Pregnancy on the Incidence of Gestational Diabetes and Glycaemia Control. Front Nutr 2022; 9:867099. [PMID: 35464031 PMCID: PMC9024356 DOI: 10.3389/fnut.2022.867099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/18/2022] [Indexed: 11/13/2022] Open
Abstract
The nutritional state before and throughout pregnancy has a critical impact on the women's health and the baby's development and growth. The release of placental hormones during pregnancy induces/ increases maternal insulin resistance and promotes nutrition utilization by the fetus. Gestational Diabetes Mellitus (GDM) is the most common medical complication in pregnancy and is associated with significant maternal and fetal morbidity. Several studies have examined the effect of physical activity, healthy eating, and various food supplements on the risk of developing gestational diabetes (GDM) and related outcomes. Among those, Myo-Inositol supplementation has shown encouraging results in the prevention of GDM. Maternal vitamin D deficiency has been associated with an elevated risk of GDM, and supplementation can improve glucose haemostasis by lowering fasting blood glucose, HbA1c, and serum insulin concentration. Probiotics modulate the gut microbiota leading to an improved glucose and lipid metabolism, which is proposed to reduce the risk of GDM. We aim to review the strength and limitation of the current evidence for using some nutritional supplements either as single agents or in combinations on the risk of developing GDM and on glycaemic control.
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Affiliation(s)
- Ibrahim Ibrahim
- Sidra Medicine, Weill Cornell Medical College-Qatar, Doha, Qatar
| | - Mohammed Bashir
- Endocrine Department, Hamad Medical Corporation, Doha, Qatar
| | - Parul Singh
- Research Department, Sidra Medicine, Doha, Qatar
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | | | - Hala Abdullahi
- Sidra Medicine, Weill Cornell Medical College-Qatar, Doha, Qatar
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14
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Beneficial effects of eicosapentaenoic acid on the metabolic profile of obese female mice entails upregulation of HEPEs and increased abundance of enteric Akkermansia muciniphila. Biochim Biophys Acta Mol Cell Biol Lipids 2022; 1867:159059. [PMID: 34619367 PMCID: PMC8627244 DOI: 10.1016/j.bbalip.2021.159059] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 08/30/2021] [Accepted: 09/24/2021] [Indexed: 01/03/2023]
Abstract
Eicosapentaenoic acid (EPA) ethyl esters are of interest given their clinical approval for lowering circulating triglycerides and cardiometabolic disease risk. EPA ethyl esters prevent metabolic complications driven by a high fat diet in male mice; however, their impact on female mice is less studied. Herein, we first investigated how EPA influences the metabolic profile of female C57BL/6J mice consuming a high fat diet. EPA lowered murine fat mass accumulation, potentially through increased biosynthesis of 8-hydroxyeicosapentaenoic acid (HEPE), as revealed by mass spectrometry and cell culture studies. EPA also reversed the effects of a high fat diet on circulating levels of insulin, glucose, and select inflammatory/metabolic markers. Next, we studied if the improved metabolic profile of obese mice consuming EPA was associated with a reduction in the abundance of key gut Gram-negative bacteria that contribute toward impaired glucose metabolism. Using fecal 16S-ribosomal RNA gene sequencing, we found EPA restructured the gut microbiota in a time-dependent manner but did not lower the levels of key Gram-negative bacteria. Interestingly, EPA robustly increased the abundance of the Gram-negative Akkermansia muciniphila, which controls glucose homeostasis. Finally, predictive functional profiling of microbial communities revealed EPA-mediated reversal of high fat diet-associated changes in a wide range of genes related to pathways such as Th-17 cell differentiation and PI3K-Akt signaling. Collectively, these results show that EPA ethyl esters prevent some of the deleterious effects of a high fat diet in female mice, which may be mediated mechanistically through 8-HEPE and the upregulation of intestinal Akkermansia muciniphila.
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15
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Rajabi-Naeeni M, Dolatian M, Qorbani M, Vaezi AA. Effect of omega-3 and vitamin D co-supplementation on psychological distress in reproductive-aged women with pre-diabetes and hypovitaminosis D: A randomized controlled trial. Brain Behav 2021; 11:e2342. [PMID: 34473420 PMCID: PMC8613419 DOI: 10.1002/brb3.2342] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Psychological distresses and pre-diabetes are among the risk factors of developing type-II diabetes. The present study was conducted to determine the effectiveness of omega-3 and vitamin D co-supplementation on psychological distresses in women of reproductive age with pre-diabetes and hypovitaminosis D. METHODS The present factorial clinical trial was conducted on 168 women of reproductive age with pre-diabetes and hypovitaminosis D. These participants were selected by stratified random sampling and were assigned to four groups for 8 weeks: group 1 (placebo group), group 2 (omega-3 group), group 3 (vitamin D group), and group 4 (co-supplement group). The medication and placebo doses being two 1000-mg tablets each day for omega-3 and 50,000-IU pearls every 2 weeks for vitamin D. Fasting blood glucose and vitamin D were measured at the beginning of the study. The Depression Anxiety Stress Scale-21 and the Pittsburgh Sleep Quality Index were completed by the participants at the start and end of the intervention. RESULTS A significant difference was observed in terms of reduction in anxiety and improvement in sleep quality in the co-supplementation compared to the other three groups (p < .05). There was also a significant difference between the group receiving both supplements and the group receiving only placebos in terms of reduction in depression and stress (p < .05). CONCLUSION Vitamin D and omega-3 co-supplementation improved depression, anxiety, and sleep quality in women of reproductive age with pre-diabetes and hypovitaminosis D. Therefore, these two supplements can be recommended for improving the mental health of this group of women. CLINICAL TRIAL REGISTRY Iranian Registry of Clinical Trials Code: IRCT20100130003226N17. Registered on February 9, 2019.
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Affiliation(s)
- Masoumeh Rajabi-Naeeni
- Department of Midwifery and Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahrokh Dolatian
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Abbas Vaezi
- Department of Internal Medicine, School of Medicine Alborz University of Medical Sciences, Karaj, Iran
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16
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Barham A, Mohammad B, Hasoun L, Awwad S, Mosleh I, Aljaberi A, Abu-Samak M. The combination of omega-3 fatty acids with high doses of vitamin D3 elevate A1c levels: A randomized Clinical Trial in people with vitamin D deficiency. Int J Clin Pract 2021; 75:e14779. [PMID: 34482574 DOI: 10.1111/ijcp.14779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 08/30/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This randomised clinical trial (RCT) was created to assess the influence of 1,25-dihydroxyvitamin D (VD3 ), omega-3 fatty acids (n-3FA) and their combination (D+) on glycated haemoglobin (A1c) levels in Jordanian peoples with vitamin D deficiency (VDD). PARTICIPANTS AND METHODS This RCT was designed to examine the follow-up (2 months) effect of either 50 000 IU VD3 , 300 mg n-3FA, or the combination of the two supplements on glycated Haemoglobin (A1c) levels in 146 Jordanian women and men with VDD, aged from 25 to 55 years. The eligible participants were randomised into four groups: Control (C); VD3 supplementation (50 000 IU of VD3 was taken weekly) (D3 ); n-3FA supplementation (300 mg of omega-3FA was taken daily) (n-3FA); VD3 and omega-3 supplementation group (D+) with the same protocol as the previous two groups. RESULTS The combination therapy (n-3FA plus VD3) for 8 weeks significantly increased A1c levels (5.79 ± 0.34 vs 5.41 ± 0.33, P < .001). Tukey test for post hoc comparisons of A1c at follow-up showed that the A1c mean levels were remarkably higher in the D+ study group comparing to the control group (5.78 vs 5.38). CONCLUSION The intervention of n-3FA alone or in combination with high doses of VD3 may lead to negative effects on glycaemic control or accelerate the insulin resistance's development in susceptible people for diabetes mellitus (type 2).
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Affiliation(s)
- Abeer Barham
- Department of Clinical Pharmacy and Therapeutics, Applied Science Private University, Amman, Jordan
| | - Beisan Mohammad
- Pharmaceutical Sciences Department, Fakeeh College for Medical Sciences, Jeddah, Kingdom of Saudi Arabia
| | - Luai Hasoun
- Department of Clinical Pharmacy and Therapeutics, Applied Science Private University, Amman, Jordan
| | - Shady Awwad
- Department of Pharmaceutical Chemistry & Pharmacognosy, Applied Science Private University, Amman, Jordan
| | - Ibrahim Mosleh
- Department of Clinical Laboratory Sciences, University of Jordan, Amman, Jordan
| | - Ahmad Aljaberi
- Department of Pharmaceutical Sciences and Pharmaceutics, Applied Science Private University, Amman, Jordan
| | - Mahmoud Abu-Samak
- Department of Clinical Pharmacy and Therapeutics, Applied Science Private University, Amman, Jordan
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17
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Mechanisms Involved in the Relationship between Vitamin D and Insulin Resistance: Impact on Clinical Practice. Nutrients 2021; 13:nu13103491. [PMID: 34684492 PMCID: PMC8539968 DOI: 10.3390/nu13103491] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/25/2021] [Accepted: 09/29/2021] [Indexed: 12/29/2022] Open
Abstract
Recent evidence has revealed anti-inflammatory properties of vitamin D as well as extra-skeletal activity. In this context, vitamin D seems to be involved in infections, autoimmune diseases, cardiometabolic diseases, and cancer development. In recent years, the relationship between vitamin D and insulin resistance has been a topic of growing interest. Low 25-hydroxyvitamin D (25(OH)D) levels appear to be associated with most of the insulin resistance disorders described to date. In fact, vitamin D deficiency may be one of the factors accelerating the development of insulin resistance. Vitamin D deficiency is a common problem in the population and may be associated with the pathogenesis of diseases related to insulin resistance, such as obesity, diabetes, metabolic syndrome (MS) and polycystic ovary syndrome (PCOS). An important question is the identification of 25(OH)D levels capable of generating an effect on insulin resistance, glucose metabolism and to decrease the risk of developing insulin resistance related disorders. The benefits of 25(OH)D supplementation/repletion on bone health are well known, and although there is a biological plausibility linking the status of vitamin D and insulin resistance supported by basic and clinical research findings, well-designed randomized clinical trials as well as basic research are necessary to know the molecular pathways involved in this association.
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18
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Mei Z, Chen GC, Hu J, Lin C, Sun Z, Liu C, Geng X, Yuan C, Qi Q, Zheng Y. Habitual use of fish oil supplements, genetic predisposition, and risk of fractures: a large population-based study. Am J Clin Nutr 2021; 114:945-954. [PMID: 34038933 DOI: 10.1093/ajcn/nqab157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 04/14/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Epidemiologic studies have suggested an inverse association between circulating concentrations of long-chain ω-3 PUFAs and fracture risk. However, whether supplementation of long-chain ω-3 PUFA (i.e. fish oil) is associated with fracture risk, and whether the association is modified by genetic predisposition to fracture risk remain unclear. OBJECTIVES To evaluate the associations of habitual fish oil supplement use with fracture risk, and to explore the potential effect modification by genetic predisposition. METHODS This study included 492,713 participants from the UK Biobank who completed a questionnaire on habitual fish oil supplement use between 2006 and 2010. HRs and 95% CIs for fractures were estimated from multivariable Cox proportional hazards models. A weighted fracture-genetic risk score (GRS) was derived from 14 validated single nucleotide polymorphisms. RESULTS During a median follow-up of 8.1 y, 12,070 incident fractures occurred among participants free of fracture at baseline (n = 441,756). Compared with nonuse, habitual use of fish oil supplements was associated with a lower risk of total fractures (HR = 0.93; 95% CI: 0.89, 0.97), hip fractures (HR = 0.83; 95% CI: 0.75, 0.92), and vertebrae fractures (HR = 0.85; 95% CI: 0.72, 0.99). The inverse association for total fractures was more pronounced among participants having a higher fracture-GRS than among those with a lower fracture-GRS (P-interaction <0.001). Among participants with a history of fracture at baseline (n = 50,957), fish oil use was associated with a lower risk of total recurrent fractures (HR = 0.88; 95% CI: 0.82, 0.96) and vertebrae recurrent fractures (HR = 0.64; 95% CI: 0.46, 0.88) but not with hip fracture recurrence. CONCLUSIONS Our findings suggest that habitual fish oil supplement use is associated with lower risks of both incident and recurrent fractures. The inverse associations of fish oil use with total fractures appeared to be more pronounced among individuals at higher genetic risk of fractures than those with lower genetic risk.
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Affiliation(s)
- Zhendong Mei
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China
| | - Guo-Chong Chen
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jianying Hu
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China
| | - Chenhao Lin
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China
| | - Zhonghan Sun
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China
| | - Chenglin Liu
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China
| | - Xin Geng
- Beijing Genomics Institute-Shenzhen, Shenzhen, China
| | - Changzheng Yuan
- Department of Big Data and Health Science, School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Qibin Qi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yan Zheng
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China.,Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.,Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
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19
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Saha S, Saha S. Changes in anthropometric and blood 25-hydroxyvitamin D measurements in antenatal vitamin supplemented gestational diabetes mellitus patients: a systematic review and meta-analysis of randomized controlled trials. J Turk Ger Gynecol Assoc 2021; 22:217-234. [PMID: 33663196 PMCID: PMC8420744 DOI: 10.4274/jtgga.galenos.2021.2020.0197] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective: Gestation weight (GW), body mass index (BMI), and blood 25-hydroxyvitamin D [25(OH)D] level during pregnancy are important determinants of the gestational outcomes. This study aimed to study how these parameters vary between antenatal vitamin D recipients and non-recipients in gestational diabetes mellitus (GDM) patients. Material and Methods: The randomized controlled trials comparing these outcomes between vitamin D recipient and non-recipient GDM patients were searched in electronic databases (PubMed, Embase, and Scopus). The reviewed studies’ data were abstracted and critically appraised using the Cochrane tool. The estimation of the weighted mean difference for GW and BMI and standardized mean difference (SMD) for 25(OH)D levels occurred by juxtaposing the interventions meta-analytically (random-effect model). The statistical inconsistency was determined by Chi2 and I2 method. The statistical significance was estimated at p<0.05 and 95% confidence interval (CI). Results: Eleven eligible trials (all Iran-based, except one), sourcing data from about 875 GDM patients, were reviewed. Overall, the risk of bias was low, except for selection and performance bias. On random-effect model meta-analysis, the 25(OH)D levels of the GDM patients favored the vitamin D recipients when compared to non-vitamin D (SMD 1.97, 95% CI: 1.06-2.88, p<0.001; I2 96.2%, p of Chi2 <0.001) and placebo (SMD 1.86, 95% CI: 0.95-2.77, p<0.001; I2 95.3%, p of Chi2 <0.001) recipients, respectively. On meta-regression, sample size was a predictor of the observed heterogeneity. For GW and BMI the interventions did not differ statistically significantly. Conclusion: In GDM patients, antenatal use of vitamin D aids in the rise of blood 25(OH)D levels. However, vitamin D supplementation did not affect change in GW or BMI.
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Zhuang Z, Yu C, Guo Y, Bian Z, Yang L, Millwood IY, Walters RG, Chen Y, Xu Q, Zou M, Chen J, Chen Z, Lv J, Huang T, Li L. Metabolic Signatures of Genetically Elevated Vitamin D Among Chinese: Observational and Mendelian Randomization Study. J Clin Endocrinol Metab 2021; 106:e3249-e3260. [PMID: 33596318 PMCID: PMC7612493 DOI: 10.1210/clinem/dgab097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Observational studies have suggested that higher circulating 25-hydroxyvitamin D [25(OH)D] levels are associated with favorable serum lipids and related metabolites. However, whether such observations reflect causality remains unclear. OBJECTIVE We aimed to investigate the causal effect of elevated 25(OH)D with a detailed systemic metabolite profile in Chinese adults. METHODS A total of 225 lipid and other metabolites were quantified in 4662 individuals in the China Kadoorie Biobank. Instrumental variable analyses were performed to test the causal associations of plasma 25(OH)D with lipids and metabolites. RESULTS Higher plasma 25(OH)D was related to favorable lipid profiles in observational analyses. The genetic risk score was robustly correlated with observed 25(OH)D (beta[SE] = 3.54 [0.32]; P < 1 × 10-5, F-statistic = 122.3) and explained 8.4% of the variation in 25(OH)D in the Chinese population. For all individual metabolites, the causal estimates were not significant at the threshold P < 5 × 10-4 (multiple testing corrected). However, a Mendelian randomization (MR) estimate showed that per 1-SD increase in genetically determined 25(OH)D was suggestive of association with decreased levels of cholesterol, lipoprotein particles, and phospholipids within very small very low-density lipoprotein (VLDL) and intermediate-density lipoprotein (IDL) (P ≤ 0.05, nominal significance). For amino acids, fatty acids, ketone bodies, glycoprotein acetyls, fatty acids, and other traits, we did not observe any significant causal association. CONCLUSIONS The MR analysis of metabolic data based a population-based cohort suggested a potential causal association of plasma 25(OH)D with cholesterol, lipoprotein particle, phospholipid concentrations, and total lipids within very small VLDL and IDL. Our findings highlight a long-term effect of 25(OH)D levels in maintaining healthy lipid metabolism.
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Affiliation(s)
- Zhenhuang Zhuang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Ling Yang
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Iona Y. Millwood
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Robin G. Walters
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Yiping Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Qinai Xu
- NCDs Prevention and Control Department, Nangang CDC, Harbin, China
| | | | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
- Peking University Institute of Environmental Medicine, Beijing, China
- Corresponding authors: Liming Li, MD, MPH, Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China, Phone: 86-10-82801528, ; Jun Lv, PhD, Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China, Phone: 86-10-82801528, ; Tao Huang, PhD, Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China, Phone: 86-10-82801528,
| | - Tao Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
- Corresponding authors: Liming Li, MD, MPH, Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China, Phone: 86-10-82801528, ; Jun Lv, PhD, Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China, Phone: 86-10-82801528, ; Tao Huang, PhD, Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China, Phone: 86-10-82801528,
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Corresponding authors: Liming Li, MD, MPH, Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China, Phone: 86-10-82801528, ; Jun Lv, PhD, Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China, Phone: 86-10-82801528, ; Tao Huang, PhD, Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China, Phone: 86-10-82801528,
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21
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He L, Xue Z, Liu Y, Chen R, Zhou S. Effects of vitamin and omega-3 fatty acid co-supplementation on blood glucose in women with gestational diabetes mellitus: A protocol for systematic review and meta analysis. Medicine (Baltimore) 2021; 100:e26106. [PMID: 34032751 PMCID: PMC8154375 DOI: 10.1097/md.0000000000026106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND There is limited study that has conducted a review investigating the clinical effects of vitamin and omega-3 fatty acid co-supplementation on blood glucose in women with gestational diabetes mellitus (GDM). Therefore, in order to provide new evidence-based medical evidence for clinical treatment, we undertook a systematic review and meta-analysis to assess the effectiveness and safety of vitamin and omega-3 fatty acid co-supplementation on blood glucose in women with GDM. METHODS This protocol was written following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement guidelines. We will conduct systematic reviews and meta-analyses to identify relevant randomized controlled trials (RCTs) involving vitamin and omega-3 fatty acid co-supplementation on GDM in electronic databases including PubMed, Web of Science, Embase, and the Cochrane Library up to June 2021. Exclusion criteria include observational studies, non-RCTs, review articles, studies with a sample size <50, and studies with insufficient outcome data. The primary outcomes include fasting glucose and insulin. Secondary outcomes are evaluated in a homeostasis model of insulin resistance, total antioxidant capacity, triglycerides, total cholesterol, low-density lipoprotein cholesterol, preterm birth and macrosomia over 4 kg. RESULTS The review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings. REGISTRATION NUMBER 10.17605/OSF.IO/NSW54.
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Affiliation(s)
- Lei He
- Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan University, Chengdu
- Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Zhiwei Xue
- Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan University, Chengdu
| | - Yijun Liu
- Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan University, Chengdu
| | - Ruixin Chen
- Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan University, Chengdu
| | - Shu Zhou
- Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan University, Chengdu
- Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
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22
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Garmendia ML, Casanello P, Flores M, Kusanovic JP, Uauy R. The effects of a combined intervention (docosahexaenoic acid supplementation and home-based dietary counseling) on metabolic control in obese and overweight pregnant women: the MIGHT study. Am J Obstet Gynecol 2021; 224:526.e1-526.e25. [PMID: 33152314 DOI: 10.1016/j.ajog.2020.10.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Lifestyle interventions have shown limited effectiveness in the prevention of gestational diabetes mellitus. The combination of lifestyle interventions with omega-3 polyunsaturated fatty acid supplementation could have a synergetic effect on maternal and offspring outcomes. OBJECTIVE We evaluated the effects of docosahexaenoic acid supplementation among obese and overweight pregnant women (independently or combined with a dietary counseling intervention) on metabolic control in mothers and their offspring. STUDY DESIGN This study was a randomized controlled trial with a 2×2 factorial design. The following inclusion criteria were used: <15 weeks of gestation; body mass index ≥25 kg/m2 at the first prenatal visit; singleton pregnancy; and 18 years of age or older. The recruited women (n=1002) were randomly allocated to 1 of the 4 parallel groups: Group 1: dietary counseling plus 800 mg/day of docosahexaenoic acid (n=250); Group 2: routine counseling plus 800 mg/day docosahexaenoic acid (n=252); Group 3: dietary counseling plus 200 mg/day docosahexaenoic acid (n=249); and Group 4: routine counseling plus 200 mg/day docosahexaenoic acid (n=251), considered as the reference group. The dietary intervention comprised 3 sessions, and it was focused on reducing the consumption of foods that most contributed to daily sugar intake. Primary outcomes were gestational diabetes mellitus defined according to the national guidelines; macrosomia (birthweight >4000 g); and neonatal insulin resistance (cord blood Homeostasis Model Assessment for Insulin Resistance ≥2.60), which was assessed in a subsample of 226 newborns. The analysis was by intention to treat and by efficacy. The trial was registered on ClinicalTrials.gov (NCT02574767). RESULTS The overall incidence of gestational diabetes mellitus was 20.2% (Group 1, 21.0%; Group 2, 20.1%; Group 3, 18.9%; and Group 4, 20.9%). Mean birthweight was 3403.0 g (standard deviation, 575.3), and the incidence of macrosomia was 11.9% (Group 1, 13.2%; Group 2, 10.8%; Group 3, 11.5%; and Group 4, 12.1%). Median cord blood Homeostasis Model Assessment for Insulin Resistance was 0.9 (interquartile range, 0.6-1.7), and 10.2% showed cord blood insulin resistance (Group 1, 12.0%; Group 2, 12.0%; Group 3, 9.7%; and Group 4, 5.1%). No significant differences were found among groups regarding primary outcomes (P<.05). Glucose concentrations in the cord blood samples were lower in those adherents to the docosahexaenoic acid supplementation (P<.05). CONCLUSION For women who were overweight or obese at the beginning of pregnancy, this combined intervention did not reduce the risk of gestational diabetes in mothers or macrosomia and insulin resistance in neonates.
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23
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Omega-3 fatty acids reduce cardiometabolic risk in first-episode schizophrenia patients treated with antipsychotics: Findings from the OFFER randomized controlled study. Schizophr Res 2021; 230:61-68. [PMID: 33684737 DOI: 10.1016/j.schres.2021.02.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 02/05/2021] [Accepted: 02/14/2021] [Indexed: 01/29/2023]
Abstract
UNLABELLED Metabolic syndrome (MetS) increases the risk of premature mortality observed in schizophrenia (SCZ). N-3 polyunsaturated fatty acid (PUFA) deficiency has been reported in different stages of schizophrenia. N-3 PUFA supplementation was found to be beneficial in both chronic SCZ and MetS. No intervention studies based on n-3 PUFA as add-on therapy to antipsychotics have examined the changes in MetS risk in first-episode schizophrenia. AIM This randomized placebo-controlled trial assesses the effect of a 26-week intervention composed of either 2.2 g/day of n-3 PUFA or olive oil placebo on the frequency of MetS and the changes in its constituents as a secondary outcome measure. METHODS Seventy-one adult inpatients diagnosed with first-episode schizophrenia were randomly assigned to study groups. The active intervention used a 3:2 mixture of eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids. Metabolic syndrome components were monitored throughout the study. RESULTS A significant reduction in the frequency of MetS was observed in the EPA + DHA group (p = 0.0408); as well as some specific MetS components: e.g., a decrease in fasting blood glucose (p = 0.045). The beneficial effects of EPA + DHA were even more pronounced in patients treated mainly with olanzapine, e.g. significant reductions of total cholesterol (p = 0.037) and blood glucose levels (p = 0.034). Significant positive correlations were found between the general psychopathology subscale of PANSS (primary outcome) and triglyceride level changes. CONCLUSION N-3 PUFA supplementation in early SCZ may constitute a safe and affordable intervention that can reduce the risk of MetS and its lethal complications.
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24
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Zivarpour P, Nikkhah E, Maleki Dana P, Asemi Z, Hallajzadeh J. Molecular and biological functions of gingerol as a natural effective therapeutic drug for cervical cancer. J Ovarian Res 2021; 14:43. [PMID: 33706784 PMCID: PMC7953815 DOI: 10.1186/s13048-021-00789-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 02/22/2021] [Indexed: 12/12/2022] Open
Abstract
Cervical cancer is one of the most common and important gynecological cancers, which has a global concern with an increasing number of patients and mortality rates. Today, most women in the world who suffer from cervical cancer are developing advanced stages of the disease. Smoking and even exposure to secondhand smoke, infections caused by the human papillomavirus, immune system dysfunction and high-risk individual-social behaviors are among the most important predisposing factors for this type of cancer. In addition, papilloma virus infection plays a more prominent role in cervical cancer. Surgery, chemotherapy or radical hysterectomy, and radiotherapy are effective treatments for this condition, the side effects of these methods endanger a person's quality of life and cause other problems in other parts of the body. Studies show that herbal medicines, including taxol, camptothecin and combretastatins, have been shown to be effective in treating cervical cancer. Ginger (Zingiber officinale, Zingiberaceae) is one of the plants with valuable compounds such as gingerols, paradols and shogoals, which is a rich source of antioxidants, anti-cancer and anti-inflammatory agents. Numerous studies have reported the therapeutic effects of this plant through various pathways in cervical cancer. In this article, we look at the signaling mechanisms and pathways in which ginger is used to treat cervical cancer.
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Affiliation(s)
- Parinaz Zivarpour
- Department of Biological sciences, Faculty of Basic Sciences, Higher Education Institute of Rab-Rashid, Tabriz, Iran
| | - Elhameh Nikkhah
- Medicinal Plants Research Cent Maragheh University of Medical Sciences, Maragheh, Iran
| | - Parisa Maleki Dana
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Jamal Hallajzadeh
- Department of Biochemistry and Nutrition, Research Center for Evidence-Based Health Management, Maragheh University of Medical Sciences, Maragheh, Iran
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25
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Role of Vitamin D in the Metabolic Syndrome. Nutrients 2021; 13:nu13030830. [PMID: 33802330 PMCID: PMC7999005 DOI: 10.3390/nu13030830] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 12/11/2022] Open
Abstract
The prevalence of hypovitaminosis D has risen in developed countries over the past few years in association with lifestyle changes and an increase in unhealthy habits. Vitamin D deficiency has been implicated in various diseases, including metabolic syndrome (MetS), which is clinically defined by a set of metabolic and vascular disorders. The objective of this study was to review scientific evidence on the relationship between MetS and vitamin D deficiency to support the development of prevention strategies and health education programs. An inverse relationship has been reported between plasma vitamin D concentrations and the features that define MetS, i.e., elevated serum concentrations of glucose, total cholesterol, low-density lipoproteins, triglycerides, glycosylated hemoglobin, and a high body mass index. Numerous studies have described the benefits of vitamin D supplementation to improve outcomes in individuals with MetS. Interventions to maintain optimal vitamin D concentrations are proposed as a preventive strategy against MetS.
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26
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Amirani E, Asemi Z, Asbaghi O, Milajerdi A, Reiner Ž, Mansournia MA, Hallajzadeh J, Moazzami B, Chaichian S. The effects of omega-3 fatty acids supplementation on metabolic status in pregnant women: a systematic review and meta-analysis of randomized controlled trials. J Diabetes Metab Disord 2021; 19:1685-1699. [PMID: 33520859 DOI: 10.1007/s40200-020-00558-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/07/2020] [Accepted: 05/26/2020] [Indexed: 12/19/2022]
Abstract
Background and objective Data regarding the effects of omega-3 polyunsaturated fatty acids (PUFA) supplementation on metabolic status of pregnant women are limited. This systematic review and meta-analysis were done based on randomized controlled trials (RCTs) dealing with the effects of omega-3 PUFA supplementation on glycemic control, lipoproteins, inflammation and oxidative stress in pregnant women. Methods Following databases were searched for eligible studies published from inception to until 2019: MEDLINE, EMBASE, Web of Science, PubMed, Scopus, Cochrane Library, and Google scholar. Studies that evaluated the effect of omega-3 PUFA supplementation on parameters of glycemic control, lipoproteins, inflammation and oxidative stress in pregnant women were found by using the key MeSH. A study quality assessment was performed using the Cochrane Collaboration risk of bias tool and heterogeneity between studies was statistically computed using Cochrane's Q test and I-square (I2). Data were pooled using a random-effects model and weighted mean difference (WMD) was considered as the overall effect size. Results No significant effects of omega-3 PUFA supplementation on FPG, insulin, insulin resistance, total cholesterol, triglycerides, LDL-cholesterol, total cholesterol/HDL-cholesterol, interleukin 6 (IL-6), IL-8, and malondialdehyde were found. However, omega-3 PUFA significantly increased serum concentrations of HDL-cholesterol (WMD: 3.10; 95% CI: 0.18, 6.03) and reduced C-reactive protein (WMD: -1.85; 95% CI: -2.61, -1.09). Conclusion Based on the results of this meta-analysis omega-3 PUFA supplementation during pregnancy has a significant beneficial effect on HDL-cholesterol, and C-reactive protein.
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Affiliation(s)
- Elaheh Amirani
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Omid Asbaghi
- Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Alireza Milajerdi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Željko Reiner
- Department of Internal Medicine, School of Medicine, University Hospital Centre Zagreb, University of Zagreb, Zagreb, Croatia
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Jamal Hallajzadeh
- Department of Biochemistry and Nutrition, Research Center for Evidence-Based Health Management, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Bahram Moazzami
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Shahla Chaichian
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
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27
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Delpino FM, Figueiredo LM, da Silva BGC, da Silva TG, Mintem GC, Bielemann RM, Gigante DP. Omega-3 supplementation and diabetes: A systematic review and meta-analysis. Crit Rev Food Sci Nutr 2021; 62:4435-4448. [PMID: 33480268 DOI: 10.1080/10408398.2021.1875977] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study aimed to review the literature on studies that evaluated the effects of omega-3 supplementation on parameters of diabetes in humans. An online search was conducted in the following databases: Pubmed, LILACS, Scielo, Scopus, and Web of Science. It included experimental studies that investigated the effects of omega-3 supplementation for diabetes treatment or prevention and its relationship with fasting blood glucose, insulin resistance, and glycated hemoglobin. Observational, non-human studies and non-randomized clinical trials were excluded. The Cochrane scale assessed the quality of the studies. A meta-analysis was carried out to evaluate the effect of omega-3 on fasting blood glucose, insulin resistance, and glycated hemoglobin. Thirty studies were included in the review. Almost 70% (n = 20) demonstrated at least one significant effect of the omega-3 supplementation related to diabetes. In the meta-analysis, there was a significant effect on the reduction of fasting blood glucose [SMD: -0.48; CI95%: -0.76, -0.19; p = 0.01; I2 = 88%] and insulin resistance [SMD: -0.61; CI95%: -0.98, -0.24; p = 0.01; I2 = 90%]. For glycated hemoglobin, there was no significant effect in the meta-analysis. This systematic review with meta-analysis demonstrated that supplementation with omega-3 has protective effects on diabetes parameters.
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Affiliation(s)
- Felipe Mendes Delpino
- Postgraduate Program in Nursing, Federal University of Pelotas, Rio Grande do Sul, Brazil.,Faculty of Nursing, Federal University of Pelotas, Pelotas, Brazil
| | | | | | - Taiciane Gonçalves da Silva
- Postgraduate Program in Nutrition and Food, Faculty of Nutrition, Federal University of Pelotas, Pelotas, Brazil
| | - Gicele Costa Mintem
- Postgraduate Program in Nutrition and Food, Faculty of Nutrition, Federal University of Pelotas, Pelotas, Brazil
| | - Renata Moraes Bielemann
- Postgraduate Program in Nutrition and Food, Faculty of Nutrition, Federal University of Pelotas, Pelotas, Brazil
| | - Denise Petrucci Gigante
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Postgraduate Program in Nutrition and Food, Faculty of Nutrition, Federal University of Pelotas, Pelotas, Brazil
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28
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Chen T, Liu D, Yao X. Progress of Clinical Trials for the Treatment of Gestational Diabetes Mellitus. Diabetes Metab Syndr Obes 2021; 14:315-327. [PMID: 33519220 PMCID: PMC7837562 DOI: 10.2147/dmso.s290749] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 12/31/2020] [Indexed: 01/09/2023] Open
Abstract
Gestational diabetes mellitus (GDM) is one of the most common and severe complications of pregnancy, which is not only associated with perinatal complications but also has a long-term adverse effect on maternal and their offsprings. At present, the treatment of GDM focuses on the control of maternal blood glucose. Although lifestyle changes, hypoglycemic drugs, blood glucose monitoring, and other medicines that can improve maternal blood glucose to a certain extent, there are still some patients affected and have adverse pregnancy outcomes. The prevention of GDM and the treatment of improving pregnancy outcomes are urgently needed. This review summarized recently published clinical trials related with the treatment of GDM, aiming to provide additional options for the treatment of GDM.
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Affiliation(s)
- Tong Chen
- Department of Endocrinology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People’s Republic of China
| | - Dan Liu
- Department of Endocrinology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People’s Republic of China
- Correspondence: Dan Liu Department of Endocrinology, First Affiliated Hospital of Dalian Medical University, Zhongshan Str. 222, Dalian116011, People’s Republic of China Email
| | - Xiaofeng Yao
- Department of Preventive Medicine, Dalian Medical University, Dalian, Liaoning, People’s Republic of China
- Xiaofeng Yao Department of Preventive Medicine, Dalian Medical University, 9 W Lushun South Road, Dalian116044, People’s Republic of China Email
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Gunasegaran P, Tahmina S, Daniel M, Nanda SK. Role of vitamin D-calcium supplementation on metabolic profile and oxidative stress in gestational diabetes mellitus: A randomized controlled trial. J Obstet Gynaecol Res 2020; 47:1016-1022. [PMID: 33372392 DOI: 10.1111/jog.14629] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/19/2020] [Accepted: 12/13/2020] [Indexed: 02/06/2023]
Abstract
AIM To assess role of vitamin D-calcium supplementation on the metabolic profile and oxidative stress in women with Gestational Diabetes Mellitus (GDM) controlled on diet. METHODS A randomized controlled trial was conducted at a tertiary care teaching hospital. Seventy women diagnosed as GDM at 24-28 weeks of gestation, controlled on a diabetic diet, were randomized to receive either vitamin D 1000 IU and calcium 1000 mg (group A, n = 34) or vitamin D 250 IU and calcium 500 mg (group B, n = 36) daily for 6 weeks. Levels of serum 25-hydroxy vitamin D, fasting plasma glucose (FPG), serum insulin, fasting lipid profile and total glutathione (GSH) were analyzed both prior to and after supplementation. Means, standard deviations and mean change were computed. Paired and independent t-tests were used to determine statistical significance between the two groups. RESULTS Women in group A showed a significant reduction in FPG level (P-value = 0.007), fasting serum insulin level (P-value = 0.000), LDL (P-value = 0.000), total cholesterol levels (P-value = 0.000) and increase in HDL levels (P-value = 0.000). Group B had a significant fall only in FPG after 6 weeks supplementation. A significant change in total glutathione level (P-value = 0.000) was observed in both groups. CONCLUSION Vitamin D and calcium supplementation at a dose of 1000 IU and 1000 mg, respectively, has a beneficial role in glucose metabolism, lipid metabolism and oxidative stress in GDM.
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Affiliation(s)
- Preetha Gunasegaran
- Department of Obstetrics and Gynaecology, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Sultana Tahmina
- Department of Obstetrics and Gynaecology, Pondicherry Institute of Medical Sciences, Puducherry, India.,Department of Obstetrics and Gynaecology, Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research, Melmaruvathur, Tamil Nadu, India
| | - Mary Daniel
- Department of Obstetrics and Gynaecology, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Sunil K Nanda
- Department of Biochemistry, Pondicherry Institute of Medical Sciences, Puducherry, India
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Alhabeeb H, Kord-Varkaneh H, Tan SC, Găman MA, Otayf BY, Qadri AA, Alomar O, Salem H, Al-Badawi IA, Abu-Zaid A. The influence of omega-3 supplementation on vitamin D levels in humans: a systematic review and dose-response meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr 2020; 62:3116-3123. [PMID: 33356450 DOI: 10.1080/10408398.2020.1863905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Inconsistencies exist with regard to the influence of omega-3 supplementation on 25-hydroxyvitamin D (25(OH)D) levels, which could be attributed to many factors, such as the duration and dose of omega-3 supplementation, and individuals' baseline 25(OH)D levels. Therefore, to address the inconsistencies, we conducted a systematic review and dose-response meta-analysis to accurately determine the effect of omega-3 supplementation on 25(OH)D levels in humans. METHODS We performed a comprehensive literature search in Web of Science, PubMed/Medline, Scopus, and Embase databases from inception up to January 2020. We included only randomized controlled trials (RCTs). We used weighted mean difference (WMD) with 95% confidence interval (CI) to assess the influence of omega-3 supplementation on serum 25(OH)D levels using the random-effects model. RESULTS Our pooled results of 10 RCTs demonstrated an overall significant increase in 25(OH)D levels following omega-3 intake (WMD = 3.77 ng/ml, 95% CI: 1.29, 6.25). In addition, 25(OH)D levels were significantly increased when the intervention duration lasted >8 weeks and when the baseline serum 25(OH)D level was ˂20 ng/ml. Moreover, omega-3 intake ≤1000 mg/day resulted in higher 25(OH)D levels compared to omega-3 intake >1000 mg/day. CONCLUSION In conclusion, omega-3 supplementation increased 25(OH)D concentrations, particularly with dosages ≤1000 mg/day and intervention durations >8 weeks.
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Affiliation(s)
- Habeeb Alhabeeb
- Clinical Research, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Hamed Kord-Varkaneh
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shing Cheng Tan
- UKM Medical Molecular Biology Institute, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | | | | | - Osama Alomar
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Hany Salem
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ismail A Al-Badawi
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ahmed Abu-Zaid
- Department of Pharmacology, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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Wang M, Chen Z, Hu Y, Wang Y, Wu Y, Lian F, Li H, Yang J, Xu X. The effects of vitamin D supplementation on glycemic control and maternal-neonatal outcomes in women with established gestational diabetes mellitus: A systematic review and meta-analysis. Clin Nutr 2020; 40:3148-3157. [PMID: 33386179 DOI: 10.1016/j.clnu.2020.12.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/21/2020] [Accepted: 12/15/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Gestational Diabetes Mellitus (GDM) is associated with a well-documented range of adverse pregnancy outcomes. The present meta-analysis was conducted to evaluate the effects of vitamin D supplementation on glycemic control and maternal-neonatal outcomes in women with established GDM. METHODS Published literature was retrieved and screened from PubMed, Embase, Web of Science, CNKI (China National Knowledge Infrastructure), Wanfang, and Cochrane Center Register of Controlled Trails up to May 2020. RCTs of vitamin D supplementation on pregnant women with GDM were included. RESULTS 19 RCTs (1550 participants) were eligible for meta-analyses. Overall, vitamin D supplementation significantly reduced serum fasting plasma glucose (FPG) (MD: -10.20 mg/dL, 95%CI: -13.43 to -6.96), insulin concentration (MD: -5.02 μIU/mL, 95%CI: -6.83 to -3.20) and the homeostasis model assessment of insulin resistance (HOMA-IR) (MD:-1.06, 95%CI: -1.40 to -0.72) in women with GDM. In addition, vitamin D supplementation in pregnant women with GDM significantly reduced adverse maternal outcomes including cesarean section (RR: 0.75, 95%CI: 0.63 to 0.89), maternal hospitalization (RR: 0.13, 95%CI: 0.02 to 0.98) and postpartum hemorrhage (RR: 0.47, 95%CI: 0.22 to 1.00). Several adverse neonatal complications including neonatal hyperbilirubinemia (RR: 0.47, 95%CI: 0.33 to 0.67), giant children (RR: 0.58, 95%CI: 0.38 to 0.89), polyhydramnios (RR: 0.42, 95% CI: 0.24 to 0.72), fetal distress (RR: 0.46, 95%CI: 0.24 to 0.90) and premature delivery (RR: 0.43, 95% CI: 0.26 to 0.72) were also significantly reduced. CONCLUSIONS This meta-analysis suggested that supplementation of GDM women with vitamin D may lead to an improvement in glycemic control and reduction of adverse maternal-neonatal outcomes.
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Affiliation(s)
- Mengmeng Wang
- Department of Preventive Medicine, Hangzhou Normal University School of Medicine, Hangzhou, 311121, China
| | - Zhaojing Chen
- Department of Preventive Medicine, Hangzhou Normal University School of Medicine, Hangzhou, 311121, China
| | - Yan Hu
- Department of Preventive Medicine, Hangzhou Normal University School of Medicine, Hangzhou, 311121, China
| | - Ying Wang
- Department of Preventive Medicine, Hangzhou Normal University School of Medicine, Hangzhou, 311121, China
| | - Yinyin Wu
- Department of Preventive Medicine, Hangzhou Normal University School of Medicine, Hangzhou, 311121, China
| | - Fuzhi Lian
- Department of Preventive Medicine, Hangzhou Normal University School of Medicine, Hangzhou, 311121, China
| | - Hongjuan Li
- Department of Basic Medicine, Hangzhou Normal University School of Medicine, Hangzhou, 311121, China
| | - Jun Yang
- Department of Preventive Medicine, Hangzhou Normal University School of Medicine, Hangzhou, 311121, China; Zhejiang Provincial Center for Uterine Cancer Diagnosis and Therapy Research, The Affiliated Women's Hospital, Zhejiang University, Hangzhou, 310006, China.
| | - Xianrong Xu
- Department of Preventive Medicine, Hangzhou Normal University School of Medicine, Hangzhou, 311121, China.
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Parrettini S, Caroli A, Torlone E. Nutrition and Metabolic Adaptations in Physiological and Complicated Pregnancy: Focus on Obesity and Gestational Diabetes. Front Endocrinol (Lausanne) 2020; 11:611929. [PMID: 33424775 PMCID: PMC7793966 DOI: 10.3389/fendo.2020.611929] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/02/2020] [Indexed: 12/14/2022] Open
Abstract
Pregnancy offers a window of opportunity to program the future health of both mothers and offspring. During gestation, women experience a series of physical and metabolic modifications and adaptations, which aim to protect the fetus development and are closely related to both pre-gestational nutritional status and gestational weight gain. Moreover, pre-gestational obesity represents a challenge of treatment, and nowadays there are new evidence as regard its management, especially the adequate weight gain. Recent evidence has highlighted the determinant role of nutritional status and maternal diet on both pregnancy outcomes and long-term risk of chronic diseases, through a transgenerational flow, conceptualized by the Development Origin of Health and Diseases (Dohad) theory. In this review we will analyse the physiological and endocrine adaptation in pregnancy, and the metabolic complications, thus the focal points for nutritional and therapeutic strategies that we must early implement, virtually before conception, to safeguard the health of both mother and progeny. We will summarize the current nutritional recommendations and the use of nutraceuticals in pregnancy, with a focus on the management of pregnancy complicated by obesity and hyperglycemia, assessing the most recent evidence about the effects of ante-natal nutrition on the long-term, on either maternal health or metabolic risk of the offspring.
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Affiliation(s)
- Sara Parrettini
- S. Maria della Misericordia Hospital, Division of Endocrinology and Metabolism, Perugia, Italy
- Department of Medicine, University of Perugia, Perugia, Italy
| | - Antonella Caroli
- S. Maria della Misericordia Hospital, Division of Endocrinology and Metabolism, Perugia, Italy
- Department of Medicine, University of Perugia, Perugia, Italy
| | - Elisabetta Torlone
- S. Maria della Misericordia Hospital, Division of Endocrinology and Metabolism, Perugia, Italy
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Jiang L, Gao C, Yan P, Chen P, Jiang C, Xu Y, Chen M. Omega-3 fatty acids plus vitamin for women with gestational diabetes or prediabetes: a meta-analysis of randomized controlled studies. J Matern Fetal Neonatal Med 2020; 35:3135-3142. [PMID: 32967476 DOI: 10.1080/14767058.2020.1814239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Omega-3 fatty acids plus vitamin (e.g. vitamin D and E) may be beneficial to treat gestational diabetes mellitus (GDM), and we aimed to study the influence of omega-3 fatty acids plus vitamin versus placebo on the treatment efficacy of GDM. METHODS We searched the databases including PubMed, Embase, and the Cochrane Central Register of Controlled Trials, and randomized controlled trials (RCTs) assessing the influence of omega-3 fatty acids and vitamins combination supplementation versus placebo on metabolic status of GDM were included. RESULTS Five RCTs were included in the meta-analysis. Compared with control intervention for women with GDM or prediabetes, omega-3 fatty acids plus vitamin substantially reduced fasting plasma glucose (FPG, mean difference [MD] = -11.25; 95% confidence intervals [CI] = -13.73 to -8.77; p < .00001), insulin (MD=-6.16; 95% CI=-7.92 to -4.39; p < .00001), homeostasis model of assessment-insulin resistance (HOMA-IR, MD = 173.51; 95% CI = 164.72 to 182.30; p < .00001) and triglycerides (MD = 173.51; 95% CI = 164.72 to 182.30; p < .00001), as well as increased total antioxidant capacity (TAC, MD = 173.51; 95% CI = 164.72 to 182.30; p < .00001), but revealed no significant impact on total cholesterol (MD = 173.51; 95% CI = 164.72 to 182.30; p < .00001), low‑density lipoprotein cholesterol (LDL-C, MD = 173.51; 95% CI = 164.72 to 182.30; p < .00001), preterm delivery (OR = 173.51; 95% CI = 164.72 to 182.30; p < .00001) or macrosomia > 4000 g (OR = 173.51; 95% CI = 164.72 to 182.30; p < .00001). CONCLUSIONS The supplementation of omega-3 fatty acids in combination with vitamin D or E can improve glycemic control, alleviate oxidative stress, and reduce triglycerides, but had no effects on total cholesterol, preterm delivery or macrosomia > 4000 g in women with GDM or prediabetes.
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Affiliation(s)
- Lan Jiang
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Chenlin Gao
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Peijun Yan
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Pan Chen
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Chunxia Jiang
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Yong Xu
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Muhu Chen
- Department of Emergency medicine, The Affiliated Hospital of Southwest Medical University, Sichuan, China
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Dibaba DT. Effect of vitamin D supplementation on serum lipid profiles: a systematic review and meta-analysis. Nutr Rev 2020; 77:890-902. [PMID: 31407792 DOI: 10.1093/nutrit/nuz037] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
CONTEXT Vitamin D deficiency is highly prevalent across the world. The existing evidence suggests vitamin D may have beneficial effects on serum lipid profiles and thus cardiovascular health. OBJECTIVE The objective of this systematic review and meta-analysis was to examine the effect of vitamin D supplementation on serum lipid profiles. DATA SOURCE Original randomized controlled trials (RCTs) examining the effect of vitamin D supplementation on serum lipid profiles and published before July 2018 were identified by searching online databases, including PubMed, Google Scholar, and ScienceDirect, using a combination of relevant keywords. DATA EXTRACTION Data on study characteristics, effect size, measure of variation, type of vitamin D supplementation, and duration of follow-up were extracted by the author. DATA ANALYSIS PRISMA guidelines for systematic reviews were followed. Random effects (DerSimonian and Laird [D-V)] models were used to pool standardized mean differences in total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides between the active and the placebo arms of RCT studies. Between-study heterogeneities were assessed using Cochrane Q and I2, and publication bias was assessed using Begg's test, Egger's test, and funnel plot. RESULTS A total of 41 RCTs comprising 3434 participants (n = 1699 in the vitamin D supplementation arm and n = 1735 in the placebo arm) were identified and included in the meta-analysis. Approximately 63.4% of study participants were women, with 14 studies conducted entirely among women. Approximately 24% of the trials had follow-up duration >6 months, whereas the remaining 76% had follow-up duration of <6 months. The standardized mean differences (SMDs) and 95% confidence intervals (CIs) for comparing the change from baseline to follow-up between the vitamin D supplementation arm and the placebo (control) arm were as follows: total cholesterol = -0.17 (-0.28 to -0.06); LDL cholesterol = -0.12 (-0.23 to -0.01); triglycerides = -0.12 (-0.25 to 0.01); and HDL cholesterol = -0.19 (-0.44 to 0.06). After removing a trial that was an outlier based on the magnitude of the effect size, the SMD for triglycerides was -0.15 (-0.24 to -0.06) and that for HDL cholesterol was -0.10 (-0.28 to 0.09). The improvements in total cholesterol and triglycerides were more pronounced in participants with baseline vitamin D deficiency. CONCLUSIONS Vitamin D supplementation appeared to have a beneficial effect on reducing serum total cholesterol, LDL cholesterol, and triglyceride levels but not HDL cholesterol levels. Vitamin D supplementation may be useful in hypercholesterolemia patients with vitamin D insufficiency who are at high risk of cardiovascular diseases.
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Affiliation(s)
- Daniel T Dibaba
- TN-Clinical and Translational Science Institute, University of Tennessee, Health Science Center, Memphis, Tennessee, USA; and the Department of Epidemiology, College of Public Health, and the Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
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Kim KS, Park SW, Cho YW, Kim SK. Vitamin D Deficiency at Mid-Pregnancy Is Associated with a Higher Risk of Postpartum Glucose Intolerance in Women with Gestational Diabetes Mellitus. Endocrinol Metab (Seoul) 2020; 35:97-105. [PMID: 32207269 PMCID: PMC7090297 DOI: 10.3803/enm.2020.35.1.97] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 11/03/2019] [Accepted: 12/23/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND To evaluate the association between serum 25-hydroxyvitamin D (25(OH)D) at mid-pregnancy and postpartum glucose intolerance in women with gestational diabetes mellitus (GDM). METHODS We enrolled 348 pregnant women diagnosed with GDM from August 2012 to October 2016. We measured serum 25(OH)D levels at mid-pregnancy and carried out a 75-g oral glucose tolerance test at 6 to 12 weeks after delivery. Vitamin D deficiency was defined as serum 25(OH)D <20 ng/mL. RESULTS The prevalence of vitamin D deficiency was 76.7% (n=267). Women with vitamin D deficiency had a higher prevalence of postpartum glucose intolerance than did those without vitamin D deficiency (48.7% vs. 32.1%, P=0.011). Serum 25(OH)D level was negatively correlated with hemoglobin A1c at antepartum and postpartum period (antepartum: r=-0.186, P=0.001; postpartum: r=-0.129, P=0.047). Homeostasis model assessment of β-cell function was positively correlated with serum 25(OH)D level only postpartum (r=0.138, P=0.035). The risk of postpartum glucose intolerance was 2.00 times (95% confidence interval, 1.13 to 3.55) higher in women with vitamin D deficiency than in those without vitamin D deficiency (P=0.018). CONCLUSION In women with GDM, vitamin D deficiency at mid-pregnancy is associated with an elevated risk of postpartum glucose intolerance.
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Affiliation(s)
- Kyung Soo Kim
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Seok Won Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Wook Cho
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Soo Kyung Kim
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
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Li F, Pei L, Huang G, Ye H. Influence of omega-3 fatty acid and vitamin co-supplementation on metabolic status in gestational diabetes: A meta-analysis of randomized controlled studies. Eur J Obstet Gynecol Reprod Biol 2020; 247:191-197. [PMID: 32145487 DOI: 10.1016/j.ejogrb.2020.02.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/10/2020] [Accepted: 02/13/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Omega-3 fatty acid and vitamin E or D co-supplementation may be an important approach to improve metabolic status in gestational diabetes, but the results are conflicting. This systematic review and meta-analysis was conducted to evaluate the effect of omega-3 fatty acid and vitamin co-supplementation on metabolic status in gestational diabetes. METHODS PubMed, Embase and the Cochrane Central Register of Controlled Trials were searched. Randomized controlled trials (RCTs) assessing the influence of omega-3 fatty acid and vitamin co-supplementation compared with placebo on metabolic status in gestational diabetes were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. RESULTS Four RCTs were included in the meta-analysis. Compared with control interventions for gestational diabetes, omega-3 fatty acid and vitamin E or D co-supplementation was associated with significantly reduced fasting plasma glucose [mean difference (MD) -10.47, 95 % confidence interval (CI) -15.33 to -5.61, p < 0.0001], homeostasis model of assessment-insulin resistance (MD -1.6, 95 % CI=-2.44 to -0.77, p = 0.0002), malondialdehyde (MD -1.00, 95 % CI -1.05 to -0.95, p < 0.00001) and triglycerides (MD 26.22, 95 % CI -38.94 to -13.51, p < 0.0001), as well as increased antioxidant capacity (MD 173.51, 95 % CI 164.72-182.30, p < 0.00001), but showed no obvious effect on nitric oxide (MD 5.95, 95 % CI -7.48 to 19.37, p = 0.39) or total cholesterol (MD 1.63, 95 % CI -13.46 to 16.72, p = 0.83). CONCLUSIONS Omega-3 fatty acid and vitamin co-supplementation may have a favourable effect on metabolic status in gestational diabetes.
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Affiliation(s)
- Fujie Li
- Chongqing Key Laboratory of Human Embryo Engineering, Chongqing Reproductive and Genetics Institute, Chongqing Health Center for Women and Children, Chongqing, China
| | - Li Pei
- Chongqing Key Laboratory of Human Embryo Engineering, Chongqing Reproductive and Genetics Institute, Chongqing Health Center for Women and Children, Chongqing, China
| | - Guoning Huang
- Chongqing Key Laboratory of Human Embryo Engineering, Chongqing Reproductive and Genetics Institute, Chongqing Health Center for Women and Children, Chongqing, China
| | - Hong Ye
- Chongqing Key Laboratory of Human Embryo Engineering, Chongqing Reproductive and Genetics Institute, Chongqing Health Center for Women and Children, Chongqing, China.
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Rajabi-Naeeni M, Dolatian M, Qorbani M, Vaezi AA. The effect of omega-3 and vitamin D co-supplementation on glycemic control and lipid profiles in reproductive-aged women with pre-diabetes and hypovitaminosis D: a randomized controlled trial. Diabetol Metab Syndr 2020; 12:41. [PMID: 32435279 PMCID: PMC7218636 DOI: 10.1186/s13098-020-00549-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 05/07/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Prediabetes can predispose the individual to type 2 diabetes in the long-term. The present study was conducted to determine the effectiveness of vitamin D and omega-3 co-supplementation on glycemic control and serum lipid profiles in women of reproductive age with prediabetes and hypovitaminosis D. METHODS The present factorial, triple-blind, clinical trial was conducted on 168 women of reproductive age with prediabetes and hypovitaminosis D. The participants were assigned to four groups based on block randomization method: the placebo group received omega-3 and vitamin D placebos; the omega-3 group took omega-3 supplements and vitamin D placebos; the vitamin D group received omega-3 placebos and vitamin D supplements and the co-supplementation group. The groups received every 2 weeks 50,000 IU pearls of vitamin D and twice-daily doses of 1000-mg omega-3 tablets or placebos for 8 weeks. Dietary intake, physical activity, anthropometric indices and blood biochemical tests were measured at the beginning and end of the study. Analysis was performed using two-way mixed ANOVA. RESULTS A significant reduction was observed in fasting glucose, insulin, homeostasis model assessment-beta cell function, weight and waist circumference in the co-supplementation group compared to the other three groups (P < 0.05). Moreover, high-density lipoprotein-cholesterol levels increased significantly in the co-supplementation group compared to the other three groups (P < 0.05). Despite the fact that homeostasis model assessment-insulin resistance, total cholesterol, triglyceride and low-density lipoprotein-cholesterol levels decreased after intervention in the co-supplementation group, there was no significant difference between the groups in these outcomes. CONCLUSION Vitamin D and omega-3 co-supplementation improved fasting serum glucose, insulin, high-density lipoprotein-cholesterol level, homeostasis model assessment-beta cell function, weight and waist circumference in women of reproductive age with prediabetes and hypovitaminosis D. This co-supplementation can therefore be recommended for glycemic control in these women.Trial registration Iranian Registry of Clinical Trials Code: IRCT20100130003226N17. Registered on 9 Feb. 2019.
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Affiliation(s)
- Masoumeh Rajabi-Naeeni
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahrokh Dolatian
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Abbas Vaezi
- Department of Internal Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
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Jin S, Sha L, Dong J, Yi J, Liu Y, Guo Z, Hu B. Effects of Nutritional Strategies on Glucose Homeostasis in Gestational Diabetes Mellitus: A Systematic Review and Network Meta-Analysis. J Diabetes Res 2020; 2020:6062478. [PMID: 32185236 PMCID: PMC7060856 DOI: 10.1155/2020/6062478] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 02/03/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy, and nutritional therapy is the basis of GDM treatment. However, the effects of different forms of nutritional supplementation on improving gestational diabetes are uncertain. OBJECTIVE We conducted a network meta-analysis to evaluate the effects of supplementation with different nutrients on glucose metabolism in women with GDM. METHODS We conducted a literature search using PubMed, EMBASE, and the Cochrane Library to identify randomized controlled trials (RCTs) comparing the differences between different nutritional strategies in women with GDM. The Cochrane tool was used to assess the risk of bias. Pairwise meta-analysis and network meta-analysis were used to compare and rank the effects of nutritional strategies for the improvement of fasting plasma glucose (FPG), serum insulin, and homeostasis model assessment-insulin resistance (HOMA-IR). RESULTS We included thirteen RCTs with a total of 754 participants. Compared with placebo, omega-3, magnesium, vitamin D, zinc, and probiotics were more beneficial for improving FPG, serum insulin, and HOMA-IR. Network analysis showed that vitamin D supplementation was superior to omega-3 (-3.64 mg/dL, 95% CI: -5.77 to -1.51), zinc (-5.71 mg/dL, 95% CI: -10.19 to -1.23), probiotics (-6.76 mg/dL, 95% CI: -10.02 to -3.50), and placebo (-12.13 mg/dL, 95% CI: -14.55 to -9.70) for improving FPG. Magnesium supplementation was more beneficial for decreasing serum insulin compared with probiotics (-5.10 μIU/mL, 95% CI: -9.32 to -0.88) and placebo (-7.80 μIU/mL, 95% CI: -9.32 to -0.88) and placebo (-7.80 . CONCLUSION Vitamin D supplementation significantly reduced FPG and regulated HOMA-IR. Magnesium supplementation was superior in decreasing serum insulin than supplementation with other nutrients. Nutrient supplementation seemed to have an effect on glucose homeostasis maintenance in patients with GDM and may be considered an adjunctive therapy.
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Affiliation(s)
- Shixiao Jin
- Department of Nursing, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, China
| | - Liyan Sha
- Department of Nursing, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, China
| | - Jianli Dong
- Department of International Medicine, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, China
| | - Jing Yi
- Department of Nursing, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, China
| | - Yang Liu
- Department of Nursing, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, China
| | - Zhongxian Guo
- Department of Nursing, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, China
| | - Bing Hu
- Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, China
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Rajabi-Naeeni M, Dolatian M, Qorbani M, Vaezi AA. The effect of co supplementation of omega-3 and vitamin D on cardio metabolic risk factors and psychological distress in reproductive-aged women with prediabetes and hypovitaminosis D: a study protocol for a randomized controlled trial. Trials 2019; 20:799. [PMID: 31888762 PMCID: PMC6937977 DOI: 10.1186/s13063-019-3948-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 12/02/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND A prediabetic state is a risk factor for type 2 diabetes. There are no approved drugs to manage prediabetes. Among the supplements routinely used by individuals, vitamin D and omega-3 have been studied to reduce fasting blood sugar. However, their co-supplementation has not been studied in individuals with prediabetes. This randomized controlled trial is designed to determine the effects of these two supplements on fasting blood sugar, other cardio metabolic risk factors, and psychological distress in reproductive-aged women with prediabetes and hypovitaminosis D. METHODS/DESIGN This 2 × 2 factorial, triple-blind, randomized, placebo-controlled, clinical trial will be done on 168 women of reproductive age diagnosed with prediabetes and hypovitaminosis D. Participants will be randomly assigned equally to four groups: (1) 1000 mg omega-3 fatty acid twice a day + vitamin D placebo every two weeks; (2) omega-3 fatty acid placebo twice a day + 50,000 IU vitamin D every two weeks; (3) 1000 mg omega-3 fatty acid twice a day + 50,000 IU vitamin D every two weeks; (4) omega-3 fatty acid placebo twice a day + vitamin D placebo every two weeks for eight weeks. At the beginning, participants will provide a self-reported questionnaire on the sociodemographic characteristics. At baseline and post-intervention visits, physical activity, Depression Anxiety Stress Scale 21 and Pittsburgh Sleep Quality Index, and a three-day food record will be collected for each individual. Blood pressure, weight, height, and waist circumference will also be measured. At the beginning and at the end, a blood sample will be used for estimating serum glucose indices (fasting blood sugar and insulin, homeostasis model assessment-insulin resistance, homeostasis model assessment-beta cell function), lipids (triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total cholesterol), and vitamin D status. Data analysis using Kolmogorov-Smirnov test, paired t-test, one-way analysis of variance, and repeated measures analysis of variance will be conducted through SPSS-24 software. DISCUSSION The primary aim of the present trial is to determine the effect of vitamin D and/or omega-3 on glycemic indices, lipid profiles, psychological distress, blood pressure, and anthropometric indices in prediabetic women with hypovitaminosis D. The results from this trial will provide evidence on the efficacy of these two supplements for preventing or delaying the onset of type 2 diabetes in high-risk individuals. TRIAL REGISTRATION Iran Clinical Trials Registry, IRCT20100130003226N17. Registered on 9 February 2019.
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Affiliation(s)
- Masoumeh Rajabi-Naeeni
- Midwifery and Reproductive Health Research Center, Department of midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahrokh Dolatian
- Midwifery and Reproductive Health Research Center, Department of midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Abbas Vaezi
- Department of Internal Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
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Palacios C, Trak‐Fellermeier MA, Martinez RX, Lopez‐Perez L, Lips P, Salisi JA, John JC, Peña‐Rosas JP. Regimens of vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev 2019; 10:CD013446. [PMID: 31581312 PMCID: PMC6776191 DOI: 10.1002/14651858.cd013446] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Vitamin D deficiency during pregnancy increases the risk of pre-eclampsia, gestational diabetes, preterm birth, and low birthweight. In a previous Cochrane Review we found that supplementing pregnant women with vitamin D alone compared to no vitamin D supplementation may reduce the risk of pre-eclampsia, gestational diabetes, and low birthweight and may increase the risk of preterm births if it is combined with calcium. However the effects of different vitamin D regimens are not yet clear. OBJECTIVES To assess the effects and safety of different regimens of vitamin D supplementation alone or in combination with calcium or other vitamins, minerals or nutrients during pregnancy, specifically doses of 601 international units per day (IU/d) or more versus 600 IU/d or less; and 4000 IU/d or more versus 3999 IU/d or less. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (12 July 2018), and the reference lists of retrieved studies. SELECTION CRITERIA Randomised trials evaluating the effect of different vitamin D regimens (dose, frequency, duration, and time of commencement of supplementation during pregnancy), alone or in combination with other nutrients on pregnancy and neonatal health outcomes. We only included trials that compared 601 IU/d or more versus 600 IU/d or less and 4000 IU/d or more versus 3999 IU/d or less. We did not include in the analysis groups that received no vitamin D, as that comparison is assessed in another Cochrane Review. DATA COLLECTION AND ANALYSIS Two review authors independently: i) assessed the eligibility of studies against the inclusion criteria; ii) extracted data from included studies, and iii) assessed the risk of bias of the included studies. Our primary maternal outcomes were: pre-eclampsia, gestational diabetes, and any adverse effects; our primary infant outcomes were preterm birth and low birthweight. Data were checked for accuracy. The certainty of the evidence was assessed using the GRADE approach. MAIN RESULTS In this review, we included data from 30 trials involving 7289 women. We excluded 11 trials, identified 16 ongoing/unpublished trials and two trials are awaiting classification. Overall risk of bias for the trials was mixed.Comparison 1. 601 IU/d or more versus 600 IU/d or less of vitamin D alone or with any other nutrient (19 trials; 5214 participants)Supplementation with 601 IU/d or more of vitamin D during pregnancy may make little or no difference to the risk of pre-eclampsia (risk ratio (RR) 0.96, 95% confidence interval (CI) 0.65 to 1.42); 5 trials; 1553 participants,low-certainty evidence), may reduce the risk of gestational diabetes (RR 0.54, 95% CI 0.34 to 0.86; 5 trials; 1846 participants; moderate-certainty evidence), may make little or no difference to the risk of preterm birth (RR 1.25, 95% CI 0.92 to 1.69; 4 trials; 2294 participants; low-certainty evidence); and may make little or no difference to the risk of low birthweight (RR 0.90, 95% CI 0.66 to 1.24; 4 trials; 1550 participants; very low-certainty evidence) compared to women receiving 600 IU/d or less.Comparison 2. 4000 IU or more versus 3999 IU or less of vitamin D alone (15 trials; 4763 participants)Supplementation with 4000 IU/d or more of vitamin D during pregnancy may make little or no difference to the risk of: pre-eclampsia (RR 0.87, 95% CI 0.62 to 1.22; 4 trials, 1903 participants, low-certainty evidence); gestational diabetes (RR 0.89, 95% CI 0.56 to 1.42; 5 trials, 2276 participants; low-certainty evidence); preterm birth (RR 0.85, 95% CI 0.64 to 1.12; 6 trials, 2948 participants, low-certainty evidence); and low birthweight (RR 0.92, 95% CI 0.49 to 1.70; 2 trials; 1099 participants; low-certainty evidence) compared to women receiving 3999 IU/d or less.Adverse events (such as hypercalcaemia, hypocalcaemia, hypercalciuria, and hypovitaminosis D) were reported differently in most trials; however, in general, there was little to no side effects reported or similar cases between groups. AUTHORS' CONCLUSIONS Supplementing pregnant women with more than the current vitamin D recommendation may reduce the risk of gestational diabetes; however, it may make little or no difference to the risk of pre-eclampsia, preterm birth and low birthweight. Supplementing pregnant women with more than the current upper limit for vitamin D seems not to increase the risk of the outcomes evaluated. In general, the GRADE was considered low certainty for most of the primary outcomes due to serious risk of bias and imprecision of results. With respect to safety, it appears that vitamin D supplementation is a safe intervention during pregnancy, although the parameters used to determine this were either not reported or not consistent between trials. Future trials should be consistent in their reports of adverse events. There are 16 ongoing trials that when published, will increase the body of knowledge.
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Affiliation(s)
- Cristina Palacios
- Robert Stempel College of Public Health and Social Work, Florida International UniversityDepartment of Dietetics and Nutrition11200 SW 8th Street, AHC 5 – 323MiamiFloridaUSA33199
| | - Maria Angelica Trak‐Fellermeier
- University of Puerto RicoCenter for Clinical Research and Health PromotionMedical Science Campus Suite A107, PO Box 365067San JuanPuerto RicoPR00935
| | | | - Lucero Lopez‐Perez
- WHO ConsultantIsla del Socorro 7Col. Prado VallejoTlalnepantlaMexico54170
| | - Paul Lips
- VU University Medical CenterInternal Medicine, Endocrine SectionP.O. Box 7057AmsterdamNetherlands1071 MC
| | - James A Salisi
- WHO Regional Office of the Western PacificNutrition Unit, Division of Non‐communicable Diseases and Health through the Life‐courseUN AvenueManilaPhilippines1000
| | - Jessica C John
- Eat, Drink and Be Healthy173 Eastern Main RoadTunapunaTrinidad and Tobago
| | - Juan Pablo Peña‐Rosas
- World Health OrganizationEvidence and Programme Guidance, Department of Nutrition for Health and Development20 Avenue AppiaGenevaGESwitzerland1211
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Barrea L, Arnone A, Annunziata G, Muscogiuri G, Laudisio D, Salzano C, Pugliese G, Colao A, Savastano S. Adherence to the Mediterranean Diet, Dietary Patterns and Body Composition in Women with Polycystic Ovary Syndrome (PCOS). Nutrients 2019; 11:nu11102278. [PMID: 31547562 PMCID: PMC6836220 DOI: 10.3390/nu11102278] [Citation(s) in RCA: 135] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 09/13/2019] [Accepted: 09/18/2019] [Indexed: 02/07/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common female endocrine disorder and is characterized by chronic anovulation, hyperandrogenism, and polycystic ovaries. Obesity, low-grade chronic inflammatory status, and insulin-resistance (IR) often coexist in PCOS. The Mediterranean diet (MD) is an anti-inflammatory dietary pattern, which is rich in complex carbohydrates and fiber, and high in monounsaturated fat. There is a close association among obesity, low-grade chronic inflammation, IR, and hormonal derangements in PCOS. The main aim of the present study was to evaluate the adherence to MD, the dietary intake, and the body composition and their association with PCOS clinical severity in a cohort of treatment-naïve women with PCOS when compared with a control group of healthy women matched for age and body mass index (BMI). In this case-controlled, cross-sectional study, we enrolled 112 patients with PCOS and 112 controls. PREvención con DIetaMEDiterránea (PREDIMED) and seven-day food records were used to evaluate the degree of adherence to the MD and dietary pattern, respectively. Body composition was evaluated by bioelectrical impedance analysis (BIA) phase-sensitive system. Testosterone levels and Ferriman-Gallwey score assessed the clinical severity of PCOS. C-reactive protein (CRP) levels were determined with a nephelometric assay with CardioPhase high sensitivity. PCOS women showed higher testosterone levels, Ferriman-Gallwey score, fasting insulin and glucose levels, and Homeostatic Model Assessment (HoMA)-IR when compared with the control group (p < 0.001). In addition, we found that the PCOS women consumed less extra-virgin olive oil, legumes, fish/seafood, and nuts compared with control group. Despite no differences in energy intake between the two groups, the PCOS women consumed a lower quantity of complex carbohydrate, fiber, monounsaturated fatty acids (MUFA), and n-3 polyunsaturated fatty acid (PUFA), and higher quantity of simple carbohydrate, total fat, saturated fatty acid (SFA), PUFA and n-6 PUFA than the control group. The PCOS women have an adverse body composition when compared with controls, with the lowest values of phase angle (PhA) and fat-free mass (p < 0.001). Additionally, after adjusting for BMI and total energy intake, testosterone levels showed significant negative correlations with PREDIMED score (p < 0.001) and consumption of protein (p = 0.005), complex carbohydrate (p < 0.001), fiber (p < 0.001), MUFA (p < 0.001), n-3 PUFA (p = 0.001), and positive associations with CRP levels, simple carbohydrate, SFA, n-6 PUFA (p < 0.001, respectively), and PUFA (p = 0.002). The cut-off for PREDIMED score ≤ 6 (p < 0.001, area under the curve (AUC) 0.848, standard error 0.036, 95% confidence interval (CI) 0.768 to 0.909) could serve as a threshold for significantly increased risk of high value of testosterone levels. In conclusion, a novel direct association between the adherence to MD and the clinical severity of the disease was reported in women with PCOS. This association could support a therapeutic role of foods and nutrients of the Mediterranean dietary pattern in the PCOS pathogenesis likely involving their inflammatory status, IR, and hyperandrogenemia. In addition, we reported a different body composition that is characterized by lower PhA and fat-free mass than controls. These data suggested a role of PhA as a useful marker of the clinical severity of this syndrome and provided strong evidence regarding the strategic relevance of the nutritional assessment in the management of women with PCOS.
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Affiliation(s)
- Luigi Barrea
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Angela Arnone
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Giuseppe Annunziata
- Department of Pharmacy, University of Naples "Federico II", Via Domenico Montesano, 49, 80131 Naples, Italy.
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Daniela Laudisio
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Ciro Salzano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Gabriella Pugliese
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
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Vitamin D and ω-3 Supplementations in Mediterranean Diet During the 1st Year of Overt Type 1 Diabetes: A Cohort Study. Nutrients 2019; 11:nu11092158. [PMID: 31505819 PMCID: PMC6770446 DOI: 10.3390/nu11092158] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 08/10/2019] [Accepted: 08/27/2019] [Indexed: 12/23/2022] Open
Abstract
Vitamin D and omega 3 fatty acid (ω-3) co-supplementation potentially improves type 1 diabetes (T1D) by attenuating autoimmunity and counteracting inflammation. This cohort study, preliminary to a randomized control trial (RCT), is aimed at evaluating, in a series of T1D children assuming Mediterranean diet and an intake of cholecalciferol of 1000U/day from T1D onset, if ω-3 co-supplementation preserves the residual endogen insulin secretion (REIS). Therefore, the cohort of 22 “new onsets” of 2017 received ω-3 (eicosapentenoic acid (EPA) plus docosahexaenoic acid (DHA), 60 mg/kg/day), and were compared retrospectively vs. the 37 “previous onsets” without ω-3 supplementation. Glicosilated hemoglobin (HbA1c%), the daily insulin demand (IU/Kg/day) and IDAA1c, a composite index (calculated as IU/Kg/day × 4 + HbA1c%), as surrogates of REIS, were evaluated at recruitment (T0) and 12 months later (T12). In the ω-3 supplemented group, dietary intakes were evaluated at T0 and T12. As an outcome, a decreased insulin demand (p < 0.01), particularly as pre-meal boluses (p < 0.01), and IDAA1c (p < 0.01), were found in the ω-3 supplemented group, while HbA1c% was not significantly different. Diet analysis in the ω-3 supplemented group, at T12 vs. T0, highlighted that the intake of arachidonic acid (AA) decreased (p < 0.01). At T0, the AA intake was inversely correlated with HbA1c% (p < 0.05; r;. 0.411). In conclusion, the results suggest that vitamin D plus ω-3 co-supplementation as well as AA reduction in the Mediterranean diet display benefits for T1D children at onset and deserve further investigation.
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Tripathi P, Rao YK, Pandey K, Gautam KA. Significance of Vitamin D on the Susceptibility of Gestational Diabetes Mellitus - A Meta-Analysis. Indian J Endocrinol Metab 2019; 23:514-524. [PMID: 31803590 PMCID: PMC6873259 DOI: 10.4103/ijem.ijem_184_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Vitamin D plays an important role in glucose tolerance by stimulating insulin secretion and evidences suggest a contradictory result on the association between vitamin D status and risk of developing gestational diabetes mellitus (GDM). The present updated meta-analysis has been undertaken to find out the joined effect of vitamin D status on the risk of effect GDM considering previously published articles. Data were collected through literature search using electronic databases to retrieve relevant published research articles using various combinations of the following keywords, "vitamin D," "vitamin D deficiency," "cholecalciferol," "25-hydroxyvitamin D," "25(OH) D," "gestational diabetes mellitus," and "GDM." A total of 36 studies including 7,596 GDM cases and 23,377 non-GDM controls were involved in this study. Overall, pooled meta-analysis showed that pregnant women diagnosed with GDM have 18% higher risk of GDM risk when compared with controls [odds ratio (OR) = 1.18, 95% confidence interval (CI) 1.10-1.25; P = 0.00] with high heterogeneity (I2 = 73.29). The mean difference was also significantly different between cases and controls (OR = -0.18, 95% CI - 0.22 to - 0.14; P = 0.00). Subgroup analysis showed significant results with age more than 30 years, Asian and European regions, and case-control, cross-sectional, and nested case-control study design. Low concentration of vitamin D is associated with the development of GDM. Although in future more studies especially systematically designed clinical trials based on vitamin D supplementation with large sample size on different population are needed to elucidate the exact concentration of vitamin D during pregnancy as well as before and after pregnancy.
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Affiliation(s)
- Prashant Tripathi
- Department of Biochemistry, GSVM Medical College, Kanpur, Uttar Pradesh, India
| | - Yashwant Kumar Rao
- Department of Pediatrics, GSVM Medical College, Kanpur, Uttar Pradesh, India
| | - Kiran Pandey
- Department of Obstetrics and Gynecology, GSVM Medical College, Kanpur, Uttar Pradesh, India
| | - Kirti Amresh Gautam
- Department of Pediatrics, GSVM Medical College, Kanpur, Uttar Pradesh, India
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Huang T, Afzal S, Yu C, Guo Y, Bian Z, Yang L, Millwood IY, Walters RG, Chen Y, Chen N, Gao R, Chen J, Clarke R, Chen Z, Ellervik C, Nordestgaard BG, Lv J, Li L. Vitamin D and cause-specific vascular disease and mortality: a Mendelian randomisation study involving 99,012 Chinese and 106,911 European adults. BMC Med 2019; 17:160. [PMID: 31466528 PMCID: PMC6716818 DOI: 10.1186/s12916-019-1401-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 07/30/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Randomised control trials and genetic analyses have demonstrated that vitamin D or 25-hydroxyvitamin D (25[OH]D) levels may not play a causal role in the development of cardiovascular disease. However, it is unclear if 25(OH)D is causally associated with cause-specific vascular disease and lipids. Therefore, we examined the causal association of 25(OH)D with myocardial infarction, stroke, ischaemic heart disease, ischaemic stroke, subarachnoid haemorrhage, intracerebral haemorrhage, and lipid levels among both Chinese and Europeans. METHODS We used a Mendelian randomisation (MR) design in the China Kadoorie Biobank, the Copenhagen City Heart Study, and the Copenhagen General Population Study. The 25(OH)D-related genetic variants in the CYP2R1 and DCHR7 genes were genotyped in 99,012 Chinese adults and 106,911 Danish adults. RESULTS In Chinese adults, plasma 25(OH)D levels were not significantly associated with cause-specific vascular disease or mortality, with the exception of intracerebral haemorrhage (HR, 1.09 [95% CI, 1.01,1.18] per 25 nmol/L higher plasma 25(OH)D). In Europeans, plasma 25(OH)D levels were inversely associated with all types of vascular diseases and mortality. However, MR analysis did not demonstrate causal associations of genetically increased 25(OH)D levels with cause-specific vascular diseases, or mortality in both Chinese and European adults. In addition, each 25 nmol/L higher 25(OH)D was observationally associated with lower total cholesterol and low-density lipoprotein cholesterol levels, but higher high-density lipoprotein cholesterol levels. Likewise, MR analysis showed that 25(OH)D levels were not causally associated with lipids in both Chinese and European adults after Bonferroni correction. CONCLUSIONS We found no evidence to support that genetically increased 25(OH)D was associated with a lower risk of ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and lipid levels in both Chinese and European adults. These results suggest that the inverse associations of vitamin D with vascular disease could be the result of confounding.
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Affiliation(s)
- Tao Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China.,Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Shoaib Afzal
- Department of Clinical Biochemistry and Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte Hospital Copenhagen, Copenhagen, Denmark
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Ling Yang
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Iona Y Millwood
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Robin G Walters
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yiping Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ningyu Chen
- NCDs Prevention and Control Department, Liuzhou Center for Disease Control and Prevention, Liuzhou, China
| | - Ruqin Gao
- Qingdao Center for Disease Control and Prevention, Qingdao, China
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Robert Clarke
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Christina Ellervik
- Department of Clinical Biochemistry and Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte Hospital Copenhagen, Copenhagen, Denmark.,The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry and Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte Hospital Copenhagen, Copenhagen, Denmark.,The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China. .,Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China. .,Peking University Institute of Environmental Medicine, Beijing, China.
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China. .,Chinese Academy of Medical Sciences, Beijing, China.
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Dwarkanath P, Vinotha P, Thomas T, Joseph S, Thomas A, Shirley G, Sheela CN, Mehta S, Kurpad AV. Relationship of Early Vitamin D Concentrations and Gestational Diabetes Mellitus in Indian Pregnant Women. Front Nutr 2019; 6:116. [PMID: 31448279 PMCID: PMC6691186 DOI: 10.3389/fnut.2019.00116] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 07/15/2019] [Indexed: 12/18/2022] Open
Abstract
Background: A high prevalence of vitamin D deficiency exists in pregnant Indian women (~90%). Increasing evidence suggests that vitamin D could play a pivotal role in maintaining normal glucose homeostasis. We aimed to determine the association between maternal vitamin D concentrations in early pregnancy and the risk of gestational diabetes mellitus (GDM). Methods: A prospective observational study was conducted on healthy pregnant women (n = 392) attending routine antenatal care at St. John's Medical College Hospital, Bangalore recruited at ~12 weeks of gestation. At baseline, details on socio-economic status, obstetric history, dietary intakes, and anthropometry were collected. Venous plasma total vitamin D concentration was assessed using tandem liquid chromatography mass spectrophotometry (LC-MS/MS). Oral glucose tolerance test (OGTT) at recruitment, followed by glucose tolerance test (GTT) at mid-pregnancy was conducted. GDM was diagnosed and confirmed using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) classification. Univariate and adjusted logistic regression models were used to evaluate the associations between total vitamin D concentrations at enrollment with GDM. Results: Of the cohort, 10.2% were diagnosed as GDM. Women with GDM were older (26 vs. 24 years) and heavier (51.6 vs. 51.2 kg) compared to the rest. A higher prevalence of GDM was observed among women with 1st trimester plasma total vitamin D in the lowest quartile (≤23.6 nmol/L) compared to the subjects in the other three quartiles (16.1 vs. 8.6%, p = 0.033). Adjusted multivariable regression analysis showed that women in the lowest quartile of plasma total vitamin D had twice the odds of GDM compared to women belonging to the remaining quartiles [OR = 2.32 (95%CI: 1.10, 4.91), p = 0.028]. Conclusions: Low plasma total vitamin D concentrations in early pregnancy may be associated with a higher risk of GDM.
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Affiliation(s)
| | - Ponnusamy Vinotha
- Department of Biostatistics, St. John's Research Institute & Medical College, Bangalore, India
| | - Tinku Thomas
- Department of Biostatistics, St. John's Research Institute & Medical College, Bangalore, India
| | - Siji Joseph
- Agilent Technologies, Global Solution Development Center, Singapore, Singapore
| | - Annamma Thomas
- Department of Obstetrics and Gynaecology, St. John's Medical College Hospital, Bangalore, India
| | - George Shirley
- Department of Obstetrics and Gynaecology, St. John's Medical College Hospital, Bangalore, India
| | - C N Sheela
- Department of Obstetrics and Gynaecology, St. John's Medical College Hospital, Bangalore, India
| | - Saurabh Mehta
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
| | - Anura V Kurpad
- Department of Physiology & Nutrition, St. John's Medical College & St. John's Research Institute, Bangalore, India
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Plows JF, Reynolds CM, Vickers MH, Baker PN, Stanley JL. Nutritional Supplementation for the Prevention and/or Treatment of Gestational Diabetes Mellitus. Curr Diab Rep 2019; 19:73. [PMID: 31368026 DOI: 10.1007/s11892-019-1199-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE OF REVIEW Gestational diabetes mellitus (GDM) is a common pregnancy complication that has short- and long-term health implications for both the mother and child. While lifestyle modifications, insulin therapy, and oral agents such as metformin are effective, they can be difficult to adhere to, and there remain concerns over long-term effects of oral agents on the infant. Further, GDM has no proven preventive strategies, which could be more effective than treatment postdiagnosis. Nutritional supplements are an appealing, potentially safer, and better tolerated alternative to pharmaceuticals to treat and/or prevent GDM. Here, we review the existing evidence for nutritional supplementation for treatment and prevention of GDM. RECENT FINDINGS There is limited evidence that myo-inositol, vitamins D and B6, magnesium, selenium, zinc, fatty acids, and probiotics might be beneficial for the prevention or treatment of GDM. There are very few studies for each nutrient, and the existing studies tend to have few participants. Where multiple studies of a nutrient exist, often those studies were conducted within the same country, limiting the generalizability of the findings, or alternatively there was no consensus across findings. There is limited evidence that nutritional supplementation of myo-inositol, vitamins D and B6, magnesium, selenium, zinc, fatty acids, and probiotics could improve glycemic control or prevent GDM. Our understanding is constrained by the small number of studies, small sample sizes in most studies, and by lack of consistency across findings. Further large, high-quality, randomized controlled trials are required to determine the efficacy of nutritional supplements to treat or prevent GDM.
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Affiliation(s)
- Jasmine F Plows
- Children's Hospital Los Angeles, 4641 Sunset Blvd, Los Angeles, CA, 90027, USA.
- Liggins Institute, University of Auckland, 85 Park Rd, Grafton, 1021, Auckland, New Zealand.
| | - Clare M Reynolds
- Liggins Institute, University of Auckland, 85 Park Rd, Grafton, 1021, Auckland, New Zealand
| | - Mark H Vickers
- Liggins Institute, University of Auckland, 85 Park Rd, Grafton, 1021, Auckland, New Zealand
| | - Philip N Baker
- University of Leicester, Maurice Shock Building, Leicester, LE1 7RH, United Kingdom
| | - Joanna L Stanley
- Liggins Institute, University of Auckland, 85 Park Rd, Grafton, 1021, Auckland, New Zealand
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Abstract
BACKGROUND Vitamin D supplementation during pregnancy may be needed to protect against adverse pregnancy outcomes. This is an update of a review that was first published in 2012 and then in 2016. OBJECTIVES To examine whether vitamin D supplementation alone or in combination with calcium or other vitamins and minerals given to women during pregnancy can safely improve maternal and neonatal outcomes. SEARCH METHODS For this update, we searched Cochrane Pregnancy and Childbirth's Trials Register (12 July 2018), contacted relevant organisations (15 May 2018), reference lists of retrieved trials and registries at clinicaltrials.gov and WHO International Clinical Trials Registry Platform (12 July 2018). Abstracts were included if they had enough information to extract the data. SELECTION CRITERIA Randomised and quasi-randomised trials evaluating the effect of supplementation with vitamin D alone or in combination with other micronutrients for women during pregnancy in comparison to placebo or no intervention. DATA COLLECTION AND ANALYSIS Two review authors independently i) assessed the eligibility of trials against the inclusion criteria, ii) extracted data from included trials, and iii) assessed the risk of bias of the included trials. The certainty of the evidence was assessed using the GRADE approach. MAIN RESULTS We included 30 trials (7033 women), excluded 60 trials, identified six as ongoing/unpublished trials and two trials are awaiting assessments.Supplementation with vitamin D alone versus placebo/no interventionA total of 22 trials involving 3725 pregnant women were included in this comparison; 19 trials were assessed as having low-to-moderate risk of bias for most domains and three trials were assessed as having high risk of bias for most domains. Supplementation with vitamin D alone during pregnancy probably reduces the risk of pre-eclampsia (risk ratio (RR) 0.48, 95% confidence interval (CI) 0.30 to 0.79; 4 trials, 499 women, moderate-certainty evidence) and gestational diabetes (RR 0.51, 95% CI 0.27 to 0.97; 4 trials, 446 women, moderate-certainty evidence); and probably reduces the risk of having a baby with low birthweight (less than 2500 g) (RR 0.55, 95% CI 0.35 to 0.87; 5 trials, 697 women, moderate-certainty evidence) compared to women who received placebo or no intervention. Vitamin D supplementation may make little or no difference in the risk of having a preterm birth < 37 weeks compared to no intervention or placebo (RR 0.66, 95% CI 0.34 to 1.30; 7 trials, 1640 women, low-certainty evidence). In terms of maternal adverse events, vitamin D supplementation may reduce the risk of severe postpartum haemorrhage (RR 0.68, 95% CI 0.51 to 0.91; 1 trial, 1134 women, low-certainty evidence). There were no cases of hypercalcaemia (1 trial, 1134 women, low-certainty evidence), and we are very uncertain as to whether vitamin D increases or decreases the risk of nephritic syndrome (RR 0.17, 95% CI 0.01 to 4.06; 1 trial, 135 women, very low-certainty evidence). However, given the scarcity of data in general for maternal adverse events, no firm conclusions can be drawn.Supplementation with vitamin D and calcium versus placebo/no interventionNine trials involving 1916 pregnant women were included in this comparison; three trials were assessed as having low risk of bias for allocation and blinding, four trials were assessed as having high risk of bias and two had some components having a low risk, high risk, or unclear risk. Supplementation with vitamin D and calcium during pregnancy probably reduces the risk of pre-eclampsia (RR 0.50, 95% CI 0.32 to 0.78; 4 trials, 1174 women, moderate-certainty evidence). The effect of the intervention is uncertain on gestational diabetes (RR 0.33,% CI 0.01 to 7.84; 1 trial, 54 women, very low-certainty evidence); and low birthweight (less than 2500 g) (RR 0.68, 95% CI 0.10 to 4.55; 2 trials, 110 women, very low-certainty evidence) compared to women who received placebo or no intervention. Supplementation with vitamin D and calcium during pregnancy may increase the risk of preterm birth < 37 weeks in comparison to women who received placebo or no intervention (RR 1.52, 95% CI 1.01 to 2.28; 5 trials, 942 women, low-certainty evidence). No trial in this comparison reported on maternal adverse events.Supplementation with vitamin D + calcium + other vitamins and minerals versus calcium + other vitamins and minerals (but no vitamin D)One trial in 1300 participants was included in this comparison; it was assessed as having low risk of bias. Pre-eclampsia was not assessed. Supplementation with vitamin D + other nutrients may make little or no difference in the risk of preterm birth < 37 weeks (RR 1.04, 95% CI 0.68 to 1.59; 1 trial, 1298 women, low-certainty evidence); or low birthweight (less than 2500 g) (RR 1.12, 95% CI 0.82 to 1.51; 1 trial, 1298 women, low-certainty evidence). It is unclear whether it makes any difference to the risk of gestational diabetes (RR 0.42, 95% CI 0.10 to 1.73) or maternal adverse events (hypercalcaemia no events; hypercalciuria RR 0.25, 95% CI 0.02 to 3.97; 1 trial, 1298 women,) because the certainty of the evidence for both outcomes was found to be very low. AUTHORS' CONCLUSIONS We included 30 trials (7033 women) across three separate comparisons. Our GRADE assessments ranged from moderate to very low, with downgrading decisions based on limitations in study design, imprecision and indirectness.Supplementing pregnant women with vitamin D alone probably reduces the risk of pre-eclampsia, gestational diabetes, low birthweight and may reduce the risk of severe postpartum haemorrhage. It may make little or no difference in the risk of having a preterm birth < 37 weeks' gestation. Supplementing pregnant women with vitamin D and calcium probably reduces the risk of pre-eclampsia but may increase the risk of preterm births < 37 weeks (these findings warrant further research). Supplementing pregnant women with vitamin D and other nutrients may make little or no difference in the risk of preterm birth < 37 weeks' gestation or low birthweight (less than 2500 g). Additional rigorous high quality and larger randomised trials are required to evaluate the effects of vitamin D supplementation in pregnancy, particularly in relation to the risk of maternal adverse events.
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Affiliation(s)
- Cristina Palacios
- Robert Stempel College of Public Health and Social Work, Florida International UniversityDepartment of Dietetics and Nutrition11200 SW 8th Street, AHC 5 – 323MiamiFloridaUSA33199
| | - Lia K Kostiuk
- University of Wisconsin ‐ MadisonPreventive MedicineMadisonWisconsinUSA53718
| | - Juan Pablo Peña‐Rosas
- World Health OrganizationEvidence and Programme Guidance, Department of Nutrition for Health and Development20 Avenue AppiaGenevaGESwitzerland1211
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Chen J, Sun B, Zhang D. Association of Dietary n3 and n6 Fatty Acids Intake with Hypertension: NHANES 2007-2014. Nutrients 2019; 11:nu11061232. [PMID: 31151215 PMCID: PMC6627798 DOI: 10.3390/nu11061232] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 05/24/2019] [Accepted: 05/24/2019] [Indexed: 01/01/2023] Open
Abstract
We conducted this cross-sectional study in the American general population to explore the association of dietary n3 and n6 fatty acids intake and the risk of hypertension. We used data from the National Health and Nutrition Examination Survey (NHANES) 2007–2014 in this study. We obtained dietary n3 and n6 fatty acids data through two 24 h dietary recall interviews and n3, n6 fatty acids intake were adjusted by weight. We defined hypertension as now taking prescribed medicine for hypertension or blood pressure above 130/80 mmHg. We applied binary logistic regression, multinomial logistic regression, and restricted cubic spline to evaluate the associations of dietary n3 and n6 fatty acids intake with hypertension. A total of 18,434 participants were included in this study. In the multivariate-adjusted model 2, the odds ratios (ORs) with 95% confidence interval (CI) of hypertension were 0.58 (0.49–0.68), 0.53 (0.45–0.63), and 0.92 (0.80–1.06) for the highest versus the lowest tertile of dietary n3, n6 fatty acids intake and n6:n3 ratio, respectively. Further excluded participants with hypertension history, the ORs with 95% CI of newly diagnosed hypertension were 0.60 (0.50–0.73), 0.52 (0.43–0.62), and 0.95 (0.79–1.14) for the highest versus lowest tertile of dietary n3, n6 fatty acids intake and n6:n3 ratio, respectively. Dose-response analyses showed that the risk of hypertension was associated with dietary n3 and n6 fatty acids intake. Our study suggested that dietary n3 and n6 fatty acids intake were inversely associated with the risk of hypertension in US adults.
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Affiliation(s)
- Jiahao Chen
- Department of Epidemiology and Health Statistics, the School of Public Health of Qingdao University, No. 38 Dengzhou Road, Qingdao 266021, China.
| | - Baoqi Sun
- Department of Epidemiology and Health Statistics, the School of Public Health of Qingdao University, No. 38 Dengzhou Road, Qingdao 266021, China.
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, the School of Public Health of Qingdao University, No. 38 Dengzhou Road, Qingdao 266021, China.
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Abstract
Gestational and pre-gestational diabetes are frequent problems encountered in obstetrical practice and their complications may influence both the mother (such as hypertension, pre-eclampsia, increased caesarean rates) and the foetus (such as macrosomia, shoulder dystocia, respiratory distress, hypoglycaemia, or childhood obesity and diabetes). Given the important implications for mothers and their offspring, screening and appropriate management of diabetes during pregnancy are essential. This is a review of articles published between 2015 and 2018 on Medline via Ovid that focus on advances in the management of diabetes in pregnancy. Recent data have concentrated predominantly on optimising glycaemic control, which is key for minimising the burden of maternal and foetal complications. Lifestyle changes, notably physical exercise and diet adjustments, appear to have beneficial effects. However, data are inconclusive with respect to which diet and form of exercise provide optimal benefits. Oral glycaemic agents-in particular, metformin-are gaining acceptance as more data indicating their long-term safety for the foetus and newborn emerge. Recent reviews present inconclusive data on the efficacy and safety of insulin analogues. New technologies such as continuous insulin pumps for type 1 diabetes and telemedicine-guided management of diabetes are significantly appreciated by patients and represent promising clinical tools. There are few new data addressing the areas of antenatal foetal surveillance, the timing and need for induction of delivery, and the indications for planned caesarean section birth.
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Affiliation(s)
- Cristina Mitric
- Obstetrics & Gynaecology, McGill University, Montreal, Quebec, H4A 3J1, Canada
| | - Jade Desilets
- Obstetrics & Gynaecology, McGill University, Montreal, Quebec, H4A 3J1, Canada
| | - Richard N Brown
- Obstetrics & Gynaecology, McGill University, Montreal, Quebec, H4A 3J1, Canada
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Elshani B, Kotori V, Daci A. Role of omega-3 polyunsaturated fatty acids in gestational diabetes, maternal and fetal insights: current use and future directions. J Matern Fetal Neonatal Med 2019; 34:124-136. [PMID: 30857450 DOI: 10.1080/14767058.2019.1593361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
ω-3-Polyunsaturated fatty acids (ω-3 PUFAs) are widely used during pregnancy and gestational diabetes mellitus (GDM). ω-3 PUFAs are beneficial in the regulation of maternal and fetal metabolic function, inflammation, immunity, macrosomia (MAC), oxidative stress, preeclampsia, intrauterine growth, preterm birth, offspring metabolic function, and neurodevelopment. Dietary counseling is vital for improving therapeutic outcomes in patients with GDM. In maternal circulation, ω-3 PUFAs are transported via transporters, synthesis enzymes, and intracellular proteins, which activate nuclear receptors and play central roles in the cellular metabolic processes of placental trophoblasts. In patients with GDM, this process is compromised due to abnormal functioning of the placenta, which disrupts the normal mother to fetus transport. This results in reduced fetal levels of ω-3 PUFAs, which contributes negatively to fetal growth, metabolic function, and development. Dietary counseling and nutritional assessment remain challenging in the prevention and alleviation of GDM. Therefore, personalized approaches, including measurement of the ω-3 index, pharmacogenetic implementation strategies, and appropriate supplementation with ω-3 PUFAs are used to achieve sufficient distribution in the maternal and fetal fluids during the entire pregnancy period. Developing new dosing guidelines and personalized approaches, determining the mechanisms of ω-3 PUFAs in the placenta, and examining the pharmacodynamic and pharmacokinetics interactions involving ω-3 PUFAs will lead to better management and increase the quality of life of patients with GDM and their offspring. Moreover, different strategies for supplementing with ω-3 PUFAs, improving their placental transport, and pharmacological exploration of the maternal-fetal interactions will help to further elucidate the role of ω-3 PUFAs in women with GDM. In this review, we summarize the current information on the potential therapeutic benefits and clinical applicability of ω-3 PUFAs in patients with GDM and their offspring, highlighting recent progress and future perspectives in this field. Studies investigating the mechanisms of ω-3 PUFA transport to targeted tissues have spurred an interest in personalized treatment strategies for patients with GDM and their offspring. To implement such therapies, we need to clarify the index/ratio of ω-3 PUFAs in maternal and fetal fluids, delineate the ω-3 PUFA transport pathways, and establish the guidelines for FA profiling prepregnancy and during pregnancy-associated weight gain. Such therapies also need to take into account the gender of the fetus, and whether the patient is obese.
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Affiliation(s)
- Brikene Elshani
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Prishtina, Prishtina, Kosovo
| | - Vjosa Kotori
- Department of Endocrinology, Pediatric Clinic, Faculty of Medicine, University of Prishtina, Prishtina, Kosovo
| | - Armond Daci
- Department of Pharmacy, Faculty of Medicine, University of Prishtina, Prishtina, Kosovo
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