The Effect of Dietary Supplements on Oxidative Stress in Pregnant Women with Gestational Diabetes Mellitus: A Network Meta-Analysis.

Christos Chatzakis,George Mastorakos,Maria Papagianni,Evangelia Tsakmaki,George Paltoglou,Alexandros Sotiriadis,Konstantinos Dinas

doi:10.3390/nu13072284

Abstract

Background: Gestational diabetes mellitus (GDM) exacerbates the oxidative stress status of the pregnant women. Τo improve the oxidative stress status, several therapeutic interventions have been suggested. The aim of this network meta-analysis is to assess the effect of different dietary supplements on the oxidative stress status in pregnant women with GDM. Methods: A network meta-analysis of randomized control trials was performed comparing the changes delta (Δ) in total antioxidant capacity (TAC) and concentration of malondialdehyde (MDA) as primary outcomes, following different therapeutic interventions with dietary supplements in pregnant women with GDM. Four electronic databases and grey literature sources were searched. The secondary outcomes were other markers of oxidative stress. Results: The meta-analysis included 16 studies of 1173 women with GDM. Regarding ΔTAC: probiotics and omega-3 with vitamin E were superior to placebo/no intervention. Regarding ΔMDA: vitamin D with calcium, omega-3, vitamin D, omega-3 with vitamin E, magnesium with zinc and calcium, and probiotics were superior to placebo/no intervention. Conclusions: Administration of dietary supplements in women with GDM can be helpful in limiting the oxidative stress which develop in these pregnancies.

Highlights

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during the second or third trimester of pregnancy excluding cases of clearly overt diabetes [1]
Randomized controlled trials (RCTs) comparing the effect of dietary supplements vs. placebo or nothing on the oxidative stress status of women with GDM were eligible for inclusion
Regarding ∆GSH (Figure S2c), all supplements administrated vitamin D with calcium, or soya, or selenium, or omega-3 with vitamin D or probiotics were superior to placebo/no intervention

Summary

Introduction

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during the second or third trimester of pregnancy excluding cases of clearly overt diabetes [1]. Increased levels of free radicals and lipid peroxides constitute a normal phenomenon during pregnancy [4,5]. Excess glucose is responsible for increased free radical production by activating several metabolic mechanisms, such as the polyol pathway, formation of AGE, activation of protein kinase C (PKC), the hexosamine pathway and directly by encouraging the ROS production in the placental mitochondria [3,4,6,7]. Increased levels of oxidative stress are associated with impaired insulin-dependent glucose uptake, elevated apoptosis rate and placental dysfunction, while creating a pro-inflammatory status in general [3]

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Discussion

Conclusion