The effects of magnesium-zinc-calcium-vitamin D co-supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes

Abstract

Background Diabetes is the most common medical condition in pregnant women and its complications affect both mother and fetus. The beneficial effects of vitamin D on gestational diabetes have been shown, though data on the effects of co-administration of vitamin D with other nutrients on pregnancy outcomes in gestational diabetes (GDM) are scarce. This study was aimed to determine the effects of magnesium-zinc-calcium-vitamin D co-supplementation on parameters of inflammation and oxidative stress, and pregnancy outcomes among women with GDM. Methods This randomized, double-blinded, placebo-controlled trial was conducted on 60 women with GDM not taking oral hypoglycemic agents. Patients were randomly assigned to take magnesium-zinc-calcium-vitamin D supplements ( n = 30) or placebo ( n = 30) for 6 weeks. Fasting blood samples were collected from participants at baseline and after the 6-week intervention to measure related biomarkers. Results Magnesium-zinc-calcium-vitamin D co-supplementation resulted in a significant reduction in serum high-sensitivity C-reactive protein (− 1.2 ± 3.5 vs. + 0.8 ± 2.0 mg/L, P = 0.01) and plasma malondialdehyde concentrations (− 0.3 ± 0.3 vs. + 0.3 ± 1.1 μmol/L, P = 0.003), as well as a significant increase in total antioxidant capacity levels (+ 38.2 ± 76.5 vs. -16.3 ± 93.5 mmol/L, P = 0.01), compared to placebo. We found a decreasing trend in newborns’ weight (3089.8 ± 519.9 vs. 3346.3 ± 411.1 g, P = 0.05) and the rate of macrosomia (3.3% vs. 16.7%, P = 0.08) in the magnesium-zinc-calcium-vitamin D supplemented women. Conclusions Overall, the findings of this study have demonstrated that magnesium-zinc-calcium-vitamin D co-supplementation for 6 weeks to women with GDM may reduce biomarkers of inflammation and oxidative stress. This study was retrospectively registered on 25 April 2017 in the Iranian website ( www.irct.ir ) for clinical trials registration ( http://www.irct.ir : IRCT201704225623N109).

Associations of Dietary Bioactive Compounds with Maternal Adiposity and Inflammation in Gestational Diabetes: An Update on Observational and Clinical Studies

“…The 17 RCTs originated from China [ 48 , 49 ], Iran [ 39 , 40 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 ], and the USA [ 63 ] ( Table 2 ). Fourteen of the RCTs [ 39 , 40 , 48 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 62 ] were double blinded, and three were not [ 49 , 61 , 63 ]. Women were aged in their twenties [ 39 , 40 , 48 , 50 , 51 , 52 , 54 , 55 , 56 , 58 , 60 , 61 , 62 , 63 ] and thirties [ 53 , 57 , 59 ] in 13 and thre...…”

“…Women were aged in their twenties [ 39 , 40 , 48 , 50 , 51 , 52 , 54 , 55 , 56 , 58 , 60 , 61 , 62 , 63 ] and thirties [ 53 , 57 , 59 ] in 13 and three trials, respectively. Eleven trials included women with overweight and GDM [ 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 60 , 61 ], and five trials included women with obesity and GDM [ 39 , 40 , 48 , 59 , 62 , 63 ]. The one remaining trial reported that women were over 20 years of age but did not report the mean or SD for age or BMI [ 49 ].…”

“…Three RCTs supplemented trace elements in women with GDM [ 51 , 58 , 60 ]. Most recently, Jamilian et al (2019) reported that calcium, magnesium, and zinc co-supplemented with vitamin D decreased hs-CRP and MDA by 17% ( p = 0.01) and 10% ( p = 0.003), respectively, and increased TAC by 6% ( p = 0.01) [ 51 ]. The changes in GSH and total nitrite were not significantly different compared to placebo group [ 51 ].…”

“…All three RCTs that supplemented trace elements in GDM reported decreased hs-CRP and increased TAC [ 51 , 58 , 60 ]. Jamilian et al (2019) contended that magnesium, zinc, and vitamin D reduced hs-CRP by inhibiting the production of reactive oxygen species, the activity of the nuclear factor kappa light-chain enhancer of activated B cells, and peroxisome proliferator-activated receptor-alpha pathways [ 51 ].…”

A Comparison of the Changes in Gestational Weight, Body Mass Index, and Serum Vitamin D Level in Gestational Diabetes Mellitus Patients Complemented with Vitamin D in Contrast to Those Who Did Not Receive the Supplement: A Protocol for Systematic Review and Meta-Analysis of Randomised Controlled Trials

“…Contemporarily, several clinical trials have studied the effects (e.g., biomarkers of inflammation, oxidative stress, cardiometabolic risk, and pregnancy outcomes) of vitamin D supplementation in GDM patients [18][19][20][21]. Although the role of vitamin D complementation in GDM patients has been tested widely, little is known about how it affects their body mass index (BMI) and gestational weight (GW).…”