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Effect of different nutrients on blood glucose, inflammatory response and oxidative stress in gestational diabetes mellitus: a network meta-analysis

Published online by Cambridge University Press:  09 January 2024

Lingling Yu Open the ORCID record for Lingling Yu [Opens in a new window] ,
Yuan Zhu ,
Lan Geng ,
Yueming Xu  and
Mei Zhao
Lingling Yu
Affiliation:
School of Nursing, Anhui Medical University, Hefei, Anhui, China
Yuan Zhu
Affiliation:
School of Nursing, Anhui Medical University, Hefei, Anhui, China
Lan Geng
Affiliation:
School of Nursing, Anhui Medical University, Hefei, Anhui, China
Yueming Xu
Affiliation:
School of Nursing, Anhui Medical University, Hefei, Anhui, China
Mei Zhao*
Affiliation:
School of Nursing, Anhui Medical University, Hefei, Anhui, China
*
*Corresponding author: Mei Zhao, email zhaomei@ahmu.edu.cn
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Abstract

We searched PubMed, Web of Science, Embase, The Cochrane Library, China Biomedical Literature Database and other databases from inception to June 2023. The included studies were randomised controlled trials (RCT). The studies were screened by four authors, divided into two independent pairs. A total of eighteen studies were included, including 1362 patients, involving twelve intervention measures. The different nutrients had a significant effect on improving blood glucose, reducing inflammation levels and reducing oxidative stress compared with placebo (P < 0.05). Cumulative probability ranking showed that vitamin A + vitamin D + vitamin E ranked first in lowering fasting blood glucose (standardised mean difference (SMD) = 41.30, 95 % CI (2.07, 825.60)) and postprandial 2-h blood glucose (SMD = 15.19, 95 % CI (4.16, 55.53)). In terms of insulin resistance index, the first highest probability ranking is vitamin D (SMD = 5.12, 95 % CI (0.76, 34.54)). In terms of reducing the high-sensitivity C-reactive protein level, the first in probability ranking is VE (SMD = 2.58, 95 % CI (1.87,3.55)). The results of cumulative probability ranking showed that Mg + Zn + Ca + VD ranked first in reducing TNF-α (SMD = 1.90, 95% CI (0.40, 9.08)) and IL-6 (SMD = 1.83, 95 % CI (0.37, 9.12)). In terms of reducing malondialdehyde levels, the first ranked probability is VB1 (SMD = 4.99, 95 % CI (1.85, 13.46)). Cumulative probability ranking results showed that Ca + VD ranked first in reducing total antioxidant capacity (SMD = 0.66,95 % CI (0.38, 1.15)) and glutathione (SMD = 1.39, 95 % CI (0.43, 4.56)). In conclusion, nutritional interventions have significant effects on improving blood glucose, inflammatory levels and oxidative stress in patients with gestational diabetes. Due to the high uncertainty in the results and differences in the number and quality of studies included, the reliability of the conclusions still needs to be validated by conducting large-sample, high-quality RCT studies.

Keywords

NutrientsGestational diabetesBlood sugarInflammatory responseOxidative stressNetwork meta-analysisRandomised controlled trial
Type
Systematic Review and Meta-Analysis
Information
British Journal of Nutrition , Volume 131 , Issue 9 , 14 May 2024 , pp. 1513 - 1527
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Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of The Nutrition Society

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References

Ye, W, Luo, C, Huang, J, et al. (2022) Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta-analysis. BMJ 377, e67946.Google ScholarPubMed
Gao, C, Sun, X, Lu, L, et al. (2019) Prevalence of gestational diabetes mellitus in mainland China: a systematic review and meta-analysis. J Diabetes Investig 10, 154–162.10.1111/jdi.12854CrossRefGoogle ScholarPubMed
Wang, H, Li, N, Chivese, T, et al. (2022) IDF diabetes atlas: estimation of global and regional gestational diabetes mellitus prevalence for 2021 by international association of diabetes in pregnancy study group’s criteria. Diabetes Res Clin Pract 183, 109050.CrossRefGoogle ScholarPubMed
Zhao, F & Xiao, B (2022) Factors influencing adverse pregnancy outcomes in gestational diabetes mellitus. Comput Intell Neurosci 2022, 5177428.Google ScholarPubMed
Zhang, Y, Xiao, CM, Zhang, Y, et al. (2021) Factors associated with gestational diabetes mellitus: a meta-analysis. J Diabetes Res 2021, 6692695.CrossRefGoogle ScholarPubMed
Alamolhoda, SH, Yazdkhasti, M, Namdari, M, et al. (2020) Association between C-reactive protein and gestational diabetes: a prospective study. J Obstet Gynaecol 40, 349–353.CrossRefGoogle ScholarPubMed
Lekva, T, Norwitz, ER, Aukrust, P, et al. (2016) Impact of systemic inflammation on the progression of gestational diabetes mellitus. Curr Diab Rep 16, 26.CrossRefGoogle ScholarPubMed
Joo, EH, Kim, YR, Kim, N, et al. (2021) Effect of endogenic and exogenic oxidative stress triggers on adverse pregnancy outcomes: preeclampsia, fetal growth restriction, gestational diabetes mellitus and preterm birth. Int J Mol Sci 22, 10122.CrossRefGoogle ScholarPubMed
Abell, SK, De Courten, B, Boyle, JA, et al. (2015) Inflammatory and other biomarkers: role in pathophysiology and prediction of gestational diabetes mellitus. Int J Mol Sci 16, 13442–13473.CrossRefGoogle ScholarPubMed
Gunasegaran, P, Tahmina, S, Daniel, M, et al. (2021) Role of vitamin D-calcium supplementation on metabolic profile and oxidative stress in gestational diabetes mellitus: a randomized controlled trial. J Obstet Gynaecol Res 47, 1016–1022.10.1111/jog.14629CrossRefGoogle ScholarPubMed
Razavi, M, Jamilian, M, Samimi, M, et al. (2017) The effects of vitamin D and n-3 fatty acids co-supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in patients with gestational diabetes. Nutr Metab (Lond) 14, 80.CrossRefGoogle Scholar
Karamali, M, Heidarzadeh, Z, Seifati, S, et al. (2016) Zinc supplementation and the effects on pregnancy outcomes in gestational diabetes: a randomized, double-blind, placebo-controlled trial. Exp Clin Endocr Diab 124, 28.Google ScholarPubMed
Amirani, E, Aghadavod, E, Shafabakhsh, R, et al. (2022) Anti-inflammatory and antioxidative effects of thiamin supplements in patients with gestational diabetes mellitus. J Matern Fetal Neonatal Med 35, 2085–2090.10.1080/14767058.2020.1779212CrossRefGoogle ScholarPubMed
Asemi, Z, Karamali, M & Esmaillzadeh, A (2014) Effects of calcium–vitamin D co-supplementation on glycaemic control, inflammation and oxidative stress in gestational diabetes: a randomised placebo-controlled trial. Diabetologia 57, 1798–1806.CrossRefGoogle ScholarPubMed
Jamilian, M, Hashemi, DS, Bahmani, F, et al. (2017) A randomized controlled clinical trial investigating the effects of n-3 fatty acids and vitamin E co-supplementation on biomarkers of oxidative stress, inflammation and pregnancy outcomes in gestational diabetes. Can J Diabetes 41, 143–149.10.1016/j.jcjd.2016.09.004CrossRefGoogle ScholarPubMed
Asemi, Z, Jamilian, M, Mesdaghinia, E, et al. (2015) Effects of selenium supplementation on glucose homeostasis, inflammation, and oxidative stress in gestational diabetes: randomized, double-blind, placebo-controlled trial. Nutrition 31, 1235–1242.10.1016/j.nut.2015.04.014CrossRefGoogle ScholarPubMed
Asemi, Z, Hashemi, T, Karamali, M, et al. (2013) Effects of vitamin D supplementation on glucose metabolism, lipid concentrations, inflammation, and oxidative stress in gestational diabetes: a double-blind randomized controlled clinical trial. Am J Clin Nutr 98, 1425–1432.CrossRefGoogle ScholarPubMed
Hutton, B, Salanti, G, Caldwell, DM, et al. (2015) The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations. Ann Intern Med 162, 777–784.10.7326/M14-2385CrossRefGoogle ScholarPubMed
Huang, JQ, Li, YT, Liu, MM, et al. (2022) Comparison of the 2022 Chinese guidelines for the diagnosis and management of hyperglycaemia in pregnancy with the American Diabetes Association guidelines for the diagnosis and management of diabetes mellitus in pregnancy. Int J Obstetr Gynaecol 49, 691–699.Google Scholar
Guyatt, GH, Oxman, AD, Schünemann, HJ, et al. (2011) GRADE guidelines: a new series of articles in the Journal of Clinical Epidemiology. J Clin Epidemiol 64, 380–382.CrossRefGoogle ScholarPubMed
Shen, Y & Yang, WW (2022) Effect of vitamin D supplementation on serum ultrasensitive C-reactive protein and homocysteine levels in gestational diabetes mellitus patients with insulin resistance. China Matern Child Health 37, 3107–3111.Google Scholar
Cao, M, Xu, Q, Run, TT, et al. (2022) Effects of folic acid combined with vitamin B_(12) on glucose metabolism and pregnancy outcome in patients with gestational diabetes mellitus. China Food Nutr 28, 87–89.Google Scholar
Ruan, BL & Ruan, JB (2022) Effectiveness of magnesium-zinc-calcium–vitamin D complex supplementation in adjuvant treatment of gestational diabetes mellitus. Wisdom Health 8, 94–97.Google Scholar
Jamilian, M, Tabassi, Z, Reiner, Ž, et al. (2020) The effects of n-3 fatty acids from flaxseed oil on genetic and metabolic profiles in patients with gestational diabetes mellitus: a randomised, double-blind, placebo-controlled trial. Br J Nutr 123, 792–799.CrossRefGoogle ScholarPubMed
Lai, XM, F’e, Wang & Zeng, SL (2020) Effects of vitamin A, D and E supplementation on blood glucose and lipid related indicators in patients with gestational diabetes. Clin Med 40, 83–86.Google Scholar
Liu, J, Zhao, GB & Lu, LZ (2020) Effects of magnesium-zinc-calcium–vitamin D complex supplementation on inflammation, oxidative stress level and pregnancy outcome in patients with gestational diabetes mellitus. China Matern Child Health 35, 2584–2586.Google Scholar
He, JZ, Zhou, JW & She, CH (2020) Observations on the effects of vitamin D on glucose metabolism, serum adipokines and inflammatory factors levels in pregnant women with gestational diabetes mellitus. Heilongjiang Med 33, 342–344.Google Scholar
Jamilian, M, Mirhosseini, N, Eslahi, M, et al. (2019) The effects of magnesium-zinc-calcium-vitamin D co-supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes. BMC Pregnancy Childb 19, 1–8.CrossRefGoogle Scholar
Zhang, YM, Song, XP & Huang, GY (2019) Effect of vitamin D supplementation on the degree of insulin resistance in patients with gestational diabetes mellitus. Chin Med 14, 249–252.Google Scholar
Karamali, M, Bahramimoghadam, S, Sharifzadeh, F, et al. (2018) Magnesium–zinc–calcium–vitamin D co-supplementation improves glycemic control and markers of cardiometabolic risk in gestational diabetes: a randomized, double-blind, placebo-controlled trial. Appl Physiol Nutr Metab 43, 565–570.CrossRefGoogle ScholarPubMed
Jamilian, M, Samimi, M, Kolahdooz, F, et al. (2016) n-3 fatty acid supplementation affects pregnancy outcomes in gestational diabetes: a randomized, double-blind, placebo-controlled trial. J Maternal-Fetal Neonatal Med 29, 669–675.10.3109/14767058.2015.1015980CrossRefGoogle ScholarPubMed
Huang, JR & Huang, LL (2015) Effect of vitamin E on CRP, IL-6, IL-8 and lipid levels in patients with gestational diabetes mellitus. J Hainan Med Coll 21, 1658–1660.Google Scholar
Duan, E & Li, YY (2013) Effect of vitamin D supplementation on insulin resistance in pregnant women with gestational diabetes mellitus and neonatal insulin. Lingnan J Emergency Med 18, 289–291.Google Scholar
Li, D, Cai, Z, Pan, Z, et al. (2021) The effects of vitamin and mineral supplementation on women with gestational diabetes mellitus. BMC Endocr Disord 21, 106.CrossRefGoogle ScholarPubMed
Krzyzanowska, K, Zemany, L, Krugluger, W, et al. (2008) Serum concentrations of retinol-binding protein 4 in women with and without gestational diabetes. Diabetologia 51, 1115–1122.CrossRefGoogle ScholarPubMed
Chen, Y, Lv, P, Du, M, et al. (2017) Increased retinol-free RBP4 contributes to insulin resistance in gestational diabetes mellitus. Arch Gynecol Obstet 296, 53–61.CrossRefGoogle ScholarPubMed
Liu, HY, Mu, GD, Zhang, HW, et al. (2019) Effect and mechanism of pioglitazone combined with vitamin E on glycaemic control in gestational diabetic mice. Chin J Clin Pharmacol 35, 2023–2026.Google Scholar
De-Regil, LM, Palacios, C, Lombardo, LK, et al. (2016) Vitamin D supplementation for women during pregnancy. The Cochrane Database of Systematic Review 2016, issue 1, CD008873.Google Scholar
Guclu, A, Erdur, FM & Turkmen, K (2016) The emerging role of sirtuin 1 in cellular metabolism, diabetes mellitus, diabetic kidney disease and hypertension. Exp Clin Endocrinol Diabetes 124, 131–139.Google Scholar
Liu, CH, Hu, RF & Zhao, HF (2019) Research progress of nutritional management during pregnancy in gestational diabetes mellitus. General Pract Nursing 17, 2216–2218.Google Scholar
Zhang, LQ (2022) Analysis of the effect of multidisciplinary diagnosis and treatment of gestational diabetes mellitus in pregnant women. Chin Community Phys 38, 135–137.Google Scholar
Yu, Y, Tian, L, Xiao, Y, et al. (2018) Effect of vitamin D supplementation on some inflammatory biomarkers in type 2 diabetes mellitus subjects: a systematic review and meta-analysis of randomized controlled trials. Ann Nutr Metab 73, 62–73.CrossRefGoogle ScholarPubMed
Ermak, G & Davies, KJ (2002) Calcium and oxidative stress: from cell signaling to cell death. Mol Immunol 38, 713–721.CrossRefGoogle ScholarPubMed
Morais, JB, Severo, JS, Santos, LR, et al. (2017) Role of magnesium in oxidative stress in individuals with obesity. Biol Trace Elem Res 176, 20–26.CrossRefGoogle ScholarPubMed
Raj, V, Ojha, S, Howarth, FC, et al. (2018) Therapeutic potential of benfotiamine and its molecular targets. Eur Rev Med Pharmacol Sci 22, 3261–3273.Google ScholarPubMed
Beltramo, E, Berrone, E, Tarallo, S, et al. (2008) Effects of thiamine and benfotiamine on intracellular glucose metabolism and relevance in the prevention of diabetic complications. Acta Diabetol 45, 131–141.10.1007/s00592-008-0042-yCrossRefGoogle ScholarPubMed
Shivappa, N, Steck, SE, Hurley, TG, et al. (2014) Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr 17, 1689–1696.CrossRefGoogle ScholarPubMed
Tabung, FK, Smith-Warner, SA, Chavarro, JE, et al. (2016) Development and validation of an empirical dietary inflammatory index. J Nutr 146, 1560–1570.10.3945/jn.115.228718CrossRefGoogle ScholarPubMed
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