Can J Diabetes, 2016, Nov. 21. pii:S1499-2671(16)30266-0.

A Randomized Controlled Clinical Trial Investigating the Effects of Omega-3 Fatty Acids and Vitamin E Co-Supplementation on Biomarkers of Oxidative Stress, Inflammation and Pregnancy Outcomes in Gestational Diabetes.

Jamilian, M. Hashemi Dizaji, S. Bahmani, F. Taghizadeh, M. et al.

Key Findings

Gestational diabetes mellitus (GDM) results from carbohydrate intolerance and insulin resistance and is characterized by hyperglycemia. Studies have demonstrated that omega-3 fatty acid and vitamin E levels are low in women with GDM. These investigators previously showed that combined omega-3 fatty acids from flaxseed oil and vitamin E taken by women with GDM for 6 weeks resulted in improved metabolic profiles.  This study demonstrated that omega-3 fatty acid ALA from flaxseed oil and vitamin E co-supplementation in women with GDM for 6 weeks had beneficial effects on plasma total antioxidant capacity; nitric oxide and plasma malondialdehyde. The incidence of newborns’ hyperbilirubinemia, Hyperbilirubinemia is a condition in which there is too much bilirubin in the blood. When red blood cells break down, a substance called bilirubin is formed. Babies are not easily able to get rid of the bilirubin and it can build up in the blood and other tissues and fluids of the baby’s body. but it did not affect plasma GSH, serum hs-CRP levels and other pregnancy outcomes. Further studies, particularly of those with elevated inflammation and oxidative stress, should measure inflammation and oxidative stress to explore the plausible mechanism.

ABSTRACT

OBJECTIVES: Limited data are available for assessing the effects of omega-3 fatty acids and vitamin E co-supplementation on metabolic profiles and pregnancy outcomes in gestational diabetes (GDM). This study was designed to determine the effects of omega-3 fatty acids and vitamin E co-supplementation on biomarkers of oxidative stress, inflammation and pregnancy outcomes in women with GDM. METHODS: This randomized, double-blind, placebo-controlled clinical trial was conducted in 60 patients with GDM who were not taking oral hypoglycemic agents. Patients were randomly allocated to intake either 1000 mg omega-3 fatty acids from flaxseed oil plus 400 IU vitamin E supplements (n=30) or placebo (n=30) for 6 weeks. Fasting blood samples were obtained from the women at the beginning of the study and after the 6-week intervention to quantify related markers. RESULTS: After 6 weeks of intervention, omega-3 fatty acids and vitamin E co-supplementation, compared with the placebo, resulted in a significant rise in total antioxidant capacity (TAC) (+187.5±224.9 vs. -32.5±136.1 mmol/L; p<0.001); nitric oxide (NO) (+5.0±7.7 vs. -12.0±28.0 µmol/L; p=0.002) and a significant decrease in plasma malondialdehyde (MDA) concentrations (-0.1±0.9 vs. +0.6±1.4 µmol/L; p=0.03). Co-supplementation with omega-3 fatty acids and vitamin E showed no detectable changes in plasma glutathione and serum high-sensitivity C-reactive protein levels. Joint omega-3 fatty acids and vitamin E supplementation resulted in lower incidences of hyperbilirubinemia in newborns (10.3% vs. 33.3%; p=0.03). CONCLUSIONS: Overall, omega-3 fatty acids and vitamin E co-supplementation for 6 weeks in women with GDM had beneficial effects on plasma TAC, MDA and NO and on the incidence of the newborns’ hyperbilirubinemia.

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