Effect of alpha-lipoic acid supplementation on the lipid profile and lipid ratios in women with gestational diabetes mellitus: A clinical trial study

Background: Evidence suggests that Oxidative stress has been shown to plays an important role in gestational diabetes mellitus (GDM) etiology. On the other hand, women with GDM are at an increased risk for complications such as endothelial dysfunction and cardiovascular diseases. Objective: To investigate the effects of alpha-lipoic acid (ALA) on the maternal circulating values of lipid profile and lipid ratios in women with GDM. Materials and Methods: Sixty women with GDM were participated in the present study. The ALA group (n = 30) received ALA (100 mg/day) and the placebo group (n = 30) received cellulose acetate (100 mg/day) for eight wk. The maternal circulating values of hemoglobin A1C, triglyceride (TG), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, triglyceride-glucose (TyG) index, atherogenic index of plasma (AIP), non-HDL-C, and lipid ratios were assessed before and after the intervention. P-value < 0.05 was considered as statistically significant. Results: The values of TyG index (p < 0.001), TG (p = 0.006), TG/HDL-C (p = 0.003), and AIP (p = 0.005) decreased significantly in the ALA group after the intervention. Conclusion: Maternal circulating values of TyG index, TG, TG/HDL, AIP decreased after eight wk of ALA supplementation in women with GDM. Key words: Lipoic acid, Gestational diabetes, Lipids, Triglycerides, Cholesterol

Explaination of the Concept of Midwife-Mother Relationship in Delivery Rooms: A Qualitative Content Analysis

Introduction: The relationship that develops between the midwife and women is at the core of human care. However, there is a lack of knowledge about the communication features of midwifes and mothers in various situations and settings. Thus, their experience in the delivery room can be the basis for the body of knowledge in their profession and provide a clear and comperhensive concept of their relationship based on the prevailing sociocultural context. Method: The present qualitative content analysis was conducted on 32 participants who were selected through purposive sampling. The participants consisted of 16 midwifes and 16 mothers hospitalized in the postpartum ward of a hospital affiliated to Arak University of Medical Sciences in 2013. Data were gathered through unstructured and semi-structured interviews. Interviews were transcribed verbatim and analyzed using the conventional content analysis approach. Sampling ceased when data saturation was achieved. Results: The data analysis revealed 2 themes that encompassed the midwife-mother relationship. The 2 themes were communication as the essence of midwifery care and reflection of communication. Each theme consisted of clasifications and main codes. Conclusion: According to the results, the concept of the midwife-mother relationship in the delivery room was identified as therapeutic alliance. The findings enhanced understanding of the meaning and dimensions of the midwife-mother relationship beyond the traditional meaning. This study offers evidence of the essence of this relationship and may go some way towards the creation of a written body of midwifery knowledge. The results can assist midwives in providing holistic and high quality care to mothers during labour, and thus, provide positive outcomes in normal child birth. Keywords: Midwife-mother relationship, Qualitative content analysis, Delivery room, Concept

Changes in Female Sex Hormones in Patients with Intentional Drug and Chemical Poisoning

ABSTRACT Background: Hormonal changes as a factor influencing the emotional state of women have an important role in the incidence of suicide. The aim of this study is to investigate changes in FSH-LH, Estrogen, and Progesterone hormones in women attempting suicide by drugs and chemicals. Methods: In this cross-sectional study, women of reproductive diagnosed with drug and chemical poisoning who were hospitalized in Farshchian Hospital, Hamadan, Iran, were assessed regarding LH, FSH estrogen and progesterone hormones over a period of six months in 2011. Overall, 80 patients were studied with regard to the inclusion and exclusion criteria. Results: The highest rate of suicide was in the age range of 14-25 years (47 patients, 60.1%). A significant relationship was observed among the blood levels of hormones FSH, LH, progesterone, and estrogen. The association of hormone levels and LMP and attempted suicide was significant. The LH level was significantly lower in patients with substance abuse. The estrogen level was significantly lower in patients with the history of self-injury. Most patients (67.5%) were in the follicular phase which was statistically significant. Conclusion: According to the obtained results, there was a significant relationship between the levels of different hormones. The significant relationship was positive in some cases but negative in other

The effects of coenzyme Q10 supplementation on gene expression related to insulin, lipid and inflammation in patients with polycystic ovary syndrome

Objective: This research was conducted to assess the effects of coenzyme Q10 (CoQ10) intake on gene expression related to insulin, lipid and inflammation in subjects with polycystic ovary syndrome (PCOS). Methods: This randomized double-blind, placebo-controlled trial was conducted on 40 subjects diagnosed with PCOS. Subjects were randomly allocated into two groups to intake either 100mg CoQ10 (n¼20) or placebo (n¼20) per day for 12 weeks. Gene expression related to insulin, lipid and inflammation were quantified in blood samples of PCOS women with RT-PCR method. Results: Results of RT-PCR shown that compared with the placebo, CoQ10 intake downregulated gene expression of oxidized low-density lipoprotein receptor 1 (LDLR) (p<0.001) and upregulated gene expression of peroxisome proliferator-activated receptor gamma (PPAR-c) (p¼0.01) in peripheral blood mononuclear cells of subjects with PCOS. In addition, compared to the placebo group, CoQ10 supplementation downregulated gene expression of interleukin-1 (IL-1) (p¼0.03), interleukin-8 (IL-8) (p¼0.001) and tumor necrosis factor alpha (TNF-a) (p<0.001) in peripheral blood mononuclear cells of subjects with PCOS. Conclusions: Overall, CoQ10 intake for 12 weeks in PCOS women significantly improved gene expression of LDLR, PPAR-c, IL-1, IL-8 and TNF-a

The effects of omega-3 fatty acids and vitamin E co-supplementation on gene expression of lipoprotein(a) and oxidized low-density lipoprotein, lipid profiles and biomarkers of oxidative stress in patients with polycystic ovary syndrome

This study was conducted to determine the effects of omega-3 fatty acids and vitamin E cosupplementation on gene expression of lipoprotein(a) (Lp[a]) and oxidized low-density lipoprotein (Ox-LDL), lipid profiles and biomarkers of oxidative stress in women with polycystic ovary syndrome (PCOS). This randomized double-blind, placebo-controlled trial was done on 68 women diagnosed with PCOS according to the Rotterdam criteria aged 18e40 years old. Participants were randomly assigned into two groups to receive either 1000 mg omega-3 fatty acids from flaxseed oil containing 400 mg a- Linolenic acid plus 400 IU vitamin E supplements (n ¼ 34) or placebo (n ¼ 34) for 12 weeks. Lp(a) and Ox-LDL mRNA levels were quantified in peripheral blood mononuclear cells of PCOS women with RT-PCR method. Lipid profiles and biomarkers of oxidative stress were quantified at the beginning of the study and after 12-week intervention. Quantitative results of RT-PCR demonstrated that compared with the placebo, omega-3 fatty acids and vitamin E co-supplementation downregulated expressed levels of Lp(a) mRNA (P < 0.001) and Ox-LDL mRNA (P < 0.001) in peripheral blood mononuclear cells of women with PCOS. In addition, compared to the placebo group, omega-3 fatty acids and vitamin E cosupplementation resulted in a significant decrease in serum triglycerides (�22.1 ± 22.3 vs. þ7.7 ± 23.6 mg/dL, P < 0.001), VLDL- (�4.4 ± 4.5 vs. þ1.5 ± 4.7 mg/dL, P < 0.001), total- (�20.3 ± 16.6 vs. þ12.2 ± 26.1 mg/dL, P < 0.001), LDL- (�16.7 ± 15.3 vs. þ11.9 ± 26.1 mg/dL, P < 0.001) and total-/HDLcholesterol (�0.5 ± 0.6 vs. þ0.4 ± 0.8, P < 0.001). There were a significant increase in plasma total antioxidant capacity (þ89.4 ± 108.9 vs. þ5.9 ± 116.2 mmol/L, P ¼ 0.003) and a significant decrease in malondialdehyde levels (�0.3 ± 0.4 vs. -0.008 ± 0.6 mmol/L, P ¼ 0.01) by combined omega-3 fatty acids and vitamin E intake compared with the placebo group. Overall, omega-3 fatty acids and vitamin E cosupplementation for 12 weeks in PCOS women significantly improved gene expression of Lp(a) and Ox- LDL, lipid profiles and biomarkers of oxidative stress

Effects of Melatonin Supplementation on Hormonal, Inflammatory, Genetic, and Oxidative Stress Parameters in Women With Polycystic Ovary Syndrome

Purpose: The aim of the current study was to evaluate the effect of melatonin administration on clinical, hormonal, inflammatory, and genetic parameters in women with polycystic ovarian syndrome (PCOS).Methods: The present randomized, double-blinded, placebo-controlled clinical trial was conducted among 56 patients with PCOS, aged 18–40 years old. Subjects were randomly allocated to take either 5 mg melatonin supplements (n = 28) or placebo (n = 28) twice a day for 12 weeks.Results: Melatonin administration significantly reduced hirsutism (β −0.47; 95% CI, −0.86, −0.09; P = 0.01), serum total testosterone (β −0.11 ng/mL; 95% CI, −0.21, −0.02; P = 0.01), high-sensitivity C-reactive protein (hs-CRP) (β −0.61 mg/L; 95% CI, −0.95, −0.26; P = 0.001), and plasma malondialdehyde (MDA) levels (β −0.25 μmol/L; 95% CI, −0.38, −0.11; P &lt; 0.001), and significantly increased plasma total antioxidant capacity (TAC) levels (β 106.07 mmol/L; 95% CI, 62.87, 149.28; P &lt; 0.001) and total glutathione (GSH) (β 81.05 μmol/L; 95% CI, 36.08, 126.03; P = 0.001) compared with the placebo. Moreover, melatonin supplementation downregulated gene expression of interleukin-1 (IL-1) (P = 0.03) and tumor necrosis factor alpha (TNF-α) (P = 0.01) compared with the placebo.Conclusions: Overall, melatonin administration for 12 weeks to women with PCOS significantly reduced hirsutism, total testosterone, hs-CRP, and MDA, while increasing TAC and GSH levels. In addition, melatonin administration reduced gene expression of IL-1 and TNF-α.Clinical Trial Registration:www.irct.ir, identifier IRCT2017082733941N9, Available online at: https://www.irct.ir/trial/2605

Effects of Vitamin E plus Omega-3 Supplementation on Inflammatory Factors, Oxidative Stress Biomarkers and Pregnancy Consequences in Women with Gestational Diabetes

Background and Aim: We are aware of no study that examined the effects of vitamin E plus omega-3 fatty acid supplementation on inflammatory and oxidative stress biomarkers in pregnant women with gestational diabetes (GDM). This study aimed to evaluate the effects of vitamin E plus omega-3 supplementation on insulin metabolism and inflammatory and oxidative stress biomarkers in pregnant women with gestational diabetes. Materials and Methods: This randomized, double-blind, placebo-controlled clinical trial was performed on 60 women with GDM. Subjects were randomly assigned to receive either 400 IU vitamin E plus 1000 mg omega-3 fatty acid supplements (n=30) or placebo (n=30) for 6 weeks. Fasting blood samples were taken at study baseline and after 6 weeks of intervention to quantify biochemical variables. Findings: Vitamin E plus omega-3 fatty acid supplementation led to a significant rise in plasma total antioxidant capacity (+187.5±224.9 vs. -32.5±136.1 mmol/L, p<0.001) and a significant decrease in MDA levels (-0.1±0.9 vs. +0.6±1.4 µmol/L, p=0.04) compared with placebo. Furthermore, a significant increase in plasma NO levels (+5.0±7.7 vs. -12.0±28.0 µmol/L, p=0.002) was seen after vitamin E plus omega-3 fatty acid supplementation compared with the placebo. Conclusion: Vitamin E plus omega-3 fatty acid supplementation in GDM women had beneficial effects on biomarkers of inflammation and oxidative stress

Metabolic Response to Soy Supplementation in Women with Polycystic Ovary Syndrome

Abstract Background: We are aware of no study examining the effects of Soy supplementation on patients with polycystic ovary syndrome (PCOS).This study was conducted to evaluate the effects of Soy supplementation on metabolic profiles in women with PCOS. Materials and Methods: This randomized, double-blind, placebo-controlled clinical trial was conducted among 70 women diagnosed with PCOS. Participants were randomly divided into two groups to receive 50 mg Soy isoflavone supplements (n=35) or placebo (n=35) for 12 weeks. Fasting blood samples were taken at baseline and after a 12-week intervention to quantify related factors. Results: Intervention group, subjects who received Soy supplements had significantly decreased total serum testosterone levels (-0.2±0.4 vs. +0.1±0.3 ng/mL, p=0.01) compared with the placebo. In addition, a significant rise in plasma glutathione (+96.0±102.2 vs. +22.7±157.8 µmol/L, p=0.04) and a significant decrease in malondialdhyde levels (-0.7±0.8 vs. +0.8±2.3, p=0.001) was observed following the consumption of Soy supplements compared with the placebo. Conclusion: According to this study, Soy supplementation among PCOS women had beneficial effects on metabolic profiles

Effects of Combined Evening Primrose Oil and Vitamin D Intake on hs-CRP, Oxidative Stress and Pregnancy Outcomes in Women with Gestational Diabetes

Abstract Background: The efficacy of evening primrose oil has been reported in metabolic syndrome and other diseases.The role of vitamin D has been proposed in the risk reducing of chronic diseases such as obesity, metabolic syndrome and diabetes too. We are aware of no study that examined the effects of evening primrose oil and vitamin D supplementation on metabolic profiles in gestational diabetes (GDM). This study was designed to assess the effects of evening primrose oil and vitamin D supplementation on metabolic profiles among pregnant women with GDM. Materials and Methods: This randomized, double-blind, placebo-controlled clinical trial was performed among 60 women with GDM. Subjects were randomly assigned to receive either evening primrose oil and vitamin D supplements (n=30) or placebo (n=30) for 6 weeks. Fasting blood samples were taken at study baseline and after 6 weeks of intervention to quantify biochemical variables. Results: Evening primrose oil and vitamin D supplementation led to a significant decrease in serum high sensitivity-C reactive protein (hs-CRP ) levels (change from baseline: -1.9±4.0 vs. +0.6±2.6 µg/mL, p=0.006) and MDA (-0.8±2.1 vs. +0.6±1.5 µmol/L,p=0.005) compared with placebo. Furthermore, a significant increase in plasma NO (+2.5±3.8 vs. -1.9±8.1 µmol/L, p=0.009) and TAC levels (+84.4±174.8 vs. -36.4±143.1 mmol/L, p=0.005) was seen after evening primrose oil and vitamin D supplementation compared with placebo. Conclusion: Evening primrose oil and vitamin D supplementation in GDM women had beneficial effects on metabolic profiles

Efficacy of Selenium Supplement on Gene Expression of Inflammatory Cytokines and Vascular Endothelial Growth Factor in Gestational Diabetes

Abstract Background: Selenium supplement has multiple important effects, including anti-inflammatory effect. The aim of this study was to assess the effects of selenium supplement on gene expression of inflammatory cytokines and vascular endothelial growth factor in gestational diabetes. Materials and Methods: This randomized double blind placebo control trial was performed on 40 patients suffering from GDM aged 18–40 years old. Participants were randomly divided into interventional group receiving 200mg/day selenium supplements (n=20) and control group receiving placebo (n=20) for 6 weeks. Primary outcome was gene expression of inflammatory cytokines and VEGF which were assessed in lymphocyte of GDM patients by RT-PCR method. Results: After 6 weeks intervention, in comparison with the control group, interventional group showed down regulation of gene expression of tumor necrosis factor alpha (TNF–α) (p=0.02) and transforming growth factor beta (TGF–β) (p=0.01) and up-regulation of gene expression of vascular endothelial (VEGF) (p = 0.03) in lymphocytes of GDM. There was not any significant change following intervention with selenium regarding gene expression of interleukin IL-1 β and IL-8 in lymphocytes of GDM patients. Conclusion: 6 weeks supplementation with selenium in patients with GDM can cause down regulated gene expression of TNF-α and TGF–β, and up regulated gene expression of VEGF. Selenium supplement had not any effect on gene expression of IL-1 β and IL-8