Effect of levetiracetam drug on antioxidant and liver enzymes in epileptic patients: case-control study

Background: There is a limited amount of data regarding levetiracetam (LEV), an antiepileptic drug. Objective: This study was conducted to assess the effect of LEV on antioxidant status and liver enzymes. Method: In this case-control study, 33 epileptic patients under treatment with LEV for at least 6 months were compared with 35 healthy subjects. We measured serum total antioxidant capacity (TAC), salivary superoxide dismutase (SOD), alanine aminoteransferase (ALT), and aspartate aminoteransferase (AST) levels in both groups. Dietary intakes were collected using a Food Frequency Questionnaire (FFQ). Result: The level of TAC in the healthy subjects was significantly higher than it was in the patients (P=0.02), but the mean of ALT (P=0.02) and AST (P=0.03) was significantly higher in the patients in comparison with the controls. Mean salivary SOD showed no difference between the two groups. In the patients, the duration of drug use was inversely correlated with serum TAC (p=0.04) and had a direct correlation with ALT (p=0.01) and AST (p=0.03.). Conclusion: The results of our study indicated that LEV increased liver enzymes Also, treatment with this drug did not improve oxidative stress, but this could be due to the different in the dietary antioxidant intake. Routine screening of the liver and antioxidant enzymes in patients with chronic use of LEV is recommended

Effects of chromium supplementation on blood pressure, body mass index, liver function enzymes and malondialdehyde in patients with type 2 diabetes:A systematic review and dose-response meta-analysis of randomized controlled trials

Background: Several studies reported beneficial effects of chromium supplementation for management of type 2 diabetes mellitus (T2DM). The present study aimed to provide a systematic review and meta-analysis of randomized controlled trials (RCTs) examining the effects of chromium supplementation on blood pressure, body mass index (BMI), liver function enzymes and malondialdehyde (MDA) in patients with T2DM. Methods: PubMed, Scopus, and Embase were searched up to 15 November 2020 with no language and time restriction. RCTs that reported the effects of chromium supplementation on blood pressure, BMI, liver function enzymes and MDA in patients with T2DM were included. A random-effects model was used to compute weighted mean differences (WMDs) with 95 % confidence intervals (CIs). Between-study heterogeneity was assessed by Cochran's Q test and quantified by I2 statistic. Results: Of 3586 publications, 15 RCTs were included for the meta-analysis. Pooled effect sizes indicated that chromium significantly reduced diastolic blood pressure (DBP) (WMD): -2.36 mmHg, 95 % CI: −4.14, −0.60; P = 0.008), and MDA (WMD: −0.55 umol/l, 95 % CI: −0.96, −0.14; P = 0.008). However, chromium supplementation did not significantly affect BMI, systolic blood pressure (SBP), alanine aminotransferase (ALT), aspartate aminotransferase (AST). Meta-regression analysis did not show significant linear relationship between dose of chromium and change in BMI (p = 0.412), SBP (p = 0. 319), DBP (p = 0.102), ALT (p = 0.923), AST (p = 0.986) and MDA (p = 0.055). Conclusion: The present systematic review and meta-analysis shows that supplementation with chromium at dose of 200–1000 μg/day may reduce DBP and MDA in T2DM patients

The association between dietary antioxidants, oxidative stress markers, abdominal obesity and poly-cystic ovary syndrome: A case control study

In this case-control study, 60 patients with Polycystic ovary syndrome (PCOS) referred to the Nursing and Midwifery Center of Khorramabad, were selected as the case group and 90 non-PCOS patients as the control group. Demographic information and anthropometric indices of each person were collected. The Food Frequency Questionnaire (FFQ) and International Physical Activity Questionnaire (IPAQ) were completed. After at least 12 h of fasting, 7 mL of blood samples were taken from the patients. There was no statistically significant difference observed in the mean of the total antioxidant capacity (TAC) between the two groups. However, a statistically significant difference was found between the two groups in terms of malondialdehyde (MDA) and some dietary antioxidants levels (mean in case group: vit C = 34/2 mg, vit E = 7/7 mg, Se = 84/6 µg, Zn = 7/5 mg, beta-carotene = 762/8 µg, mean in control group: vit C = 72/5 mg, vit E = 10/6 mg, Se = 91/0 µg, Zn = 10/6 mg, beta-carotene = 1609/5 µg).IMPACT STATEMENT What is already known on this subject? Polycystic ovary syndrome (PCOS) is one of the most common endocrine abnormalities and is considered as the main cause of infertility. Some studies have evaluated the link between dietary intakes and oxidative stress markers in PCOS patients. It is well known that about 40–50% of individuals with PCOS are obese and that leads to an increase in lipid catabolism and production of free radicals and oxidative stress. What the results of this study add? The aim of the present study was to compare the level of dietary antioxidants and oxidative stress markers including TAC, MDA and abdominal obesity prevalence in PCOS patients with healthy individuals. What the implications are of these findings for clinical practice and/or further research? We hope that our study can be influential in the field of PCOS. Furthermore, our findings have indicated a statistically significant difference between the two groups in terms of MDA and some dietary antioxidants levels. This result might be encouraging in using antioxidant in patients with PCOS

The Effects of Vitamin D on Kynurenine Level in Children With Attention Deficit Hyperactivity Disorder: An Epidemiological Study

Background and aims: Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders with a worldwide prevalence of 5%. The prevalence is even higher among school age children ranging from 8% to 12%. ADHD is predominantly childhood-onset disorder and can persist into adolescence and adulthood to inflict long-term harm. The aim of this study was to identify the epidemiological features of ADHD and investigate the effects of vitamin D on kynurenine level in children with ADHD in Iran using ELISA method. Methods: A case-control study was designed. The study participants consisted of 40 patients with ADHD and 40 healthy participants as control group. It was conducted in Isfahan Hasht Behesht hospital from July to November 2015. All samples were treated with 1000 U of vitamin D as a tablet twice daily. The level of kynurenine was measured in blood samples using enzyme-linked immunosorbent assay (ELISA) method. Data analysis was done using SPSS software. Results: The results of this study showed that the mean vitamin D levels were 49.73 and 73.72, respectively before and after treatment in patient group, which seem significant. The mean vitamin D level after treatment was higher in patient group in comparison with control group. On the other hand, the mean kynurenine levels were 608.1 and 662.9, respectively before and after treatment in patient group. The mean kynurenine level was the same before and after treatment. Conclusion: According to the results of the study, we can conclude that vitamin D did not have a significant effect on kynurenine level in children with ADHD

Vitamin B12 and folate status in patients with epilepsy under levetiracetam monotherapy

Background: Antiepileptic drugs (AEDs) may lead to an increase in the plasma concentration of homocysteine. There is limited information, especially from Iran, regarding the risk in patients who are treated with levetiracetam as a new type of AED. The aim of the present study was to investigate the effect of levetiracetam on plasma homocysteine, vitamin B12, and folate levels in adult patients with epilepsy. Methods: We conducted a case-control study and enrolled adult patients with epilepsy who had received monotherapy with levetiracetam for at least 6 months at some time prior to the study. homocysteine serum, vitamin B12, and folate were measured, and folate and vitamin B12 intake was determined by the food frequency questionnaire (FFQ). Results: Thirty-three patients on levetiracetam and 35 control subjects aged between 18 and 60 years were enrolled. No statistically significant differences in the means of the serum markers of vitamin B12, FA, and homocysteine levels were found between the two groups. In the first model,i.e., the crude model, no significant differences were observed in the serum concentrations of homocysteine, vitamin B12, and folate. In the second model, education was considered, and body mass index and folate intake was controlled with no significant difference being observed in the mean homocysteine serum level. Conclusions: Treatment with levetiracetam in patients with epilepsy has no effect on the serum levels concentrations of homocysteine, vitamin B12, and folate. This medication is suggested for patients who use AEDs on a long-term basis and at high dosages

The effect of garlic (Allium sativum) on polycystic ovary syndrome related hormones and glycemic parameters: A randomized, double-blinded clinical trial

Background: The purpose of the present study was to investigate the effect of garlic supplementation on androgen levels and glycemic-related markers in patients with PCOS. Methods: In these 8 weeks of randomized double-blinded control trial, 80 women were randomly assigned into two groups in which patients were asked to intake either 800 mg/day garlic or an identical placebo. A blood sample was obtained pre- and post-trial to assess androgens and glycemic-related parapets. A 3-days- food record and a short form of international physical activity questionnaires (IPAQ) were also evaluated at the beginning and end of the trial. Results: All participants completed the trial. Garlic supplementation resulted in significant reduction in fasting plasma glucose (-3.22 ± 7.41 vs. 0.72 ± 5.37; P = 0.008) and homeostatic model assessment for insulin resistance (HOMA-IR) (-0.29 ± 1.45 vs. 0.28 ± 1.20; P = 0.02). In addition, a trend to a significant improvement was detected in free androgen index (FAI) (P = 0.09), insulin levels (P = 0.07), and quantitative insulin sensitivity check index (QUICKI) (P = 0.06). However, no significant difference was found in testosterone and sex hormone-binding globulin (SHBG) (P > 0.05). Conclusions : Present study indicates that garlic supplementation could be beneficial for FPG and insulin resistance improvement. However, garlic supplementation does not show remarkable efficacy on androgens. Further studies are warranted to confirm the results

The effects of vitamin D supplementation on the antioxidant serum level in 6-13 years old children with ADHD

Background: The causes of Attention-deficit/hyperactivity disorder (ADHD) (the most common psychological disorder is still unknown. The main symptoms include impulsivity, hyperactivity and attention deficit. Some studies have shown the relationship between ADHD and oxidative stress, and yet some researches have shown the effects on vitamin D on the antioxidants level. This research intends to identify the effect of vitamin D supplementation on the antioxidant serum level in 6-13 years old children with ADHD. Methods: This double blind clinical trial was conducted in Isfahan city, the center of Iran, from October 2015 to February 2016. The sample included 35 subjects of both groups that were randomly selected among 6-13 years old children with ADHD diagnosed by pediatric psychologist. The intervention group consumed 1000 IU of vitamin D3 daily for three months, and the control group used placebo for the same period of time. Their stature and weight were recorded by digital instruments without the shoes with the least clothes. The next step was to train the food record of the students to the parents so that 3 food records were taken during the study. 25-hydroxyvitamin D3 (25(OH)D3), TAC (Total antioxidant capacity), MDA (Malondialdehyde), CAT (Catalase) and GSH (Glutathione) of the participants of both groups were measured before and after the intervention. Results: In this Study, both groups were adjusted in terms of their age, gender and BMI. The mean score of the variables of leisure time and sport showed no significant difference in the both groups. Comparing the average TAC and MDA between the two groups before intervention didn’t show a significant difference (P1TAC=0.06) (P1MDA=0.32), but after the intervention, the vitamin D intake group showed the increase in TAC and decrease in MDA (P2TAC=0.001) (P2 MDA=0.01). Moreover, CAT and GSH showed no significant difference in the two groups before and after intervention. Conclusion: Vitamin D supplementation for 3 months led to the improvement of antioxidant capacity by the increase of TAC and decrease of MDA, but the CAT and GSH showed no significant change in the mentioned period of time. &nbsp

Effects of Vitamin E on seizure frequency, electroencephalogram findings, and oxidative stress status of refractory epileptic patients

Background: Oxidative stress has been a frequent finding in epileptic patients receiving antiepileptic drugs (AEDs). In this study, the influence of Vitamin E on the antiseizure activity and redox state of patients treated with carbamazepine, sodium valproate, and levetiracetam has been investigated. Materials and Methods: This double-blind, placebo-controlled trial was carried out on 65 epileptic patients with chronic antiepileptic intake. The subjects received 400 IU/day of Vitamin E or placebo for 6 months. Seizure frequency, electroencephalogram (EEG), and redox state markers were measured monthly through the study. Results: Total antioxidant capacity, catalase and glutathione were significantly higher in Vitamin E received group compared with controls (P < 0.05) whereas malodialdehyde levels did not differ between two groups (P < 0.07). Vitamin E administration also caused a significant decrease in the frequency of seizures (P < 0.001) and improved EEG findings (P = 0.001). Of 32 patients in case group, the positive EEG decreased in 16 patients (50%) whereas among 33 patients in control group only 4 patients (12.1%) showed decreased positive EEG. Conclusion: The results of this preliminary study indicate that coadministration of antioxidant Vitamin E with AEDs improves seizure control and reduces oxidative stress

Beneficial effects of folic acid supplementation on lipid markers in adults: A GRADE-assessed systematic review and dose-response meta-analysis of data from 21,787 participants in 34 randomized controlled trials

International audienceFolic acid supplementation has received considerable attention in the literature, yet there is a large discrepancy in its effects on lipid markers in adults. Therefore, this systematic review and meta-analysis of 38 randomized controlled trials (RCTs) evaluated the effects of folic acid supplementation on triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol concentrations in a cohort of 21,787 participants. A systematic search current as of March 2021 was performed in PubMed/Medline, Scopus, Web of Science, and Embase using relevant keywords to identify eligible studies. A fix or random-effects model was used to estimate the weighted mean difference (WMD) and 95% confidence intervals (CIs). Thirty-four RCTs were included in this meta-analysis. The pooled analysis revealed that serum TG (WMD: −9.78 mg/dL; 95% CI: −15.5 to −4.00; p = 0.001, I2=0.0%, p = 0.965) and TC (WMD: −3.96 mg/dL; 95% CI: −6.71 to −1.21; p = 0.005, I2=46.9%, p = 0.001) concentrations were significantly reduced following folic acid supplementation compared to placebo. However, folic acid supplementation did not affect serum concentrations of LDL (WMD: −0.97 mg/dL; 95% CI: −6.82 to 4.89; p = 0.746, I2=60.6%, p < 0.001) or HDL cholesterol (WMD: 0.44 mg/dL; 95% CI: −0.53 to 1.41; p = 0.378, I2= 0.0%, p = 0.831). A significant dose-response relationship was observed between the dose of folic acid supplementation and serum concentrations of HDL cholesterols (r = 2.22, p = 0.047). Folic acid supplementation reduced serum concentrations of TG and TC without affecting LDL or HDL cholesterols. Future large RCTs on various populations are needed to show further beneficial effects of folic acid supplementation on lipid profile

Effects of Folic Acid Supplementation on Oxidative Stress Markers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

International audience(1) Background: This systematic review and meta-analysis aimed to assess the effects of folic acid supplementation on oxidative stress markers. (2) Methods: Online database including PubMed, Scopus, Web of Science, and Cochrane were searched up to January 2021, to retrieve randomized controlled trials (RCTs) which examined the effect of folic acid supplementation on markers of oxidative stress. Meta-analyses were carried out using a random-effects model. I2 index was used to evaluate the heterogeneity of RCTs. (3) Results: Among the initial 2322 studies that were identified from electronic databases search, 13 studies involving 1013 participants were eligible. Pooled effect size from 13 studies indicated that folic acid supplementation elicits a significant rise in serum concentrations of glutathione (GSH) (WMD: 219.01 umol/L, 95% CI 59.30 to 378.71, p = 0.007) and total antioxidant capacity (TAC) (WMD: 91.70 umol/L, 95% CI 40.52 to 142.88, p < 0.001) but has no effect on serum concentrations of nitric oxide (NO) (WMD: 2.61 umol/L, 95% CI −3.48 to 8.72, p = 0.400). In addition, folic acid supplementation significantly reduced serum concentrations of malondialdehyde (MDA) (WMD: −0.13 umol/L, 95% CI −0.24 to −0.02, p = 0.020). (4) Conclusions: This meta-analysis study suggests that folic acid supplementation may significantly improve markers within the antioxidative defense system by increasing serum concentrations of GSH and TAC and decreasing serum concentrations of MDA