Skip to main content

The Effects of Magnesium and Vitamin E Co-Supplementation on Hormonal Status and Biomarkers of Inflammation and Oxidative Stress in Women with Polycystic Ovary Syndrome

Abstract

Synergistic approach of magnesium and vitamin E may benefit clinical symptoms of patients with polycystic ovary syndrome (PCOS) through improving their metabolic profiles and reducing oxidative stress and inflammation. This study was designed to determine the effects of magnesium and vitamin E co-supplementation on hormonal status and biomarkers of inflammation and oxidative stress in women with PCOS. This randomized, double-blind, placebo-controlled trial was conducted among 60 women with PCOS, aged 18–40 years old. Participants were randomly divided into two groups to take 250 mg/day magnesium plus 400 mg/day vitamin E supplements or placebo (n = 30 each group) for 12 weeks. Fasting blood samples were taken at baseline and after the 12-week intervention to quantify related variables. Magnesium and vitamin E co-supplementation resulted in a significant reduction in hirsutism (β − 0.37; 95% CI, − 0.70, − 0.05; P = 0.02) and serum high-sensitivity C-reactive protein (hs-CRP) (β − 0.67 mg/L; 95% CI, − 1.20, − 0.14; P = 0.01), and a significant increase in plasma nitric oxide (NO) (β 3.40 μmol/L; 95% CI, 1.46, 5.35; P = 0.001) and total antioxidant capacity (TAC) levels (β 66.32 mmol/L; 95% CI, 43.80, 88.84; P < 0.001). Overall, magnesium and vitamin E co-supplementation for 12 weeks may benefit women with PCOS on hirsutism, serum hs-CRP, plasma NO, and TAC levels. Clinical trial registration number http://www.irct.ir: IRCT2017082733941N8

This is a preview of subscription content, access via your institution.

Fig. 1

References

  1. Bozdag G, Mumusoglu S, Zengin D, Karabulut E, Yildiz BO (2016) The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod 31:2841–2855

    Article  PubMed  Google Scholar 

  2. Boots CE, Jungheim ES (2015) Inflammation and human ovarian follicular dynamics. Semin Reprod Med 33:270–275

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Shorakae S, Teede H, de Courten B, Lambert G, Boyle J, Moran LJ (2015) The emerging role of chronic low-grade inflammation in the pathophysiology of polycystic ovary syndrome. Semin Reprod Med 33: 257–269

  4. Artimani T, Karimi J, Mehdizadeh M et al (2018) Evaluation of pro-oxidant-antioxidant balance (PAB) and its association with inflammatory cytokines in polycystic ovary syndrome (PCOS). Gynecol Endocrinol 34:148–152

    Article  CAS  PubMed  Google Scholar 

  5. Chakraborty P, Ghosh S, Goswami SK, Kabir SN, Chakravarty B, Jana K (2013) Altered trace mineral milieu might play an aetiological role in the pathogenesis of polycystic ovary syndrome. Biol Trace Elem Res 152:9–15

    Article  CAS  PubMed  Google Scholar 

  6. Zhang D, Luo WY, Liao H, Wang CF, Sun Y (2008) The effects of oxidative stress to PCOS. Sichuan Da Xue Xue Bao Yi Xue Ban 39:421–423

    CAS  PubMed  Google Scholar 

  7. Simental-Mendia LE, Sahebkar A, Rodriguez-Moran M, Zambrano-Galvan G, Guerrero-Romero F (2017) Effect of magnesium supplementation on plasma c-reactive protein concentrations: a systematic review and meta-analysis of randomized controlled trials. Curr Pharm Des 23:4678–4686

    Article  CAS  PubMed  Google Scholar 

  8. Razzaghi R, Pidar F, Momen-Heravi M, Bahmani F, Akbari H, Asemi Z (2018) Magnesium supplementation and the effects on wound healing and metabolic status in patients with diabetic foot ulcer: a randomized, double-blind, placebo-controlled trial. Biol Trace Elem Res 181:207–215

    Article  CAS  PubMed  Google Scholar 

  9. Saboori S, Shab-Bidar S, Speakman JR, Yousefi Rad E, Djafarian K (2015) Effect of vitamin E supplementation on serum C-reactive protein level: a meta-analysis of randomized controlled trials. Eur J Clin Nutr 69:867–873

    Article  CAS  PubMed  Google Scholar 

  10. Dou M, Ma AG, Wang QZ et al (2009) Supplementation with magnesium and vitamin E were more effective than magnesium alone to decrease plasma lipids and blood viscosity in diabetic rats. Nutr Res 29:519–524

    Article  CAS  PubMed  Google Scholar 

  11. Chang W, Ma A, Wang Q, Mao R, Li C (2014) Effects of vitamin E and magnesium on glucolipid metabolism in obese rats. Wei Sheng Yan Jiu 43:713–718

    CAS  PubMed  Google Scholar 

  12. Barbagallo M, Dominguez LJ, Tagliamonte MR, Resnick LM, Paolisso G (1999) Effects of vitamin E and glutathione on glucose metabolism: role of magnesium. Hypertension 34:1002–1006

    Article  CAS  PubMed  Google Scholar 

  13. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group (2004) Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 81:19–25

    Google Scholar 

  14. Hatch R, Rosenfield RL, Kim MH, Tredway D (1981) Hirsutism: implications, etiology, and management. Am J Obstet Gynecol 140:815–830

    Article  CAS  Google Scholar 

  15. Tatsch E, Bochi GV, Pereira Rda S et al (2011) A simple and inexpensive automated technique for measurement of serum nitrite/nitrate. Clin Biochem 44:348–350

    Article  CAS  PubMed  Google Scholar 

  16. Benzie IF, Strain JJ (1996) The ferric reducing ability of plasma (FRAP) as a measure of “antioxidant power”: the FRAP assay. Anal Biochem 239:70–76

    Article  CAS  Google Scholar 

  17. Beutler E, Gelbart T (1985) Plasma glutathione in health and in patients with malignant disease. J Lab Clin Med 105:581–584

    CAS  PubMed  Google Scholar 

  18. Janero DR (1990) Malondialdehyde and thiobarbituric acid-reactivity as diagnostic indices of lipid peroxidation and peroxidative tissue injury. Free Radic Biol Med 9:515–540

    Article  CAS  PubMed  Google Scholar 

  19. Afshar Ebrahimi F, Foroozanfard F, Aghadavod E, Bahmani F, Asemi Z (2018) The effects of magnesium and zinc co-supplementation on biomarkers of inflammation and oxidative stress, and gene expression related to inflammation in polycystic ovary syndrome: a randomized controlled clinical trial. Biol Trace Elem Res 184:300–307

    Article  CAS  PubMed  Google Scholar 

  20. Asemi Z, Foroozanfard F, Hashemi T, Bahmani F, Jamilian M, Esmaillzadeh A (2015) Calcium plus vitamin D supplementation affects glucose metabolism and lipid concentrations in overweight and obese vitamin D deficient women with polycystic ovary syndrome. Clin Nutr 34:586–592

    Article  CAS  PubMed  Google Scholar 

  21. Foroozanfard F, Jamilian M, Bahmani F et al (2015) Calcium plus vitamin D supplementation influences biomarkers of inflammation and oxidative stress in overweight and vitamin D-deficient women with polycystic ovary syndrome: a randomized double-blind placebo-controlled clinical trial. Clin Endocrinol 83:888–894

    Article  CAS  Google Scholar 

  22. Maktabi M, Jamilian M, Asemi Z (2018) Magnesium-zinc-calcium-vitamin D co-supplementation improves hormonal profiles, biomarkers of inflammation and oxidative stress in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Biol Trace Elem Res 182:21–28

    Article  CAS  PubMed  Google Scholar 

  23. Ebrahimi FA, Samimi M, Foroozanfard F et al (2017) The effects of omega-3 fatty acids and vitamin E co-supplementation on indices of insulin resistance and hormonal parameters in patients with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Exp Clin Endocrinol Diabetes 125:353–359

    Article  CAS  PubMed  Google Scholar 

  24. Izadi A, Ebrahimi S, Shirzai S et al (2018) Hormonal and metabolic effects of coenzyme q10 and/or vitamin e in patients with polycystic ovary syndrome. J Clin Endocrinol Metab. https://doi.org/10.1210/jc.2018-01221

  25. Mondul AM, Rohrmann S, Menke A et al (2011) Association of serum alpha-tocopherol with sex steroid hormones and interactions with smoking: implications for prostate cancer risk. Cancer Causes Control 22:827–836

    Article  PubMed  PubMed Central  Google Scholar 

  26. Blank SK, McCartney CR, Helm KD, Marshall JC (2007) Neuroendocrine effects of androgens in adult polycystic ovary syndrome and female puberty. Semin Reprod Med 25:352–359

    Article  CAS  PubMed  Google Scholar 

  27. Dokras A, Sarwer DB, Allison KC et al (2016) Weight loss and lowering androgens predict improvements in health-related quality of life in women with PCOS. J Clin Endocrinol Metab 101:2966–2974

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Boztosun A, Acmaz G, Ozturk A, Muderris II (2013) Clinical efficacy of low dose flutamide plus Diane-35 in the treatment of idiopathic hirsutism and polycystic ovary syndrome. Ginekol Pol 84:258–262

    PubMed  Google Scholar 

  29. Barbagallo M, Dominguez LJ, Galioto A et al (2003) Role of magnesium in insulin action, diabetes and cardio-metabolic syndrome X. Mol Asp Med 24:39–52

    Article  CAS  Google Scholar 

  30. Rizzo MR, Abbatecola AM, Barbieri M et al (2008) Evidence for anti-inflammatory effects of combined administration of vitamin E and C in older persons with impaired fasting glucose: impact on insulin action. J Am Coll Nutr 27:505–511

    Article  CAS  PubMed  Google Scholar 

  31. Petrovic J, Stanic D, Dmitrasinovic G et al (2016) Magnesium supplementation diminishes peripheral blood lymphocyte DNA oxidative damage in athletes and sedentary young man. Oxidative Med Cell Longev 2016(2019643)

  32. Moslehi N, Vafa M, Rahimi-Foroushani A, Golestan B (2012) Effects of oral magnesium supplementation on inflammatory markers in middle-aged overweight women. J Res Med Sci 17:607–614

    PubMed  PubMed Central  Google Scholar 

  33. Mortazavi M, Moeinzadeh F, Saadatnia M, Shahidi S, McGee JC, Minagar A (2013) Effect of magnesium supplementation on carotid intima-media thickness and flow-mediated dilatation among hemodialysis patients: a double-blind, randomized, placebo-controlled trial. Eur Neurol 69:309–316

    Article  CAS  PubMed  Google Scholar 

  34. Kasperczyk S, Dobrakowski M, Kasperczyk A et al (2017) alpha-Tocopherol supplementation and the oxidative stress, homocysteine, and antioxidants in lead exposure. Arch Environ Occup Health 72:153–158

    Article  CAS  PubMed  Google Scholar 

  35. Nadeem A, Raj HG, Chhabra SK (2008) Effect of vitamin E supplementation with standard treatment on oxidant-antioxidant status in chronic obstructive pulmonary disease. Indian J Med Res 128:705–711

    CAS  PubMed  Google Scholar 

  36. Rajendran S, Willoughby SR, Chan WP et al (2009) Polycystic ovary syndrome is associated with severe platelet and endothelial dysfunction in both obese and lean subjects. Atherosclerosis 204:509–514

    Article  CAS  PubMed  Google Scholar 

  37. Hyderali BN, Mala K (2015) Oxidative stress and cardiovascular complications in polycystic ovarian syndrome. Eur J Obstet Gynecol Reprod Biol 191:15–22

    Article  CAS  PubMed  Google Scholar 

  38. Aneiros E, Philipp S, Lis A, Freichel M, Cavalie A (2005) Modulation of Ca2+ signaling by Na+/Ca2+ exchangers in mast cells. J Immunol 174:119–130

    Article  CAS  PubMed  Google Scholar 

  39. Mazur A, Maier JA, Rock E, Gueux E, Nowacki W, Rayssiguier Y (2007) Magnesium and the inflammatory response: potential physiopathological implications. Arch Biochem Biophys 458:48–56

    Article  CAS  PubMed  Google Scholar 

  40. Jiang Q (2014) Natural forms of vitamin E: metabolism, antioxidant, and anti-inflammatory activities and their role in disease prevention and therapy. Free Radic Biol Med 72:76–90

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Funding

The present study was supported by a grant from the Vice-chancellor for Research, AUMS, Arak, and Iran.

Author information

Affiliations

Authors

Contributions

ZA and MS contributed in conception, design, statistical analysis, and drafting of the manuscript. ZA supervised the study.

Corresponding author

Correspondence to Zatollah Asemi.

Ethics declarations

This randomized, double-blinded, placebo-controlled clinical trial is registered in the Iranian clinical trials website (http://www.irct.ir: IRCT2017082733941N8), has followed the Declaration of Helsinki guideline, and informed consent was given by all participants. The study protocol was approved by the Ethics Committee of Arak University of Medical Sciences (AUMS).

Competing Interests

The authors declare that they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Shokrpour, M., Asemi, Z. The Effects of Magnesium and Vitamin E Co-Supplementation on Hormonal Status and Biomarkers of Inflammation and Oxidative Stress in Women with Polycystic Ovary Syndrome. Biol Trace Elem Res 191, 54–60 (2019). https://doi.org/10.1007/s12011-018-1602-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12011-018-1602-9

Keywords

  • Supplementation
  • Hormonal status
  • Inflammation
  • Oxidative damage