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Changes in Bone Turnover, Inflammatory, Oxidative Stress, and Metabolic Markers in Women Consuming Iron plus Vitamin D Supplements: a Randomized Clinical Trial

Abstract

We aimed to investigate whether combination of vitamin D and iron supplementation, comparing vitamin D alone, could modify bone turnover, inflammatory, oxidative stress, and metabolic markers. Eighty-seven women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18–45 years were randomly assigned into two groups: (1) receiving either 1000 IU/day vitamin D3 plus 27 mg/day iron (D-Fe); (2) vitamin D3 plus placebo supplements (D-P), for 12 weeks. In D-Fe group, significant decrease in red blood cells (RBC) (P = 0.001) and hematocrit (Hct) (P = 0.004) and increases in mean corpuscular hemoglobin concentration (MCHC) (P = 0.001), 25OHD (P < 0.001), osteocalcin (P < 0.001), high-density cholesterol (HDL) (P = 0.041), and fasting blood sugar (FBS) (P < 0.001) were observed. D-P group showed significant decrease in RBC (P < 0.001), Hb (P < 0.001), Hct (P < 0.001), mean corpuscular volume (MCV) (P = 0.004), mean corpuscular hemoglobin (MCH) (P < 0.001), MCHC (P = 0.005), serum ferritin (P < 0.001), and low-density cholesterol (LDL) (P = 0.016) and increases of 25OHD (P < 0.001), osteocalcin (P < 0.001), C-terminal telopeptide (CTX) (P = 0.025), triglyceride (TG) (P = 0.004), FBS (P < 0.001), and interleukin-6 (IL-6) (P = 0.001) at week 12. After the intervention, the D-P group had between-group increases in mean change in the osteocalcin (P = 0.007) and IL-6 (P = 0.033), and decreases in the RBC (P < 0.001), Hb (P < 0.001), Hct (P < 0.001), and MCV (P = 0.001), compared with the D-Fe group. There were significant between-group changes in MCH (P < 0.001), MCHC (P < 0.001), ferritin (P < 0.001), and serum iron (P = 0.018). Iron–vitamin D co-supplementation does not yield added benefits for improvement of bone turnover, inflammatory, oxidative stress, and metabolic markers, whereas, vitamin D alone may have some detrimental effects on inflammatory and metabolic markers. IRCT registration number: IRCT201409082365N9

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Acknowledgments

We thank the participants for their cooperation and participation in this study.

Funding

This work was financially supported by the Vice Chancellor of Research, Iran University of Medical Sciences.

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FA-Z and MV designed this study. BA, FA-Z, and HS participated in the conduct of the study. MS and FZ analyzed the data. BA, FA-Z, MS, and HS drafted the manuscript. MV and SMK critically revised the manuscript. All authors read and approved the final manuscript.

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Correspondence to Mohammadreza Vafa.

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Written informed consent was obtained from all participants on recruitment. The protocol of this study was approved by the Medical Ethics Committee of Iran University of Medical Sciences, is in conformity with the Declaration of Helsinki (approval number: IR.IUMS.REC.1394.25971), and was registered at the Iranian Registry of Clinical Trials (IRCT registration number: IRCT201409082365N9) which is available at: http://irct.ir/user/trial/20288/view.

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Abiri, B., Vafa, M., Azizi-Soleiman, F. et al. Changes in Bone Turnover, Inflammatory, Oxidative Stress, and Metabolic Markers in Women Consuming Iron plus Vitamin D Supplements: a Randomized Clinical Trial. Biol Trace Elem Res 199, 2590–2601 (2021). https://doi.org/10.1007/s12011-020-02400-8

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Keywords

  • Vitamin D
  • Iron
  • Bone turnover
  • Inflammation
  • Oxidative stress