Skip to main content
SpringerLink
Log in

Serum vitamin E level and gestational diabetes mellitus: a systematic review and meta-analysis

  • Review article
  • Published:
Journal of Diabetes & Metabolic Disorders Aims and scope Submit manuscript

Abstract

Purpose

Gestational diabetes mellitus (GDM) is one of the most common medical complications in pregnancy. This systematic review aimed to evaluate the association between vitamin E and GDM.

Methods

Relevant articles from the Cochrane Library, PubMed, Scopus, Science Direct, Web of Science, and EMBASE databases up to December 2019 were searched. The inclusion criteria were observational full-text articles. The fixed and random effect models were used to analyze the pooled data using Review Manager 5.3.

Results

Thirteen studies, including 596 participants, of whom 285 were diagnosed with GDM were included in the meta-analysis. The vitamin E level was significantly lower in women with GDM (MD: - 0.10; 95% CI: [−0.15, − 0.05]). The level of vitamin E was not different between overweight women with GDM and healthy pregnant women (MD: 0.03; 95% CI: [−0.08, 0.013]). The level of vitamin E was significantly lower in the third trimester of pregnancy in GDM women in comparison to the healthy pregnant women(MD: -0.09; 95% CI: [−0.12, −0.06]).

Conclusion

This study showed that the level of vitamin E is significantly lower in GDM women compared to healthy pregnant women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Association A.D. Standards of medical care in diabetes. Diabetes Care. 2014;37(Suppl. 1):S14–80.

    Article  Google Scholar 

  2. Cho NH. IDF diabetes atlas. 7th ed. Brussels: International Diabetes Federation; 2015.

    Google Scholar 

  3. Buchanan TA, Xiang A, Kjos SL, Lee WP, Trigo E, Nader I, et al. Gestational diabetes: antepartum characteristics that predict postpartum glucose intolerance and type 2 diabetes in Latino women. Diabetes. 1998;4:1302–10. https://doi.org/10.2337/diab.47.8.1302.

    Article  Google Scholar 

  4. Lind L, Hanni A, Lithell H, Hvarfner A, Sörensen OH, Ljunghall S. Vitamin D is related to blood pressure and other cardiovascular risk factors in middle-aged men. Am J Hypertens. 1995;8:94–901.

    Article  Google Scholar 

  5. Metzger BE, International Association of Diabetes and Pregnancy Study Groups Consensus Panel. International association of diabetes and pregnancy study groups on the diagnosis and classification of recommendations hyperglycemia in pregnancy. Diabetes Care. 2010; 33(3):676–682. https://doi.org/10.2337/dc09-1848.

  6. Suhail M, Patil S, Khan S, Siddiqui S. Antioxidant vitamins and Lipoperoxidation in non-pregnant, pregnant, and gestational diabetic women: erythrocytes osmotic fragility profiles. J Clin Med Res. 2010;2:266–73.

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Maritim AC, Sanders RA, Watkins JB. Diabetes, oxidative stress, and antioxidants: a review. J Biochem Mol Toxicol. 2003;17:24–38.

    Article  CAS  Google Scholar 

  8. Valdés-Ramos R, Ana Laura GL, Beatriz Elina MC, Alejandra Donají BA. Vitamins and Type 2 Diabetes Mellitus. Endocr Metab Immune Disord Drug Targets. 2015;15(1):54–63. https://doi.org/10.2174/1871530314666141111103217.

  9. Thomas JE, Foody JM. The pathophisiology of cardiovascular disease in diabetes mellitus and the future of therapy. J Cardiometab Syndr. 2007;2:108–13.

    Article  Google Scholar 

  10. Baynes JW. Role of oxidative stress in development of complications in diabetes. Diabetes. 1991;40:405–12.

    Article  CAS  Google Scholar 

  11. Resende F, Clemente H, Bezerra D, Grilo E, Melo L, Bellot P, et al. Alpha-tocopherol concentration in serum and colostrum of mothers with gestational diabetes mellitus. Rev Paul Pediatr. 2014;32:178–86.

    Article  Google Scholar 

  12. Paolisso G, Gambardella A, Giugliano D, Galzerano D, Amato L, Volpe C, et al. Chronic intake of pharmacological doses of vitamin E might be useful in the therapy of elderly patients with coronary heart disease. Am J Clin Nutr. 1995;61:848–52.

    Article  CAS  Google Scholar 

  13. Sivan E, Reece E, Wu Y, Homko C, Polansky M, Borenstein M. Dietary vitamin E prophylaxis and diabetic embryopathy:Morphologic and biochemical analys. Am J Obstet Gynecol. 1996;175:793–9.

    Article  CAS  Google Scholar 

  14. Martinoli L, Di Felic M, Seghieri G, Ciuti M, De Giorgio LA, Fazzini A, et al. Plasma retinol and alpha-tocopherol concentrations in insulin-dependent diabetes mellitus:their relationship to microvascular complications. Int J Vitam Nutr Res. 1993;63:87–92.

    CAS  PubMed  Google Scholar 

  15. Asayama K, Nakane T, Ushida N, et al. Serum antioxidant status in streptocizin-induced diabetic rat. Horm Metab Res. 1994;26:313–5.

    Article  CAS  Google Scholar 

  16. Santra D, Sawhney H, Aggarwal N, Majumdar S, Vasishta K. Lipid peroxidation and vitamin E status in gestational diabetes mellitus. J Obstet Gynaecol Res. 2003;29:300–4.

    Article  CAS  Google Scholar 

  17. Cinar MG, Ulker S, Alper G, Evinc A. Effect of dietary vitamin E supplementation on vascular reactivity of thoracic aorta in streptozotocin diabetic rats. Pharmacology. 2001;62:56–64.

    Article  CAS  Google Scholar 

  18. Kharb S. Lipid peroxidation in pregnancy with preeclampsia and diabetes. Gynecol Obstet Investig. 2001;50:113–6.

    Article  Google Scholar 

  19. Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA group, Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097.

    Article  Google Scholar 

  20. Downs SH, Black N. The feasibility of creating a checklist for the assessmentof the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998;52:377–84.

    Article  CAS  Google Scholar 

  21. Handler A, Kennelly J, Peacock N. Reducing Racial/Ethnic Disparities in Reproductive and Perinatal Outcomes: The Evidence from Population-Based Interventions, Springer Science+Business Media, LLC2011. Boston, MA: Springer. https://doi.org/10.1007/978-1-4419-1499-6.

  22. Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;2:1539–58.

    Article  Google Scholar 

  23. Higgins JP, Thompson SG, Eeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557–60.

    Article  Google Scholar 

  24. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177–88.

    Article  CAS  Google Scholar 

  25. Vijayalaxmi KG, Urooj A. Biochemical profile and outcome in normal and high risk subjects. Indian J Clin Biochem. 2009;24:269–74.

    Article  CAS  Google Scholar 

  26. Al Senaidy AM. Plasma α- and γ-tocopherol have different pattern during normal human pregnancy. Mol Cell Biochem. 1996;154:71–75.

  27. Bayer R. Indications for vitamin E therapy in endangered pregnancies. Arch Gynakol. 1967;204:249–50.

    Article  CAS  Google Scholar 

  28. Bodzek P, Wielkoszyński T. Evaluation of vitamin C and E concentration--some nonenzymatic indicators of antioxidant protective barrier in pregnant women. Wiad Lek. 2003;56:508–14.

    PubMed  Google Scholar 

  29. Grissa O, Atègbo JM, Yessoufou A, Tabka Z, Miled A, Jerbi M. Antioxidant status andcirculating lipids are altered in human gestational diabetes and macrosomia. Transl Res. 2007;150:164–71.

    Article  CAS  Google Scholar 

  30. Hekmat K, Bagheri HR, Abedi P, Tabesh H. The relationship of fat soluble antioxidants with gestational diabetes in Iran: a case–control study. J Matern Fetal Neonatal Med. 2014;27:1676–9.

    Article  CAS  Google Scholar 

  31. Kharb S. Total radical-trapping antioxidant potential in gestational diabetes. Int J Gynaecol Obstet. 2008;103:257–8. https://doi.org/10.1016/j.ijgo.2008.06.017.

    Article  PubMed  Google Scholar 

  32. Surapaneni KM, Vishnu PV. Antioxidant enzymes and vitamins in gestational diabetes. J Clin Diagn Res. 2008;2:1081–5.

    CAS  Google Scholar 

  33. Shang M, Zhao J, Yang L, Lin L. Oxidative stress and antioxidant status in women with gestational diabetes mellitus diagnosed by IADPSG criteria. Diabetes Res Clin Pract. 2015;109:404–10.

    Article  CAS  Google Scholar 

  34. Dey P, Gupta P, Acharya NK, Rao SN, Ray S, Chakrabarty S. Antioxidants and lipid peroxidation in gestational diabetes - A preliminary study. Indian J Physiol Pharmacol. 2008;52:149–56.

    CAS  PubMed  Google Scholar 

  35. Sobki SH, Al-Senaidy AM, Al-Shammari TA, Inam SS, Al-Gwiser AA, Bukhari SA. Impact of gestational diabetes on lipid profiling and indices of oxidative stress in maternal and cord plasma. Saudi Med J. 2004;25:876–880.

  36. Harsem NK, Braekke K, Torjussen T, Hanssen K, Staff A.C. Advanced Glycation end products in pregnancies complicated with diabetes mellitus or preeclampsia. Hypertens Pregnancy. 2008;27:374–86. https://doi.org/10.1080/10641950802000968.

    Article  CAS  PubMed  Google Scholar 

  37. Peuchant E, Brun JL, Rigalleau V, Dubourg L, Thomas MJ, Daniel JY, et al. Oxidative and antioxidative status in pregnant women with either gestational or type 1 diabetes. Clin Biochem. 2004;37:293–8.

    Article  CAS  Google Scholar 

  38. Monnier L, Mas E, Ginet C, Michel F, Villon L, Cristol JP, et al. Activation of oxidative stress by acute glucose fluctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes. JAMA. 2006;295:1681–7.

    Article  CAS  Google Scholar 

  39. Robertson RP. Chronic oxidative stress as a central mechanism for glucose toxicity in pancreatic islet beta cells in diabetes. J Biol Chem. 2004;279:42351–4.

    Article  CAS  Google Scholar 

  40. Pazdro R, Burgess JR. The role of vitamin E and oxidative stress in diabetes complications. Mech Ageing Dev. 2010;131:276–86.

    Article  CAS  Google Scholar 

  41. Jin L, Xue HY, Jin LJ, Li SY, Xu YP. Antioxidant and pancreas-protective effect of aucubin on rats with streptozotocin-induced diabetes. Eur J Pharmacol. 2008;582:162–7.

    Article  CAS  Google Scholar 

  42. Biri A, Onan A, Devrim E, Babacan F, Kavutcu M, Durak I. Oxidant status in maternal and cord plasma and placental tissue in gestational diabetes. Placenta. 2006;27(2–3):327–32.

    Article  CAS  Google Scholar 

  43. Amirkhizi F, Siyasi F, Hamedi S, Jalali M. Evaluation of oxidative stress and total antioxidant capacity in plasma in women with general and abdominal obesity. Med J Mashhad Univ Med Sci. 2012;55:170–7.

    Google Scholar 

  44. Furukawa S, Fujita T, Shimbukuro M, Iwaki M, Yamada Y, Nakajima Y, et al. Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Invest. 2004;114:1752–61.

    Article  CAS  Google Scholar 

  45. Keaney JF, Larson MG, Vasan RS, Wilson PWF, Lipinska I, Corey D, et al. Obesity and systemic oxidative stress. Clinical correlates of oxidative stress in the Framingham Study. Arterioscler Thromb Vasc Biol. 2003;23:434–439.

  46. Melissas J, Malliaraki N, Papadakis JA, Taflampas P, Kampa M, Castanas E. Plasma antioxidant capacity in morbidly obese patients before and after weight loss. Obes Surg. 2006;16:314–20.

    Article  Google Scholar 

  47. Mandach U, Huch R, Huch A. Maternal and cord serum vitamin E levels in normal and abnormal pregnancy. Int J Vitam Nutr Res. 1994;64:26–32.

    Google Scholar 

  48. Ortega RM, López-Sobaler AM, Andrés P, Martínez RM, Quintas ME, Requejo AM. Maternal vitamin E status during the third trimester of pregnancy in Spanish women: influence on breast milk vitamin E concentration. Nutr Res. 1999;19:25–36.

    Article  CAS  Google Scholar 

Download references

Acknowledgments

We would like to thank Dr. Mahmoud Maniati for English language editing.

Availability of data and material

N.A.

Author information

Authors and Affiliations

  1. Midwifery Department, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran

    Foruzan Sharifipour

  2. Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

    Parvin Abedi

  3. Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Science, Golestan Ave, Ahvaz, Iran

    Parvin Abedi & Maryam Zahedian

  4. Department of Midwifery, Marand Branch, Islamic Azad University, Marand, Iran

    Shahla Faal Ciahkal

  5. School of Health Sciences-MPH Program Health Professions Building 2212, Central Michigan University, Mt Pleasant, MI, USA

    Shayesteh Jahanfar

  6. Midwifery Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

    Zeynab Mohaghegh

Authors
  1. Foruzan Sharifipour
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Parvin Abedi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shahla Faal Ciahkal
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shayesteh Jahanfar
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Zeynab Mohaghegh
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Maryam Zahedian
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

F.S., PA, and S.J. were involved in conception. F.S., S.F., Z.M., M.Z. Involved in search, data extraction, and data analysis. F.S., PA, and S.J. were responsible for data interpretation, writing, and finalizing manuscript in English.

Corresponding author

Correspondence to Parvin Abedi.

Ethics declarations

Conflict of interest

There is no competing interest for authors.

Ethical approval

Not applicable.

Consent to participate

Not applicable.

Consent for publication

Not applicable.

Additional information

Publisher’s note

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

Electronic Supplementary Material

ESM 1

(DOC 62 kb)

ESM 2

(DOCX 30.6 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sharifipour, F., Abedi, P., Ciahkal, S.F. et al. Serum vitamin E level and gestational diabetes mellitus: a systematic review and meta-analysis. J Diabetes Metab Disord 19, 1787–1795 (2020). https://doi.org/10.1007/s40200-020-00582-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40200-020-00582-5

Keywords

Search

Navigation