Article

Effects of Zinc Supplementation on Endocrine Outcomes in Women with Polycystic Ovary Syndrome: a Randomized, Double-Blind, Placebo-Controlled Trial

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Abstract

The current study was conducted to evaluate the effects of zinc supplementation on endocrine outcomes, biomarkers of inflammation, and oxidative stress in patients with polycystic ovary syndrome (PCOS). This study was a randomized double-blind, placebo-controlled trial. Forty-eight women (18-40 years) with PCOS diagnosed according to Rotterdam criteria were randomly assigned to receive either 220 mg zinc sulfate (containing 50 mg zinc) (group 1; n = 24) and/or placebo (group 2; n = 24) for 8 weeks. Hormonal profiles, biomarkers of inflammation, and oxidative stress were measured at study baseline and after 8-week intervention. After 8 weeks of intervention, alopecia (41.7 vs. 12.5 %, P = 0.02) decreased compared with the placebo. Additionally, patients who received zinc supplements had significantly decreased hirsutism (modified Ferriman-Gallwey scores) (-1.71 ± 0.99 vs. -0.29 ± 0.95, P < 0.001) and plasma malondialdehyde (MDA) levels (-0.09 ± 1.31 vs. +2.34 ± 5.53 μmol/L, P = 0.04) compared with the placebo. A trend toward a significant effect of zinc intake on reducing high-sensitivity C-reactive protein (hs-CRP) levels (P = 0.06) was also observed. We did observe no significant changes of zinc supplementation on hormonal profiles, inflammatory cytokines, and other biomarkers of oxidative stress. In conclusion, using 50 mg/day elemental zinc for 8 weeks among PCOS women had beneficial effects on alopecia, hirsutism, and plasma MDA levels; however, it did not affect hormonal profiles, inflammatory cytokines, and other biomarkers of oxidative stress.

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... Beneficial effects of chromium administration on improved endocrine profiles, biomarkers of inflammation, and oxidative stress might be attributed to the activation of glutathione reductase or some other enzymes, improved insulin resistance, and inhibition of protein glycosylation [10]. Although we have previously shown the favorable effects of trace elements on endocrine outcomes in PCOS women [11], limited data are available evaluating the effect of chromium administration on endocrine profiles, inflammatory cytokines, and biomarkers of oxidative stress among women with PCOS. This study aimed to determine the effects of chromium supplementation on endocrine profiles, biomarkers of inflammation, and oxidative stress in women with PCOS. ...
... Nature Made Pharmaceutical Company (California, USA) and Barij Essence Pharmaceutical Company (Kashan, Iran) provided chromium supplements and its placebos (cellulose), respectively. All individuals were taking metformin tablet at the initial dose of 500 mg, which was increased in a stepwise manner during the first 3 weeks to a total of 1500 mg/day [11]. At the beginning of the study, patients were asked to maintain their habitual diet and routine level of physical activity throughout the study period as well as not to take any anti-inflammatory medications, supplements, and other medications that might affect their reproductive physiology during the 8-week treatment [11]. ...
... All individuals were taking metformin tablet at the initial dose of 500 mg, which was increased in a stepwise manner during the first 3 weeks to a total of 1500 mg/day [11]. At the beginning of the study, patients were asked to maintain their habitual diet and routine level of physical activity throughout the study period as well as not to take any anti-inflammatory medications, supplements, and other medications that might affect their reproductive physiology during the 8-week treatment [11]. Compliance to the consumption of chromium supplements and placebos was checked through asking participants to bring the medication containers. ...
Article
Full-text available
Limited data are available indicating the effects of chromium administration on endocrine profiles, biomarkers of inflammation, and oxidative stress among women with polycystic ovary syndrome (PCOS). This study was done to assess the effects of chromium administration on endocrine profiles, biomarkers of inflammation, and oxidative stress in women with PCOS. Participants of this randomized, double-blind, placebo-controlled trial consisted of 60 patients with PCOS who received either 200 μg chromium supplements (n = 30) or placebo daily (n = 30) for 8 weeks. Endocrine profiles, inflammatory factors, and biomarkers of oxidative stress were assessed at study baseline and at the end of intervention. After 8 weeks of intervention, pregnancy rate in chromium group was higher than that in the placebo group: 16.7 % (5/30) vs. 3.3 % (1/30), P = 0.08. In addition, prevalence of acne (20.0 vs. 3.3 %, P = 0.04) decreased following the administration of chromium supplements compared with the placebo. Taking chromium led to a significant reduction in hirsutism (−1.8 ± 2.5 vs. −0.2 ± 0.8, P = 0.002), serum high-sensitivity C-reactive protein (hs-CRP) (−717.0 ± 1496.1 vs. +227.1 ± 1669.6 ng/mL, P = 0.02), plasma malondialdehyde (MDA) (−0.1 ± 0.7 vs. +1.1 ± 1.5 μmol/L, P < 0.001), and a significant increase in plasma total antioxidant capacity (TAC) concentrations (+250.7 ± 265.2 vs. +13.0 ± 201.6 mmol/L, P < 0.001). We failed to find any significant effect of chromium administration on endocrine profiles and nitric oxide (NO) and glutathione (GSH) levels. Overall, taking chromium for 8 weeks among women with PCOS had beneficial effects on acne, hirsutism, hs-CRP, TAC, and MDA levels, but it did not affect endocrine profiles, NO, and GSH. Clinical trial registration number: IRCT201506105623N44 (www. irct. ir)
... The selected papers were published between 2007 and 2020 ( Table 1). Of the papers, 16 studies were conducted in Asia [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35], four in America [36][37][38][39], and one in Europe [40]. The mean age of subjects in the intervention groups ranged from 20.7 to 75.1 years, and a total of 1321 participants were enrolled into the included studies. ...
... Minimum and maximum dosage of Zn were 30 and 528 mg / day, respectively. Gluconate [23,25,30,33,[35][36][37]40] and sulfate [20][21][22]24,[26][27][28][29]31,32,34,38,39] were used as the formulation of supplemental Zn in 8 and 13 studies, respectively. Controls received placebo in most of the studies [9,[20][21][22][25][26][27][28][29][30][31][32][33][34][35][36][38][39][40]. ...
... Gluconate [23,25,30,33,[35][36][37]40] and sulfate [20][21][22]24,[26][27][28][29]31,32,34,38,39] were used as the formulation of supplemental Zn in 8 and 13 studies, respectively. Controls received placebo in most of the studies [9,[20][21][22][25][26][27][28][29][30][31][32][33][34][35][36][38][39][40]. Pakasi et al, reported two effect sizes for having two control groups receiving placebo and vitamin A [21]. ...
Article
Background Zinc (Zn) is a trace metal that is considered to have an impact on chronic inflammation. However, findings of clinical trials have been inconsistent. The present systematic review and meta-analysis aimed to provide a more robust examination of the evidence on the effectiveness of Zn supplements on markers of inflammation and oxidative stress. Methods A systematic search in PubMed, Scopus, Web of Science and Cochrane Library was undertaken to identify relevant randomized controlled trials (RCTs) assessing the impact of Zn on inflammation and oxidative stress until 17 August 2020. We applied a random-effects method to obtain effect sizes (ES) and 95% confidence intervals (CIs). Meta-regression was used to detect the potential source of between-study heterogeneity. Results Twenty-one eligible RCTs comprising 1321 participants were included in the meta-analysis. In comparison with the control groups, serum C-reactive protein (CRP) (ES = −0.92 mg/L, 95% CI = [−1.36, −0.48], P < 0.001, I² = 90.2%), tumor necrosis factor-alpha (TNF-α) (ES = −0.49 pg/mL, 95% CI = [−084, −0.14], P = 0.006, I² = 34.6%) and malondialdehyde (MDA) (ES = −0.42, 95% CI = [−083, −0.01], P = 0.04, I² = 76.1%) were significantly reduced in the groups receiving Zn. Serum interleukin 6 (ES = −1.02 pg/mL, 95% CI = [−2.06, 0.02], P = 0.05, I² = 92.3%) was marginally reduced following Zn supplementation. Moreover, treatment duration was found as the source of inter-study heterogeneity. Conclusion This meta-analysis suggests that Zn supplements reduce serum concentrations of markers of inflammation and oxidation: CRP, TNF-α and MDA.
... The dosage of zinc was within the range of 15− 240 mg/day in the reviewed studies, and the intervention duration was 6-25 weeks. Three of the RCTs were conducted on hemodialysis [30,31,35,36,42], and patients with prediabetes and diabetes [32,44,47], patients with obesity [23,34], pregnant women with impaired glucose tolerance [43], pregnant women [38], subjects with gestational diabetes mellitus [25], polycystic ovary syndrome [33], metabolic syndrome [37], major depressive disorder [41], and diabetic foot ulcer [39], elderly subjects [29,48], and patients with colorectal cancer [49], pulmonary tuberculosis [45], type II spinocerebellar ataxia [46], and non-alcoholic fatty liver disease [50]. ...
... Eight RCTs recruited female subjects only [23,25,33,38,40,41,43,51], while 16 studies were conducted on both genders [29][30][31][32][34][35][36]39,42,[44][45][46][47][48][49][50], and one study had non-defined genders [37]. In addition, 10 RCTs used zinc gluconate [23,29,31,34,38,43,44,48,50,51], and the others administered zinc sulfate as the intervention [30,[32][33][34][35][36][37][39][40][41][42]. ...
... Eight RCTs recruited female subjects only [23,25,33,38,40,41,43,51], while 16 studies were conducted on both genders [29][30][31][32][34][35][36]39,42,[44][45][46][47][48][49][50], and one study had non-defined genders [37]. In addition, 10 RCTs used zinc gluconate [23,29,31,34,38,43,44,48,50,51], and the others administered zinc sulfate as the intervention [30,[32][33][34][35][36][37][39][40][41][42]. Notably, all the RCTs had a parallel design [23,25,. ...
Article
Background & objective: Current evidence is debatable regarding the feasible effects of zinc supplementation on the inflammation and oxidative stress status of adults. This systematic review and meta-analysis aimed to clarify this inconclusiveness. Materials and methods: Literature search was conducted via online databases such as PubMed, Scopus, ISI Web of Science, Cochrane Library, and Google Scholar until June 2020. The overall effect was presented as the weighted mean difference (WMD) at 95 % confidence interval (CI) in a random-effects meta-analysis model. Publication bias was also assessed using Egger's and Begg's statistics. Results: In total, 25 clinical trials (n = 1428) were reviewed, which indicated that zinc supplementation significantly affects the concentration of C- reactive protein (WMD: -0.03 mg/l; 95 % CI: -0.06, 0.0; P = 0.029), interlukin-6 (WMD: -3.81 pg/mL; 95 % CI: -6.87, -0.76; P = 0.014), malondialdehyde (WMD: -0.78 μmol/l; 95 % CI: -1.14, -0.42; P < 0.001), and total antioxidant capacity (WMD: 95.96 mmol/l; 95 % CI: 22.47, 169.44; P = 0.010). In addition, a significant between-study heterogeneity and a non-significant increment was reported in nitric oxide (WMD: 1.47 μmol/l; 95 % CI: -2.45, 5.40; P = 0.461) and glutathione (WMD: 34.84 μmol/l; 95 % CI: -5.12, 74.80; P = 0.087). Conclusion: According to the results, zinc supplementation may have beneficial anti-inflammatory and anti-oxidative effects in adults.
... Two reviewers (SA and OT) extracted the following information from eligible studies: first author's name, year of publication, study location, age of participants, sex of participants, follow-up duration, study design, number of participants in the intervention and control groups, type of zinc supplementation, dose of zinc supplementation, outcome assessment method (measured or self-reported), and means and SDs of body composition and anthropometric measures before and after the intervention or mean differences (MDs) and SDs during the follow-up period. Corresponding authors were contacted to provide missing information (37,(41)(42)(43). For trials that evaluated multiple doses of zinc supplementation, we included the highest dose in the analysis (44,45). ...
... Anthropometric characteristics were measured by 1 member of the research team in all studies. Four trials were conducted in patients undergoing HD (39, 52, 63, 67), 5 were conducted in patients with prediabetes or type 2 diabetes (41, 53, 58, 60, 69), 4 recruited patients with polycystic ovary syndrome (38,43,54,61), and 6 enrolled healthy subjects (44,45,55,57,59,74). The remaining trials included patients with atherosclerosis or ischemic stroke (42,65), anorexia nervosa (37), postmenopausal osteoporosis (56), pulmonary tuberculosis (68), depressive symptoms (62), hypothyroidism (66), and head and neck cancers (64). ...
... Pooling effect sizes from 7 trials (456 participants) (43,57,59,61,65,69,74) revealed no significant effect of zinc supplementation on WC, with no evidence of between-study heterogeneity (WMD = −0.09 cm; 95% CI: −0.66, 0.48 cm; P = 0.76; I 2 = 0.0%; P-heterogeneity = 0.97) (Figure 4 and Supplemental Table 5). ...
Article
The aim of this study was to determine the effect of zinc supplementation on anthropometric measures. In this systematic review and dose–response meta-analysis, we searched PubMed, Scopus, ISI Web of Science, and the Cochrane Library from database inception to August 2018 for relevant randomized controlled trials. Mean differences and SDs for each outcome were pooled using a random-effects model. Furthermore, a dose–response analysis for zinc dosage was performed using a fractional polynomial model. Quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Twenty-seven trials (n = 1438 participants) were included in the meta-analysis. There were no significant changes in anthropometric measures after zinc supplementation in the overall analysis. However, subgroup analyses revealed that zinc supplementation increased body weight in individuals undergoing hemodialysis (HD) [3 trials, n = 154 participants; weighted mean difference (WMD) = 1.02 kg; 95% CI: 0.38, 1.65 kg; P = 0.002; I2 = 11.4%] and decreased body weight in subjects who are overweight/obese but otherwise healthy (5 trials, n = 245 participants; WMD = −0.55 kg; 95% CI: −1.06, −0.04 kg; P = 0.03; I2 = 31.5%). Dose–response analyses revealed a significant nonlinear effect of supplementation dosage on BMI (P = 0.001). Our data suggest that zinc supplementation increases body weight in patients undergoing HD and decreases body weight in individuals who are overweight/obese but otherwise healthy, although after normalization for study duration, the association observed in subjects who are overweight/obese disappeared. Although more high-quality studies are needed to reach a definitive conclusion, our study supports the view that zinc may be associated with body weight.
... Eleven studies recruited both male and female [10, 17, 19, 20, 23, 39-41, 43, 45, 46]. Six RCTs included women only [7,21,[36][37][38]42], whereas the remaining three studies included men only [18,22,44]. The normal levels of zinc had been reported in most of the studies (14 RCTs), 4 studies showed subnormal zinc status, and baseline level of zinc was not reported in 2 studies. ...
... The ages of the participants ranged between 13 and 67 years old. In 11 RCTs, zinc was supplemented at a dose of 30 mg per day [10, 20, 23, 37-41, 43, 45], 4 RCTs used 50 mg/day [19,36,42,46], 1 RCT used 22 mg/day [7], and 4 trials used 100, 150, 40, and 240 mg/day, respectively [17,18,22,44]. ...
... The intervention period ranged from 28 [46] to 240 days [22]. The selected studies enrolled subjects with gestational diabetes mellitus (GDM) [38], obese subjects [5,6,13,14], prediabetic subjects [41], patients with diabetes mellitus (DM) [7, 10, 17-19, 22, 39, 44-46], polycystic ovary syndrome (PCOS) patients [36,42], overweight and obese women with hypothyroidism [37], and those with atherosclerosis [43]. ...
Article
Full-text available
The prevalence of cardiometabolic risk factors has been increasing worldwide. The results of reported studies on the effects of zinc supplementation on cardiometabolic risk factors are unequivocal. This systematic review and meta-analysis of randomized controlled trials was conducted to evaluate the effects of zinc supplementation on cardiometabolic risk factors. A systematic search was conducted through international databases (PubMed/Medline, Institute of Scientific Information, and Scopus) until December 2018 to include all randomized controlled trials (RCT), quasi-RCT, and controlled clinical trials which assessed the effect of zinc supplementation on cardiometabolic risk factors including lipid profile, glycemic indices, blood pressure, and anthropometric indices. Random- or fixed-effects meta-analysis method was used to estimate the standardized mean difference (SMD) and 95% confidence interval (CI). A total of 20 studies were included in the meta-analysis, which included a total of 1141 participants in the intervention group. Meta-analysis showed that zinc supplementation significantly decreased plasma levels of triglyceride (SMD − 0.66, 95% CI − 1.27, − 0.06), very-low-density lipoprotein (SMD − 1.59, 95% CI − 2.86, − 0.31), and total cholesterol (SMD − 0.65, 95% CI − 1.15, − 0.15). Similarly, zinc supplementation significantly decreased fasting blood glucose (SMD − 0.52, 95% CI − 0.96, − 0.07) and HbA1c (SMD − 0.64, 95% CI − 1.27, − 0.02). The effects of zinc supplementation on blood pressure and anthropometric indices were not statistically significant (P > 0.05). Zinc supplements had beneficial effects on glycemic indices and lipid profile. Thus, it appeared that zinc supplementation might be associated with a decrease in cardiometabolic risk factors contributing to a reduction in risk of atherosclerosis.
... Zinc has anti-androgenic properties as it was shown to decrease the production of dihydrotestosterone (DHT) by inhibiting 5-alpha reductase activity [5][6][7]. Zinc supplementation in women with polycystic ovary syndrome (PCOS) was shown to decrease hirsutism scores [8]. ...
... The association between serum zinc levels and PCOS has been investigated. In some studies, and according to the findings of a recent metaanalysis, serum zinc levels were found to be lower in women with PCOS compared to healthy controls [8,11,12,14,15]. ...
... Differently, they also found lower zinc levels in women with PCOS [12]. The direct effect of zinc on hirsutism was investigated in a randomized, double-blinded study, and it was shown that after taking 50 mg zinc supplement per day for 8 weeks, hirsutism scores of 48 patients with PCOS decreased significantly [8]. On the other hand, some animal studies demonstrated a possible androgenic effect of zinc. ...
Article
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Zinc has shown to have an anti-androgenic effect through 5 alpha-reductase enzyme activity inhibition in skin. However, there are contradicting findings concerning the effect of zinc on hirsutism mainly from studies including adult women with polycystic ovary syndrome (PCOS). The aim of our study was to investigate the association between serum zinc levels and hirsutism in adolescents. Between October 2017 and June 2018, 51 female adolescents with hirsutism (mean age: 16.11 ± 1.47 years) and 51 healthy female controls were included in the study (mean age: 15.5 ± 1.40 years). Adolescents with hirsutism were classified under two groups; PCOS (n = 34, 66.7%) and idiopathic causes of hirsutism (idiopathic hirsutism (n = 9, 17.6%) and idiopathic hyperandrogenemia (n = 8, 15.7%)). The serum zinc levels were measured via atomic absorption spectrophotometry. The mean zinc levels of adolescents with hirsutism (102.02 ± 11.64 μg/dl) and the control group (101.72 ± 16.71 μg/dl) were similar (p = 0.915). Additionally, there was no significant difference among the mean zinc levels of the hirsutism sub-groups and the control group (p = 0.979). While some studies demonstrated low zinc levels in women with hirsutism, some studies similar to ours showed no association. Adolescence is a developmental phase where generally isolated mild hirsutism is not associated with hyperandrogenism and more studies are needed to evaluate the effect of zinc on hirsutism in this age group.
... µg/dL; p = 0.022). Several studies reported a positive impact of zinc supplementation on the metabolic and endocrine manifestations of PCOS [28][29][30]. These metabolic improvements associated with zinc supplementation can be attributed to the antioxidant properties exhibited by zinc [5,26,31]. ...
... Zinc has been shown to exhibit anti-inflammatory and antioxidant properties. Jamilian et al. [29] conducted a randomized, placebo-controlled, double-blind study in women with PCOS (n = 48; 18-40 years old). Subjects were randomized into two groups of 24 subjects. ...
... After 8 weeks, compared to placebo, zinc supplementation significantly reduced hirsutism (a reduction of 1.71 in Ferriman-Gallwey scores, a gold standard for the evaluation of hirsutism; p < 0.001) and decreased circulating malondialdehyde (MDA) concentrations (a marker of oxidative stress) (−0.09 µmol/L, p = 0.04). Although this study found a significant beneficial effect of zinc supplementation on alopecia, hirsutism, and plasma MDA, no effect was observed on the hormonal profiles of women with PCOS [29]. ...
Article
Full-text available
Polycystic ovary syndrome (PCOS) is an endocrinopathy that is common among women of reproductive age. It is a heterogeneous disorder with an unknown etiology. Different strategies have been proposed for the treatment of PCOS. Recent studies recommend supplementation with specific minerals for treating various PCOS phenotypes. We searched PubMed, Google Scholar, and SCOPUS databases by using search terms combining PCOS with the supplementation of magnesium, zinc, selenium, or chromium. This review presents a narrative concerning the association between PCOS and magnesium, zinc, selenium, and chromium supplementation. We review findings from various randomized controlled trials and meta-analyses conducted in women of childbearing age with PCOS. Recent reports highlight the beneficial effect of minerals on the clinical and metabolic symptoms of PCOS. Further studies are required to establish the appropriate dosage level of these minerals for ameliorating the pathologies associated with PCOS because of the potential health risks linked with higher doses.
... During the secondary screening, 48 studies were excluded for the following reasons: studies did not report relevant outcome (n = 18), trials were carried out on children, adolescent, and pregnant women (n = 6), trials without the placebo group (n = 6), those were administered other components in combination with zinc (n = 4), trials were performed on the same population (n = 2), trials without sufficient information (n = 4), and non-RCT studies (n = 8). Finally, 10 RCTs were included in the current systematic review and meta-analysis [22][23][24][25][32][33][34][35][36][37]. Out of them, 8 trials (with 9 treatment arms) have reported the effect of zinc on serum MDA [22][23][24][25][32][33][34][35], 4 on serum TAC [22,23,35,36], 3 (with 4 treatment arms) on serum GSH [22,24,35], and 4 on serum NO [22,32,35,37]. ...
... Finally, 10 RCTs were included in the current systematic review and meta-analysis [22][23][24][25][32][33][34][35][36][37]. Out of them, 8 trials (with 9 treatment arms) have reported the effect of zinc on serum MDA [22][23][24][25][32][33][34][35], 4 on serum TAC [22,23,35,36], 3 (with 4 treatment arms) on serum GSH [22,24,35], and 4 on serum NO [22,32,35,37]. The detailed phases of the selection process are displayed in Fig. 1. ...
... Finally, 10 RCTs were included in the current systematic review and meta-analysis [22][23][24][25][32][33][34][35][36][37]. Out of them, 8 trials (with 9 treatment arms) have reported the effect of zinc on serum MDA [22][23][24][25][32][33][34][35], 4 on serum TAC [22,23,35,36], 3 (with 4 treatment arms) on serum GSH [22,24,35], and 4 on serum NO [22,32,35,37]. The detailed phases of the selection process are displayed in Fig. 1. ...
Article
Abstract Background Oxidative stress plays an important role in the occurrence of chronic diseases. Zinc supplementation is also known to be an antioxidant agent. While, there is no review on the effects of zinc supplementation on oxidative stress, this study aimed to systematically summarize randomized clinical trials (RCTs) which have evaluated the impacts of zinc supplementation on oxidative stress biomarkers. Methods Systematic searches were performed using the PubMed/Medline, Scopus, and Google Scholar databases, up to April 2020. All RCTs assessed the effect of oral zinc supplementation on serum malondialdehyde (MDA), total antioxidant capacity (TAC), glutathione (GSH), and nitric oxide (NO) levels, were included. For each variable, mean differences (MD) and standard deviations (SDs) were combined using the random-effects model, and the fractional polynomial model was used to implement the dose-response analysis. Results Ten RCTs were included. The pooled analysis of data showed that zinc supplementation significantly reduced MDA levels (MD: -0.42 μmol/L; 95% CI: -0.71 to -0.13), increased serum TAC (MD: 225.96 mmol/L; 95% CI: 68.42 to 383.5) and GSH levels (MD: 49.99 μmol/L; 95% CI: 2.25 t 97.73), compared with the placebo group. In contrast, no significant changes were seen in NO levels following zinc supplementation (MD: -1.66 μmol/L; 95% CI: -5.89 to 2.57). Dose-response analysis showed a significant non-linear relationship between zinc supplementation dosage and serum levels of MDA (p < 0.01), but not other biomarkers. Conclusions The current study showed the zinc supplementation would significantly decrease MDA and increase TAC and GSH, but not NO levels. Thus, it encourages the use of zinc supplementation in oxidative stress-related diseases.
... Kim et al. [33] found a significant reduction in serum hs-CRP of young women after 30 mg Zn supplementation after 8 weeks. Jamilian et al. [34] showed a nonsignificant downward trend in serum hs-CRP levels after 50 mg Zn supplementation in women with polycystic ovary syndrome (PCOS). In summary, most of the studies in this regard are consistent with our results and it seems that Zn and Mg play a role in reducing inflammatory markers. ...
... Interestingly, the present study revealed that Zn, Mg, and vitamin A co-supplementation led to an increase in antioxidant pathways. This confirms a previous study [34] which showed that TAC was significantly different in women with PCOS who received 220 mg zinc sulfate (containing 50 mg Zn) compared to the control group. However, Maktabi et al. [35] reported that 100 mg Mg, 4 mg Zn, 400 mg Ca, and 200 IU vitamin D co-supplementation had no significant effect on serum levels of TAC in women with PCOS. ...
... However, a study conducted by Kelishadi et al. [36] reported a significant reduction in serum levels of MDA in subjects after 8 weeks supplementation with 20 mg Zn. Also, Jamilian et al. [34] demonstrated that supplementation with 50 mg Zn reduced serum levels of MDA in women with PCOS. In addition, an animal study revealed that the MDA levels in kidney and testes tissues of hypothyroid rats were reduced significantly after Zn supplementation [37]. ...
Article
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Hypothyroidism can occur due to deficiencies in micronutrients such as zinc, magnesium, and vitamin A. The aim of this study was to determine the effects of supplementation with these micronutrients on thyroid function, oxidative stress, and hs-CRP levels in patients with hypothyroidism. In a randomized double-blind, placebo-controlled trial with two parallel groups, 86 hypothyroid patients aged 20–65 were allocated to receive daily supplementation with either: (intervention group, n = 43) one 30 mg zinc gluconate capsule per day, one 250 mg magnesium oxide tablet per day, and one 25,000 IU vitamin A capsule twice/week for 10 weeks or (placebo group, n = 43) placebo capsules and tablets as above for 10 weeks. Neither of the groups changed their diet or physical activity. Thyroid hormones (free and total thyroxine (FT4 and TT4), free tri-iodothyronine (FT3), and thyroid-stimulating hormone (TSH)), oxidative markers (malondialdehyde (MDA) and total antioxidant capacity (TAC)), serum hs-CRP, and anthropometric indices (height and weight) were assessed at the baseline and at the end of the study. In the intervention group, we found a significant increase in serum FT4, decreased anthropometric indices, and lower levels of serum hs-CRP by the end of the 10 week protocol (P < 0.05). In the placebo group, serum TAC was decreased and hs-CRP increased (P < 0.05), with no significant changes in serum TSH, FT3, TT4, and MDA after the intervention. Zinc, vitamin A, and magnesium supplementation may have beneficial effects in patients with hypothyroidism and in diseases associated with hyperthyroidism.
... Few data have been reported regarding circulating levels of trace elements in PCOS. Most of these data have been produced by clinical trials evaluating outcomes of nutritional supplementation [30][31][32][33][34][35][36]. A synthesis of the evidence produced by case-control studies is not available. ...
... Indeed, while evidence suggests zinc is associated with insulin resistance and diabetes [20,51], only few data are available regarding zinc levels and insulin resistance, independent of obesity, in patients with PCOS [43]. Zinc also seems to inhibit 5α-reductase activity in the skin, which catalyzes the transformation of testosterone to its nonaromatizable form, dihydrotestosterone [52], and one study reported improvement on alopecia and hirsutism in PCOS women after short-term period of zinc supplementation [34]. Thus, lower zinc levels might be related to clinical hyperandrogenism in PCOS, and further studies are warranted to test this hypothesis. ...
Article
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Polycystic ovary syndrome (PCOS) is a prevalent condition in women of reproductive age. PCOS is characterized by androgen excess and chronic anovulation and associated with low-grade inflammation and metabolic comorbidities. Some trace elements have been linked to pathophysiological mechanisms of oxidative stress and inflammation in different disorders. Therefore, we conducted a systematic review and meta-analysis of the available evidence regarding trace element concentrations in PCOS. We reviewed MEDLINE and EMBASE in search of case-control, cross-sectional, and cohort studies published until September 2015. Of 183 studies identified, six were selected for systematic review. All used the Rotterdam criteria for the diagnosis of PCOS. Two studies evaluating chromium and one assessing cobalt levels did not observe differences between PCOS and controls. Another study recorded similar nickel and vanadium levels between the groups, but lower selenium concentrations in women with PCOS compared to controls. Four studies were included in the random effects model meta-analysis, for a total of 264 PCOS and 151 control women. Copper levels were found to be higher in women with PCOS than in controls [mean difference 0.12 ppm (95 % CI 0.07; 0.17 ppm); I 2 = 0 %]. Manganese [mean difference 0.04 ppm (95 % CI −0.05; 0.13 ppm); I 2 = 94.4 %] and zinc concentrations [mean difference 0.02 ppm (95 % CI −0.12; 0.16 ppm); I 2 = 92.4 %] were similar between the groups. The present results suggest a relationship between increased copper concentration and PCOS. This systematic review and meta-analysis is registered in PROSPERO under number CRD42016034036.
... Zinc also demonstrated multiple roles as a modulator of inflammation in cell cultures and animal model. Zinc supplementation improve inflammatory reaction in PCOS patients 10 . ...
... Zinc may be related to the development of polycystic ovarian syndrome and its long term metabolic complications via its important role in the metabolism of glucose and the synthesis, secretion, and signaling of insulin. In addition, zinc may be related to PCOS through its antioxidant effect 10,24 . The deficiency of such a potent antioxidant such can cause an increase in oxidative damage in multiple organs, such as the heart. ...
Article
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Background: Multiple logistic regression analysis of several metabolic variables between polycystic ovary syndrome and control groups revealed that zinc level was the most important variable to predict polycystic ovarian syndrome. Objective: This study was designed to illustrate the correlation between zinc and copper levels with the biochemical changes associated with polycystic ovary syndrome. Materials and Methods: Twelve women with polycystic ovary syndrome and twelve healthy and normal ovulatory women were included in this study. The serum levels of luteinizing hormone, follicle stimulating hormone, progesterone, testosterone and prolactin were analyzed by enzyme linked immunosorbent assay. Serum zinc and copper was analyzed using atomic absorption spectrophotometer. Student (t) test was performed for comparison and Pearson's correlation coefficients (r) were calculated to quantify the correlation between the biochemical parameters in the study. Results: Both zinc and copper levels showed no significant correlation with other biochemical markers associated with polycystic ovary syndrome. The results revealed an increase in serum zinc concentration in polycystic syndrome group, while it showed no significant difference in copper levels between polycystic ovary syndrome and healthy groups. Conclusion: The study concluded that the rise in zinc level in polycystic ovary syndrome group might be due to the increase in oxidative stress within the body that put the antioxidant defense system in a hyperactive state in order to compensate for this stress.
... Despite the potential beneficial effects of Zn supplementation on the treatment or risk of developing MetS or prediabetes, the number of intervention studies using Zn alone or in combination with other micronutrients is very limited. A brief description of what we identified as the most relevant intervention studies follows, and are also summarized in Table 1 [33,[65][66][67][68][69][70][71][72][73]. ...
... Two of these studies were conducted in obese adolescents supplemented with 20 mg Zn/8 weeks [68,69], one study carried out in adults with prediabetes who received 30 mg Zn/day during 6 months [71] and one study in patients with polycystic ovary syndrome (PCOS), a rather common endocrine pathology associated with obesity, T2D, and dyslipidemia, who received 50 mg Zn/day during 8 weeks [73]. In another study, also in patients with PCOS, Zn supplementation was associated with reduced malondialdehyde concentration as indicative of reduced damage induced by reactive oxygen species [72]. One study in women with gestational diabetes mellitus supplemented with 30 mg Zn/day during 6 weeks presented increased PPAR-γ and GLUT 1 expressions in umbilical cord blood [33]. ...
Article
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Zinc (Zn) plays crucial roles in mammalian metabolism. There is increasing interest about the potential beneficial effects of Zn on the prevention or treatment of non-communicable diseases. This review critically analyzes the information related to the role of Zn on the metabolic syndrome (MetS) as well as type 2 diabetes (T2D), and summarizes the biological basis of these potential effects of Zn. There are several mechanisms by which Zn may help to prevent the development or progression of MetS and T2D, respectively. Zn is involved in both insulin secretion and action in peripheral tissues. Specifically, Zn has insulin-mimetic properties that increase the activity of the insulin signaling pathway. Zn modulates long-chain polyunsaturated fatty acids levels through its action on the absorption of essential fatty acids in the intestine and its subsequent desaturation. Zn is also involved in both the assembly of chylomicrons and lipoproteins as well as their clearance, and thus, plays a role in lipolysis regulation. Finally, Zn has been found to play a role in redox metabolism, and in turn, on blood pressure. The evidence related to the association between Zn status and occurrence of MetS is inconsistent. Although there are several studies reporting an inverse relationship between Zn status or dietary Zn intake and MetS prevalence, others found a direct relationship between Zn status and MetS prevalence. Intervention studies also provide confusing information about this issue, making it hard to reach firm conclusions. Zn as part of the treatment for patients with T2D has been shown to have positive responses in terms of glucose control outcomes, but only among those with Zn deficiency.
... al. demonstrated that taking 50 mg/day supplement as zinc sulfate for 12 weeks on patients with diabetic foot ulcer, could improve TAC levels [45]. However, Jamilian et al. did not observe any significant difference in TAC levels after 8week supplementation with 50 mg of elemental zinc in PCOS women [46]. Zinc as an antagonist of redox-active transition metals, such as iron and copper, compete for the binding sites on the cell membrane, thus, can inhibit lipid peroxidase. ...
... Supporting our results, Dias et al. noticed that administration of rosuvastatin with or without supplementation with 30 mg/day zinc for4 months in subjects with atherosclerosis did not affect hs-CRP levels [50]. Furthermore, no significant change in hs-CRP levels was observed following the administration of 50 mg/day zinc supplementation for 8 weeks compared with the placebo in a study by Jamilian et al. [46]. On the other hand, Kelishadi et al. observed that hs-CRP levels significantly decreased after receiving supplemental zinc (20 mg/day) for 8 weeks among obese Iranian children with metabolic syndrome [51]. ...
Article
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Zinc is known to have multiple beneficial effects including anti-inflammatory and antioxidant and anti-depressant actions. Data on the effects of zinc supplementation on biomarkers of inflammation, oxidative stress, and antidepressant-like effect among young women with premenstrual syndrome (PMS) are scarce. This study was a randomized, double-blind, placebo-controlled trial. Sixty women (18–30 years) with premenstrual syndrome diagnosed according to 30-item questionnaire were randomly assigned to receive either 30-mg zinc gluconate (group 1; n = 30) and/or placebo (group 2; n = 30) for 12 weeks. Premenstrual syndrome symptoms, total antioxidant capacity, high sensitivity reactive protein, and brain-derived neurotrophic factor were measured at study baseline and after 12-week intervention. After 12 weeks of intervention, PMS physical symptoms (P = 0.03) and psychological symptoms (P = 0.006) significantly decreased in zinc group compared to placebo group. We observed a significant increase in brain-derived neurotrophic factor (P = 0.01) and total antioxidant capacity (P ˂ 0.001) after 12 weeks of intervention with zinc compared to placebo. We failed to find any significant effect of zinc supplementation on high sensitivity reactive protein. Overall, zinc supplementation for 12 weeks among women with premenstrual syndrome had beneficial effects on physical and psychological symptoms of premenstrual syndrome, total antioxidant capacity, and brain-derived neurotrophic factor.
... However, no association has been found between hirsutism and serum zinc concentration. Changes in LH, FSH and prolactin concentrations were also associated with hormonal imbalances among women with PCOS, although the direction of these changes was not so obvious [27,[46][47][48]50] and in some studies statistically insignificant [28,[46][47][48][49][50], also following supplementation with zinc sulfate [54]. ...
... The redox imbalance in PCOS is manifested by an impaired antioxidative mechanism, i.e., decrease of CAT and glutathione peroxidase (GPx) activity, and increase of oxidative stress biomarkers, i.e., malondialdehyde (MDA) concentration [48]. In women with PCOS, decreased lipid peroxidation, indicated by lower MDA concentrations, was observed following zinc supplementation [54,56] (Table 3). ...
Article
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Zinc is an essential microelement that plays many important functions in the body. It is crucial for the regulation of cell growth, hormone release, immunological response and reproduction. This review focuses on its importance in the reproductive system of women of reproductive and postmenopausal ages, not including its well described role in pregnancy. Only recently, attention has been drawn to the potential role of zinc in polycystic ovary syndrome (PCOS), dysmenorrhea, or endometriosis. This review is mainly based on 36 randomized, controlled studies on reproductive, pre- and post-menopausal populations of women and on research trying to explain the potential impact of zinc and its supplementation in the etiology of selected female reproductive system disorders. In women with PCOS, zinc supplementation has a positive effect on many parameters, especially those related to insulin resistance and lipid balance. In primary dysmenorrhea, zinc supplementation before and during each menstrual cycle seems to be an important factor reducing the intensity of menstrual pain. On the other hand, little is known of the role of zinc in endometriosis and in postmenopausal women. Therefore, further studies explaining the potential impact of zinc and its supplementation on female reproductive system would be highly advisable and valuable.
... To explore the causal correlations between trace elements and PCOS, many randomized controlled trials (RCTs) have been performed to establish whether trace element supplements have beneficial effects on PCOS treatment (52,53). The group of Afshar (53) showed that Mg and Zn co-supplementation decreased serum high-sensitivity C-reactive protein and increased plasma total antioxidant capacity levels. ...
... The group of Afshar (53) showed that Mg and Zn co-supplementation decreased serum high-sensitivity C-reactive protein and increased plasma total antioxidant capacity levels. However, inconsistent results have been obtained from different studies (52). Notably, increases in Cu and ferritin were difficult to adjust through simple supplements. ...
Article
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Polycystic ovary syndrome (PCOS) is reported to be associated with certain trace elements. However, previous data are inconsistent and potentially biased due to small sample sizes. The potential utility of trace element levels for screening of PCOS remains to be established. The aim of this meta-analysis was to investigate the potential relationships between PCOS and serum levels of zinc (Zn), copper (Cu), magnesium (Mg), iron (Fe) and ferritin. We carried out a literature search of PubMed, EMBASE, and Web of Science for relevant cross-sectional/case-control studies published prior to October 2019. Random-effect models were used to estimate the overall standard mean differences (SMDs) between PCOS and healthy control subjects. The screening value of potential microelement biomarkers for PCOS was assessed using the receiver operating characteristic (ROC) curve. Twenty-one studies featuring 2,173 women with PCOS and 1,897 healthy women were selected for analysis. Our results showed that Cu and ferritin levels were significantly higher in women with PCOS than healthy controls, with SMDs of 0.52 [95% confidence interval (CI): 0.38–0.67, I2 = 47.6%] and 1.05 (95% CI: 0.25–1.86, I2 = 97.0%), respectively. The serum ferritin concentration was distinguished as a potential biomarker for PCOS based on the high area under ROC curve value of 0.71 (95% CI: 0.57–0.86). Although we did not identify a statistical association between serum Zn concentration and PCOS overall, the concentration of Zn in PCOS women with insulin resistance (IR) was lower than that in healthy women (SMD = −0.89, 95% CI: −1.73 to −0.06). Furthermore, the concentrations of Mg (SMD = 0.31, 95% CI: −0.32–0.94, I2 = 95.4%) and Fe (SMD = −0.59, 95% CI: −1.29–0.12, I2 = 97.2%) were not statistically significant between the PCOS and control groups. We generated hypothetical pathways for associations among serum Cu, ferritin and PCOS. The serum concentrations of both Cu and ferritin were significantly higher in women with PCOS, and ferritin was identified as a potential early indicator for PCOS screening. Further studies are essential to determine the specific underlying mechanisms.
... Apreviously published study showed that after 8 weeks of zinc supplementation, plasma MDA levels were significantly decreased in Patients with Hypothyroidism. (−0.09 ± 1.31 vs. + 2.34 ± 5.5, P= 0.04) (49). In addition, serum hs-CRP levels were significantly decreased and plasma TAC levels were increased after 12 weeks of magnesium and zinc co-supplementation (13). ...
... However, in another RCT, the MDA and TAC levels were not found to be significantly altered after 10 weeks of magnesium, zinc, and vitamin A co-supplementation (50). Combined supplementation of magnesium and zinc had a strong synergistic effect on improving OS and inflammatory response in PCOS patients (8,13,49). However, since these studies were conducted in different populations, the synergistic effect of magnesium and zinc was hypothetical. ...
Article
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The objective of this systematic review is to synthesize the available evidence on the effectiveness of magnesium supplements on the markers of inflammation, oxidative stress (OS), and metabolism in PCOS patients and to provide a basis for its clinical treatment. Electronic databases (PubMed, Cochrane Library databases, Embase, Web of science, CMB, CNKI, VIP, Wan Fang and ClinicalTrials.gov) were searched from their inception until January 2022. Randomized controlled trials (RCTs) for PCOS undergoing therapy with magnesium supplementation alone or in combination with other agents. The primary outcomes were the markers of blood glucose and OS.363 patients from nine RCTs were included in the current systematic review. Four of the nine studies reported the effects of magnesium supplementation alone on OS or metabolic markers in women with PCOS. Whilemagnesium supplementation alone did not show any significant improvement in the markers of inflammation, OS or metabolism in PCOS, seven of the nine articles reported the effect of magnesium co-supplementation on OS or metabolic markers in PCOS patients. Magnesium combined with vitamin E or zinc-calcium-vitamin D significantly improved glucose and lipid metabolism in PCOS patients. Magnesium intake alone did not lead to a significant improvement in the markers of OS, blood glucose, or serum lipids in PCOS. However, magnesium combined with other supplements (vitamin E, zinc, zinc-calcium-vitamin D) significantly improved serum hs-CRP, insulin, HOMA-IR, TG, TC levels, and the improvement in OS markers was inconclusive. The effect of magnesium and melatonin supplementation on the markers of metabolism needs to be further verified. System Review Registration PROSPERO https://www.crd.york.ac.uk/PROSPERO/#myprospero , CRD42022303410.
... These articles were published from 1981 (Duchateau et al. 1981) to 2020 (Freiberg et al. 2020). Studies were conducted in Iran (Rashidi et al. 2009;Pourteymour Fard Tabrizi et al. 2011;Ranjbar et al., 2014;Jamilian et al. 2016;Momen-Heravi et al. 2017;Khazdouz et al. 2018;Hadadi et al. 2019;Khorsandi et al. 2019;Jafari, Amani, and Tarrahi 2020), USA (Prasad et al. 2007;Bao et al. 2008), Bangladesh (Islam et al. 2016), Italy (Mocchegiani et al. 1995;Fortes et al. 1998;Provinciali et al. 1998;Iovino et al. 2018), India (Khan et al. 2013), Indonesia (Pakasi et al. 2010), Thailand (Asdamongkol, Phanachet, and Sungkanuparph 2013;Meksawan, Sermsri, and Chanvorachote 2014;Sangthawan, Phungrassami, and Sinkitjarurnchai 2015), Turkey (Turk et al. 1998b), China (Guo and Wang 2013), and other countries. The sample size of studies ranged from 17 (Meksawan, Sermsri, and Chanvorachote 2014;Mei et al. 1991) to 127 (Freiberg et al. 2020). ...
... One study was conducted exclusively in men (Bonham et al. 2003) and 12 in women. Zinc was administered as sulfate (Bobat et al. 2005;Cvijanovich et al. 2016;Duchateau et al. 1981;Fortes et al. 1998;Foster, Petocz, and Samman 2013;Green et al. 2005;Iovino et al. 2018;Islam et al. 2016;Jamilian et al. 2016;Khan et al. 2013;Khazdouz et al. 2018;Khorsandi et al. 2019;Meksawan, Sermsri, and Chanvorachote 2014;Mocchegiani et al. 1995;Mujica-Coopman et al. 2015;Pakasi et al. 2010;Pourteymour Fard Tabrizi et al. 2011;Provinciali et al. 1998;Ranjbar et al., 2014;Rashidi et al. 2009;Sangthawan, Phungrassami, and Sinkitjarurnchai 2015;Turk et al. 1998b) gluconate (Bao et al. 2008;Freiberg et al. 2020;Guo and Wang 2013;Hadadi et al. 2019;Hodkinson et al. 2007;Jafari, Amani, and Tarrahi 2020;Kim and Ahn 2014;Momen-Heravi et al. 2017;Prasad et al. 2007;Range et al. 2006), acetate (Bao et al. 2008), and glycine form (Dias et al. 2014), and dose ranged between 5 (Adriani and Wirjatmadi 2014) to 44 (Duchateau et al. 1981) mg/d. All studies used a parallel design. ...
Article
Purpose This systematic review and meta-analysis aimed to investigate the effect of zinc supplementation on immune factors in randomized controlled trials. Methods A comprehensive search was done in PubMed, Scopus, Web of Science, Embase, and Cochrane databases up to December 2020. We used standard and weighted mean differences and 95% confidence intervals for net changes in selected parameters of immune responses. Subgroup analysis was used to find heterogeneity. Result Overall, 35 RCTs comprising 1995 participants were eligible for this meta-analysis. There was a significant reduction of circulating CRP (WMD: −32.4; 95% CI: −44.45 to −19.62, p < 0.001), hs-CRP (WMD: −0.95; 95% CI: −1.01 to −0.89, p < 0.001), Neutrophil levels (SMD: −0.46; 95% CI: −0.90 to −0.01, p = 0.043), following zinc supplementation. CD4 level also increased significantly, (WMD: 1.79; 95% CI: 0.57 to 3, p = 0.004). Zinc supplementation had no significant effect on WBC (SMD: −0.66; 95% CI: −1.67 to 0.36, p = 0.204), lymphocyte (WMD: 1.86; 95% CI: −0.86 to 4.58, p = 0.181), monocyte levels (SMD: −0.16; 95% CI: −0.07 to 0.39, p = 0.167), CD3 (SMD: 0.37; 95% CI: −0.49 to 1.22, p = 0.399). Conclusion Zinc supplementation decreased the CRP, hs-CRP and TNF-α, IL-6, neutrophil and increased CD3 and CD4 level significantly.
... However, conflicting results have been reported. In some studies, beneficial effects of Zn supplementation on antioxidant status have been shown (Momen-Heravi et al., 2017), while others did not find any significant effect (Jamilian et al., 2016). ...
... Five studies reported the effect of Zn supplementation on GPx, five studies reported GSH, 17 articles reported SOD, and six articles reported TAC. Eight studies had been conducted in Iran (Fathi et al., 2020;Jafari et al., 2020;Jamilian et al., 2016;Mazani et al., 2013;Momen-Heravi et al., 2017;Nazem et al., 2019;Nematollahi-Mahani et al., 2014;Rashidi et al., 2011), two in Tunisia (Anderson et al., 2001;Roussel et al., 2003), two in France (Andriollo-Sanchez et al., 2008;Hininger-Favier et al., 2007), two in Brazil (Dias et al., 2014;Ribeiro et al., 2016), one in UK (Bonham et al., 2003), one in Turkey (Ertekin et al., 2004) (Guo and Wang, 2013), one in Poland (Suliburska et al., 2018), and one in Canada (Fischer et al., 1984). A total number of 1815 participants were included in the present meta-analysis among with 913 subjects being in the intervention group and 902 in the control group. ...
Article
Oxidative stress is a contributing factor to many chronic diseases. It has been investigated that zinc (Zn) may enhance the antioxidant defense. The current dose-response and time-response meta-analysis aims to determine the efficacy of Zn supplementation in improving antioxidant defense. Scopus, PubMed/Medline, Web of Science, and Embase databases were searched systematically up to 30th December 2020. Meta-analysis was performed on human controlled clinical trials using random effects method. To find any source of heterogeneity, subgroup analysis and meta-regression were performed. Trim and fill analysis was used for adjusting the publication bias. To find any non-linear relationship between variables and effect size, dose-response and time-response analyses were performed. Cochrane Collaboration’s tool was used for evaluating the quality assessment. A total of 23 controlled clinical trials were analyzed. The range of Zn supplementation duration in various studies was within 4-24 weeks. Zn supplementation did not have beneficial effects on glutathione peroxidase (GPx) activity (SMD= -0.34 U/g; 95% CI: -0.93, 0.25; P= 0.258). There were significant increasing effects of Zn supplementation on glutathione (GSH) (SMD= 1.28 μmol/l; 95% CI: 0.42, 2.14; P=0.003) and total antioxidant capacity (TAC) levels (SMD= 1.39 mmol/l; 95% CI: 0.44, 2.35; P=0.004). Zn had ameliorative effects on superoxide dismutase (SOD) activity after elimination of publication bias (SMD: 0.84 U/g; 95% CI: 0.12, 1.56, P<0.05). Zn could also elevate GSH and TAC levels, plus SOD activity after modifying the publication bias. Finally, Zn had no significant effect on GPx activity.
... Serum high sensitivity C-reactive protein (hs-CRP) concentrations were assessed using an ELISA kit (LDN, Nordhorn, Germany) with intra-and inter-assay CVs of 2.8 and 4.9 %, respectively. The plasma nitric oxide (NO) was determined by the Griess method [23] and TAC was quantified by the use of the ferric reducing antioxidant power method developed by Benzie and Strain [24] . Assessment of glutathione (GSH) and malondialdehyde (MDA) levels were done by the Beutler method [25] and by the thiobarbituric acid reactive substance spectrophotometric test [26], respectively. ...
Article
The current study was conducted to assess the effects of vitamin D-K-calcium co-supplementation on endocrine, inflammation, and oxidative stress biomarkers in vitamin D-deficient women with polycystic ovary syndrome (PCOS). This randomized double-blind, placebo-controlled trial was performed on 60 vitamin D-deficient women diagnosed with PCOS aged 18-40 years old. Participants were randomly allocated into 2 groups to intake either 200 IU vitamin D, 90 μg vitamin K plus, 500 mg calcium supplements (n=30), or placebo (n=30) twice a day for 8 weeks. Endocrine, inflammation, and oxidative stress biomarkers were quantified at the beginning and the end of the study. After 8 weeks of intervention, compared with the placebo, vitamin D-K-calcium co-supplementation resulted in a significant reduction in serum-free testosterone (- 2.1±1.6 vs.+0.1±1.0 pg/ml, p<0.001) and dehydroepiandrosterone sulfate (DHEAS) levels (- 0.8±1.0 vs.-0.1±0.5 μg/ml, p=0.006). In addition, a significant increase in plasma total antioxidant capacity (TAC) (+ 75.7±126.1 vs.-80.4±242.8 mmol/l, p=0.005) and a significant difference in plasma malondialdehyde (MDA) concentrations (+ 0.03±0.6 vs.+1.4±2.4 μmol/l, p=0.005) was observed following the supplementation with vitamin D-K-calcium compared with the placebo. A trend toward a greater decrease in luteinizing hormone was observed in vitamin D-K-calcium co-supplement group compared to placebo group (- 7.0 vs.-1.2 IU/l, p=0.09). We did not find any significant effect of vitamin D-K-calcium co-supplementation on prolactin, follicle-stimulating hormone, 17-OH progesterone, inflammatory markers, and glutathione levels. Overall, vitamin D-K-calcium co-supplementation for 8 weeks among vitamin D-deficient women with PCOS had beneficial effects on serum DHEAS, free testosterone, plasma TAC, and MDA levels. © Georg Thieme Verlag KG Stuttgart · New York.
... Participants were randomly assigned to one of two treatment groups: Placebo Group (PbG: 25 women); Zinc Group (ZnG: 26 women) -50 mg/day of Zn (600% of Recommended Dietary Allowances (RDA)). Zn supplements were supplied by SM Natural Solutions, Sabadell, Spain (Number 0B62713821) following the period of eight weeks, dosage and mode of application recommended by the manufacturer and based in previous studies with similar dosage and period of supplementation (Jamilian et al., 2016;Nazem et al., 2019). Placebo capsules contained lactose and were made of the same size and colour as Zn supplements for identical appearance and taste. ...
Article
Background & aims Menopausal hormonal changes increase the risk of deficiencies of minerals such as zinc (Zn), which could further worsen the decreased antioxidant defense of postmenopausal women. This study assesses the effect of 8 weeks of Zn supplementation upon the antioxidant status and clinical nutritional parameters of a postmenopausal population. Methods Fifty-one postmenopausal women were divided into two groups: placebo (PbG) and zinc supplementation (ZnG). Mineral status was determined by flame atomic absorption spectrophotometry (FAAS). Total antioxidant capacity (TAC) and superoxide dismutase (SOD) were analyzed by kinetic colorimetric methods. Glutathione peroxidase (GPx) was assessed by an enzymatic immunological method. Results Poor Zn status was initially observed in erythrocyte samples. Total antioxidant capacity showed a significant correlation (r = 0.730; p < 0.05) to erythrocyte Zn after the intervention (ZnG: r = 0.96; p < 0.001). Moreover, erythrocyte Zn in ZnG was positively correlated to GPx after the intervention (r = 0.61; p < 0.01). Conclusions The postmenopausal women initially presented Zn deficiency, and the status of this mineral improved after the intervention. Zinc supplementation may be an effective approach for correcting the observed deficiencies, enhancing antioxidant defense in this risk population. Clinical trial registration The present study is registered at the US National Institutes of Health (ClinicalTrials.gov), NCT03672513.
... Reduced levels of circulating zinc are common in obesity (8,9) whereas recent studies report conflicting results with regard to the levels of circulating zinc in the blood of PCOS women (3)(4)(5). However, zinc supplementation has several beneficial effects on the metabolic status in PCOS women (6,48). So far, limited attempts have been made to understand the underlying molecular events of the zinc disturbances in PCOS. ...
Article
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Polycystic ovary syndrome (PCOS) is associated with infertility, increased androgen levels, and insulin resistance. In adipose tissue, zinc facilitates insulin signaling. Circulating zinc levels are altered in obesity, diabetes, and PCOS; and zinc supplementation can ameliorate metabolic disturbances in PCOS. In adipose tissue, expression of zinc influx transporter ZIP14 varies with body mass index (BMI), clinical markers of metabolic syndrome, and peroxisome proliferator-activated receptor gamma (PPARG). In this study, we investigated expression levels of ZIP14 and PPARG in subcutaneous adipose tissue of 36 PCOS women (17 lean and 19 obese women) compared with 23 healthy controls (7 lean and 16 obese women). Further, expression levels of zinc transporter ZIP9, a recently identified androgen receptor, and zinc efflux transporter ZNT1 were investigated, alongside lipid profile and markers of glucose metabolism [insulin degrading enzyme, retinol-binding protein 4 (RBP4), and glucose transporter 4 (GLUT4)]. We find that ZIP14 expression is reduced in obesity and positively correlates with PPARG expression, which is downregulated with increasing BMI. ZNT1 is upregulated in obesity, and both ZIP14 and ZNT1 expression significantly correlates with clinical markers of altered glucose metabolism. In addition, RBP4 and GLUT4 associate with obesity, but an association with PCOS as such was present only for PPARG and RBP4. ZIP14 and ZNT1 does not relate to clinical androgen status and ZIP9 is unaffected by all parameters investigated. In conclusion, our findings support the existence of a zinc dyshomeostasis in adipose tissue in metabolic disturbances including PCOS-related obesity.
... To calculate the sample size, we used the standard formula suggested for clinical trials by considering type 1 error (α) of 0.05 and type 2 error (β) of 0.20 (power = 80%). Based on a previous study [19], we used 1391.56 ng/mL as SD and 1120.0 ng/mL as the difference in mean (d) of hs-CRP as primary variable. ...
... Interestingly, lower intake would decrease serum CRP concentration by 1.68 mg/L in a meta-analysis including 217 subjects and 200 controls (44). Another double-blinded study in 2015 found that after an 8-week intervention of 50 mg zinc daily, patients with polycystic ovary syndrome consumed only had a significant trend on reduced CRP levels (86). An important fact is that the improvement of oxidative stress comes from zinc-linked primary antioxidant enzymes (87). ...
Article
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It is widely accepted that the zinc element is crucial in human beings. Zinc has gained more attention during the COVID-19 pandemic due to its utilization for the treatment and prevention of respiratory tract infections. However, some studies also pointed out that zinc intake might cause unwanted side effects and even be dangerous when overdosed. To reveal the relationship between zinc intake and health outcomes, we performed an umbrella review from human studies. In total, the umbrella review included 43 articles and identified 11 outcomes for dietary zinc intake and 86 outcomes for supplementary zinc intake. Dietary zinc intake in the highest dose would decrease the risk of overall and specific digestive tract cancers, depression, and type 2 diabetes mellitus (T2DM) in adults. Supplementary zinc consumption in adults was linked to an improvement of depression, antioxidant capacity and sperm quality, higher serum zinc concentration, and lower concentration of inflammatory markers. Zinc supplementation in children would reduce the incidence of diarrhea and pneumonia, improve zinc deficiency and boost growth. However, zinc might not decrease all-cause mortality in adults or the in-hospital mortality of COVID-19. And better maternal and neonatal outcomes may not derive from pregnant women who consumed higher or lower doses of zinc supplementation (>20 mg/day and <20 mg/day, respectively). Dose-response analyses revealed that a daily 5 mg increment of zinc would lower the risk of colorectal and esophageal cancer, whereas a large dose of zinc supplementation (daily 100 mg) showed no benefit in reducing prostate cancer risk.
... Based on the guidelines and similar to previous studies among patients with PCOS, all patients were taking metformin tablet 1500 mg (i.e., 500 mg three times daily) (13,23,24). At the onset of the study, patients were asked to keep routine levels of PA and their habitual diet during the 8-week intervention. ...
Article
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Context Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive age women. No study has examined the hormonal and metabolic effects of coenzyme Q10 and/or vitamin E in patients with PCOS. Objective To evaluate the effects of coenzyme Q10 and/or vitamin E on glucose homeostasis parameters and reproductive hormones in women with PCOS. Design/Setting/Participants Randomized double-blind placebo-controlled clinical trial among 86 women with PCOS. Intervention Coenzyme Q10 (CoQ10) or vitamin E or combination for 8 weeks. Main Outcome Measures Glucose homeostasis parameters and sex hormones concentrations. Results We observed that, after adjustment for potential confounders, supplementation with CoQ10 alone or in combination with vitamin E, compared with placebo, had significant effects on fasting blood sugar (FBS), while the effect of vitamin E on FBS was not statistically significant. A significant reduction in homeostasis model assessment of insulin resistance (HOMA-IR) was observed in the CoQ10 and combined groups. CoQ10, vitamin E and Co-supplementation compared with the placebo group, led to decreased serum total testosterone levels (P<0.001). CoQ10 supplementation in combination with vitamin E resulted in a significant improvement in sex hormone-binding globulin (SHBG) compared to other groups (P=0.008). Findings from linear regression analysis revealed that changes in FBS, insulin, and HOMA-IR were predictors of change in FAI (P<0.05). Conclusions In conclusion, CoQ10 with or without vitamin E supplementation among women with PCOS had beneficial effects on serum FBS and insulin levels as well as HOMA-IR and total testosterone levels. However only co-supplementation was able to affect SHBG concentrations.
... Due to a lack of evidence regarding the appropriate dosage of melatonin for patients with PCOS, we used the following dose of melatonin based on a previous published study in diabetic patients with coronary heart disease (CHD) (26). All individuals were taking metformin tablets at an initial dose of 500 mg, which was increased in a stepwise manner during the first 3 weeks to a total of 1,500 mg/day (27). In addition, all individuals were taking 10 mg/day medroxyprogesterone tablet from the 15th until the 25th day of the menstrual cycle. ...
Article
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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 < 0.001), and significantly increased plasma total antioxidant capacity (TAC) levels (β 106.07 mmol/L; 95% CI, 62.87, 149.28; P < 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/26051
... Curcumin reduces insulin resistance and has also anti-inflammatory actions [82]. Zinc can enhance fertility and the immune system and can also improve the clinical signs of hyperandrogenemia such as hirsutism and alopecia [83]. Omega-3 fatty acids can improve menstrual regularity and lipid profile in women with PCOS [84]. ...
Article
Introduction: Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in reproductive-aged women. Hyperandrogenism, polycystic ovaries, chronic anovulation, and metabolic aberrations are its common features. The treatment approach focuses on the main aberrations, which characterize the different phenotypes. Areas covered: Management strategies targeting the metabolic phenotype include lifestyle modifications for weight loss and improvement of dietary habits, as well as medication, such as insulin-sensitizers. The treatment of hyperandrogenic phenotype includes cosmetic procedures and the combined oral contraceptives with or without antiandrogens. The therapeutic approach to reproductive phenotype includes diet and lifestyle modifications, clomiphene citrate, and aromatase inhibitors. Alternative treatments include dietary supplements, herbs, resveratrol, myo-inositol, and acupuncture. Expert opinion: New studies have shown that higher anti-Müllerian hormone levels, gut microbiome composition, and plasma metabolomics are new parameters that are related to the most severe phenotypes. The clinical phenotypes can change over the lifespan with weight gain and can coexist in the same individual. Individualized treatment remains the main approach but grouping the phenotypes and following therapeutic recommendations may prove to be also clinically appropriate.
... Zinc deficient can serve with as well as the originator and the booster of lack of zinc. The fundamental pathways and metabolism properties the PCOS have which reducing antioxidative potential by inducing insulin sensitivity, triggering programmed cell death necrobiosis (Jamilian et al. 2016). ...
... Based on the guidelines and similar to previous studies on PCOS patients, all patients took metformin tablets at the dose of 1500 mg (500 mg 3 times daily) (28,36,37). Patients were asked not to change their ordinary physical activity or routine dietary intakes throughout the study. ...
Article
Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive age women. Objective: This study was conducted to investigate the effects of CoQ10 and/or vitamin E on cardiometabolic outcomes in patients with PCOS. Methods: This randomized clinical trial was carried out among 86 women with PCOS. Patients were assigned to take CoQ10, vitamin E, CoQ10 plus vitamin E or placebo for 8 weeks. Fasting blood samples were obtained at the beginning and end of the study. Results: A significant decrease in serum triglycerides (TG) (p <0.001) was found following the administration of CoQ10 and/or vitamin E supplements compared with the placebo group. Supplementation with CoQ10 and vitamin E failed to affect total cholesterol levels. However, co-administration of CoQ10 and vitamin E resulted in a significant decrease in serum total cholesterol levels (9.92 [15.11, 4.74]). Additionally, only the combination of supplements was able to significantly reduce low-density lipoprotein-cholesterol (LDL-C) (‒9.63 [‒15.34, ‒3.92]), increase high-density lipoprotein-cholesterol (HDL-C) (2.33 [0.51, 4.16), reduce atherogenic coefficient (AC) (‒0.29 [‒0.43, ‒0.16], p = 0.03) and decrease visceral adiposity index (VAI) values. Co-Q10 and vitamin E (alone or in combination) had significant effects on non-HDL-C (p = 0.004), atherogenic Index of Plasma (AIP) (p = <0.001) and lipid accumulation product (LAP) (p <0.001) and SBP (p = 0.005). However, the reduction in DBP was statistically significant only for patients who received combined supplementations (p = 0.04). Conclusions: In conclusion, CoQ10, vitamin E (alone or in combination) had beneficial effects on cardiometabolic outcomes among women with PCOS.
... Consistent with our results, in several trials zinc supplementation in various diseases, have shown no significant difference of serum level of hs-CRP [7,38]. However, the decreasing effect of zinc supplementation on serum level of hs-CRP was reported in elderly subjects and adults with metabolic syndrome [8,39]. ...
Article
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Migraine is a widespread incapacitating neurologic disorder with debilitating headaches which are usually throbbing due to inefficacy and several side effects, complementary therapies recommended as possible alternatives. The current randomized controlled trial was carried out to evaluate the effect of zinc gluconate supplementation on migraine-related symptoms, serum level of high sensitivity C-reactive protein (hs-CRP) and lipid profile in migraineurs. Present study was designed as randomized double-blind, placebo-controlled trial. Sixty women with migraine (mean age of 35.44 ± 7.42 years) were randomly allocated to obtain 15 mg per day of zinc gluconate or placebo for 12 weeks. Frequency, periods of headaches and severity of migraine based on numerical rating scale questionnaire and migraine disability assessment (MIDAS) test were checked. Fasting serum level of lipid profile and hs-CRP were assessed at the beginning and the end of trial. Zinc gluconate supplementation significantly reduced the frequency (p = 0.001), periods of migraine attacks (p < 0.001) and severity of migraine and MIDAS (p < 0.001) compared with control group. The serum level of low-density lipoprotein (p < 0.001), total cholesterol (p < 0.001) and hs-CRP (p < 0.001) decreased following zinc supplementation, but no significant differences in serum level of triglycerides (p = 0.1) and high-density lipoprotein (p = 0.3) was observed. However, after adjustment for baseline values using analysis of covariance test, none of lipid profile components and hs-CRP showed a significant difference. Zinc supplementation has beneficial effect on the migraine related complications like its severity, frequency. Trial registration: Iranian Registry of Clinical Trials Identifier: IRCT20191014045100N1.
... An improvement was reported in insulin resistance in patients with PCOS after zinc supplementation [41,42]. It has been reported that hirsutism also improved in PCOS patients with Zn replacement [43,44]. These results and the results of the present study suggest that low Zn levels in PCOS patients may be associated with insulin resistance and hyperandrogenemia. ...
Article
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This study aimed to determine the relationship between the metabolic and endocrinological pathologies in polycystic ovary syndrome (PCOS) and the levels of arsenic, chromium, cadmium, lead, mercury, antimony, zinc, and copper to evaluate the relationship of these toxic metals with inflammatory/oxidative parameters. This study included a total of 154 patients (84 with PCOS, 70 healthy volunteers). Metabolic and endocrine parameters and arsenic, chromium, cadmium, lead, mercury, antimony, zinc, and copper serum levels of the patients were compared between the groups. Considering the action mechanism of toxic metals, serum malondialdehyde (MDA), superoxide dismutase (SOD), serum total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), tumor necrosis factor-alpha (TNFα), and high-sensitivity C-reactive protein (HsCRP) levels were determined. Serum TAS (p = 0.002), OSI (p = 0.006), SOD (p = 0.006), zinc (p = 0.010), and copper (p = 0.030) values were statistically lower whereas TOS (p = 0.008), MDA (p < 0.001), HsCRP (p < 0.001), TNFα (p < 0.001), antimony (p < 0.001), cadmium (p < 0.001), lead (p < 0.001), and mercury (p < 0.001) levels were significantly higher in the PCOS group than those determined in the control group. Antimony was positively correlated with fasting glucose (FG) and HOMA-IR while cadmium, in addition to FG and HOMA-IR, positively correlated with insulin and lead had a positive correlation only with FG (p < 0.05). Also, these three heavy metals correlated positively with some oxidative system and inflammatory parameters and negatively with the antioxidant system parameters (p < 0.05). In conclusion, heavy metal exposures in PCOS may be related to insulin resistance and hirsutism through oxidative and inflammatory mechanisms. This approach can be used to identify the risky patient group and to develop new treatment modalities.
... Based on guidelines and according to previous studies in PCOS patients, all women were taken metformin tablet [18,19]. To determine compliance, patients were asked to bring the medication containers and all individuals were received short messages on their cell phones to take the supplements every day. ...
Article
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Background: This study aimed at determining the effects of coenzyme Q10 (CoQ10) supplementation on the inflammatory and endothelial dysfunction indices among overweight and obese women with polycystic ovary syndrome (PCOS). Methods: This randomized double-blind, placebo-controlled clinical trial was performed among overweight and obese women diagnosed with PCOS. Forty three PCOS women were randomly assigned to two groups: one group received 200 mg CoQ10 capsules per day (n = 22) and the other received placebo (n = 21) for 8 weeks. Biomarkers of inflammation and endothelial dysfunction including high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1) and E-selectin were measured and compared before and after the intervention. Results: At the end of study, compared with pldacebo, CoQ10 supplementation resulted in significant decreases in serum levels of TNF-α (p = 0.009), hs-CRP and IL-6 (p = 0.001, p = 0.007, respectively). In addition, supplementation with CoQ10 resulted in a significant reduction in serum VCAM-1 (p = .002) and E-selectin (p = .006) compared with the control group. There were no significant differences for serum ICAM-1. Conclusions: The present study showed that CoQ10 supplementation for 8 weeks had a beneficial effect on inflammatory and endothelial dysfunction markers in overweight and obese patients with PCOS.
... On the other hand, another study showed no significant changes in MDA and SOD levels after the consumption of 250 and 500 mg of vitamin C, respectively [70]. In other study, it was observed that supplementation with zinc (50 mg/d) for 8 weeks produced a significant decrease in MDA levels compared to placebo [71]. ...
Article
Full-text available
The aim of the study was to analyze how cardiovascular risk factors can be modified using nutritionally improved cooked ham enriched with a pool of antioxidants to influence relevant metabolic targets. Sixty-five untreated subjects (49.2% males, 50.8% females, mean age 40.92 ± 9.03 years) with total cholesterol level ≥180 mg/dL or LDL cholesterol ≥130 mg/dL participated in a 8-weeks randomized, double-blind controlled trial. Participant in the intervention group (51.5% males, 48.5% females, mean age 41.6 ± 9.8 years and mean BMI 25.1 ± 3.6 kg/m 2) consumed cooked ham enriched with antioxidants (100 g/d) and controls (49.9% males, 53.1% females, mean age 40.2 ± 8.3 years and mean BMI 26.3 ± 3.2 kg/m 2) received placebo. At 8 weeks, oxidized LDL decreased significantly between experimental and placebo groups (p < 0.036). Experimental group differences were also significant (p < 0.05). Similar findings in malondialdehyde, total cholesterol, high-sensitivity C-reactive protein, and interleukin 6 were observed in the intervention group. Significant between-group differences in these variables were also found, except for total cholesterol and interleukin 6. The effects on inflammation and oxidation support the direct action of these antioxidants on the etiopathogenic factors of atheromatous plaque. We also observed an improvement in the lipid profiles among the subjects.
... An important trace element is Zinc which support the biological functions and helps in normal growth and development of immune system defense (11). The concentration changes of Zinc in PCOS patients caused body disorders and several studies have been showed the correlation between Zinc and PCOS and suggested an extensive study to understand the roles of Zinc element in PCOS development (12). The present study was designed to estimate the hormones levels (progesterone, prolactin, and luteinizing and follicle stimulating hormones, (LH and FSH, respectively), antioxidant factors: catalase (CAT), glutathione-s-transferase (GST), and zinc (Zn) concentration) and lipid profiles for Iraqi women patients with PCOS in the southern area of Iraq, Basrah province, Al-Zubair Hospital. ...
Article
Full-text available
Background: Polycystic ovary syndrome (PCOS) is a hormonal disorder in women with unknown causes and is the leading cause of infertility in women of reproductive age, presenting a wide range of clinical manifestations worldwide. The objective of study is to compare the correlation between hormones, lipid profile, oxidative stress and Zinc concentration in PCOS patients. Methods: The present study examined hormone levels (progesterone, prolactin, luteinizing and follicle stimulation hormones (LH and FSH, respectively), antioxidant factors (catalase, glutathione-s- transferase), lipid profiles and zinc concentration of 50 Iraqi women patients' diagnosis with PCOS and 40 healthy women, divided in two age groups of 15-29 and 30-45 years. Body mass index was estimated for two age groups. Results: The results showed decreasing of catalase, glutathione, and Zn concentrations with an increase in age. A slightly significant increase in LH and prolactin and decrease in high-density lipoprotein (HDL-C) with an increase in age in the patient group compared to the control group was noted. Conclusion: Our study demonstrated that some factors (such as family history, genetics, environmental, etc…) could play a role in altering hormone levels, lipid profiles, and antioxidant. Controlling these factors may be useful for reducing the PCOS-associated problems in women's health. Needed extensive studies to assess the correlation with insulin resistant and obesity.
Article
Background/Objectives Clinical efficacy of Zn supplementation in improvement of oxidative stress biomarkers has been investigated in some clinical trial studies. The purpose of current dose-response meta-analysis is to systematically aggregate and evaluate all related studies to highlight the possible effect of Zn supplementation on oxidative stress. Methods Systematic search was performed on Scopus, PubMed/Medline, Web of Science and Embase up to December 31, 2020. Random effect method was used to perform pooled-analysis. Possible sources of heterogeneity were found using subgroup analysis and meta-regression. In the presence of publication bias, trim and fill analysis was performed to adjust the results. Non-linear relationship between effect size and variables was investigated performing dose-response analysis. Quality of included studies was assessed using Cochrane Collaboration’s tool. Results Pooled-analysis of 18 studies showed that Zn supplementation improved MDA and Hcys levels (SMD= -1.53 μmol/L; 95% CI: -2.22, -0.85; P< 0.001 and SMD= -0.62 μmol/L; 95% CI: -1.08, -0.15; P< 0.001, respectively). There was no significant effect of Zn supplementation on TBARS (SMD= -0.59 μmol/l; 95% CI: -1.31, 0.13; P=0.108). Zn had maximum reducing effect on MDA in <40 mg/day dosage. Conclusion Zn supplementation reduces MDA and Hcys levels, but not TBARS level. Supplementation with Zn <40 mg/day has optimum effect on MDA level. Zn supplementation could be considered clinically as a beneficial approach in amending oxidative stress.
Article
The study aimed to evaluate the serum level of zinc and copper in women with polycystic ovarian syndrome (PCOS). A case-control study was conducted at Saad Abualila infertility center (Khartoum, Sudan). The cases were women who had a PCOS based on Rotterdam criteria. The controls were infertile women with no evidence of PCOS. The socio-demographic characteristics and medical history data were gathered using questionnaires. Zinc and copper levels were measured using atomic absorption spectrophotometer. While there was no difference in zinc and copper levels between the two groups (50 women in each arm), mean (SD) of body mass index (BMI) was significantly higher in women with PCOS compared to the controls [28.4 (4.2) vs. 25.6 (5.7) kg/m2; P = 0.006], respectively. There were no significant differences in the level of luteinizing hormone (LH), follicle stimulating hormone (FSH), LH/FSH, prolactin, testosterone, cholesterol, triglycerides and low-density lipoprotein (LDL) between the cases and the controls. In linear regression analyses, none of the investigated factors were associated with PCOS. Zinc and copper were not associated with PCOS in this setting.
Article
Objective: Limited data are available evaluating the effects of oral carnitine supplementation on weight loss and metabolic profiles of women with polycystic ovary syndrome (PCOS). This study was designed to determine the effects of oral carnitine supplementation on weight loss, and glycaemic and lipid profiles in women with PCOS. Design, patients and measurements: In a prospective, randomized, double-blind, placebo-controlled trial, 60 overweight patients diagnosed with PCOS were randomized to receive either 250 mg carnitine supplements (n=30) or placebo (n=30) for 12 weeks. Fasting blood samples were obtained at the beginning and end of the study to quantify parameters of glucose homeostasis and lipid concentrations. Results: At the end of the 12 weeks, taking carnitine supplements resulted in a significant reduction in weight (-2.7±1.5 vs. +0.1±1.8 kg, P<0.001), BMI (-1.1±0.6 vs. +0.1±0.7 kg/m(2) , P<0.001), waist circumference (WC) (-2.0±1.3 vs. -0.3±2.0 cm, P<0.001) and hip circumference (HC) (-2.5±1.5 vs. -0.3±1.8 cm, P<0.001) compared with placebo. In addition, compared with placebo, carnitine administration in women with PCOS led to a significant reduction in fasting plasma glucose (-0.38±0.36 vs. +0.11±0.97 mmol/L, P=0.01), serum insulin levels (-14.39±25.80 vs. +3.01±37.25 pmol/L, P=0.04), homeostasis model of assessment-insulin resistance (-0.61±1.03 vs. +0.11±1.43, P=0.04) and dehydroepiandrosterone sulfate (-3.64±7.00 vs. -0.59±3.20 μmol/L, P=0.03). Conclusions: Overall, 12 weeks of carnitine administration in PCOS women resulted in reductions in weight, BMI, WC and HC, and beneficial effects on glycaemic control; however, it did not affect lipid profiles or free testosterone. This article is protected by copyright. All rights reserved.
Article
Chronic inflammation has been considered as the main cause of chronic diseases. Zn has anti-inflammatory effects by decreasing the expression of inflammatory markers. The present systematic review and meta-analysis study aims to evaluate the impact of Zn supplementation on inflammation. Pubmed (Medline), Scopus, Web of Science, and Embase databases were searched up to December 10 th , 2020. Randomized placebo-controlled trials have investigated the effects of Zn supplementation on serum/plasma levels of inflammatory cytokines in >15 years’ subjects were included. A pooled meta-analysis was performed using a random-effect model. Sensitivity analysis was performed to determine the robustness of the observed effect sizes. Potential causes of heterogeneity were determined using subgroup analyses. The relationship between effect size and co-variables was explored using meta-regression. In the cases of the presence of publication bias, trim and fill analysis was carried out. Cochrane Collaboration’s tool was used for assessing the quality of the included studies. A total of 12 studies was included in meta-analysis. Zn could decrease IL-6 levels (SMD= -0.76 pg/ml; 95% CI: -1.28, -0.24; P = 0.004). There was no significant change in TNF-α (SMD= 0.42 pg/ml; 95% CI: -0.31, 1.16; P = 0.257) and IL-2 levels (SMD= 1.64 pg/ml; 95% CI: -1.31, 4.59; P = 0.277) following Zn supplementation. However, Zn could increase IL-2 significantly after deletion of one arm in sensitivity analysis (SMD= 2.96 pg/ml; 95% CI: 2.03, 3.88; P < 0.05). Conclusively, Zn supplementation can decrease the IL-6 level. Zn increased IL-2 level after sensitivity analysis. Zn supplementation has not ameliorative effects on TNF-α.
Article
Background: A couple may be considered to have fertility problems if they have been trying to conceive for over a year with no success. This may affect up to a quarter of all couples planning a child. It is estimated that for 40% to 50% of couples, subfertility may result from factors affecting women. Antioxidants are thought to reduce the oxidative stress brought on by these conditions. Currently, limited evidence suggests that antioxidants improve fertility, and trials have explored this area with varied results. This review assesses the evidence for the effectiveness of different antioxidants in female subfertility. Objectives: To determine whether supplementary oral antioxidants compared with placebo, no treatment/standard treatment or another antioxidant improve fertility outcomes for subfertile women. Search methods: We searched the following databases (from their inception to September 2019), with no language or date restriction: Cochrane Gynaecology and Fertility Group (CGFG) specialised register, CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL and AMED. We checked reference lists of relevant studies and searched the trial registers. Selection criteria: We included randomised controlled trials (RCTs) that compared any type, dose or combination of oral antioxidant supplement with placebo, no treatment or treatment with another antioxidant, among women attending a reproductive clinic. We excluded trials comparing antioxidants with fertility drugs alone and trials that only included fertile women attending a fertility clinic because of male partner infertility. Data collection and analysis: We used standard methodological procedures expected by Cochrane. The primary review outcome was live birth; secondary outcomes included clinical pregnancy rates and adverse events. Main results: We included 63 trials involving 7760 women. Investigators compared oral antioxidants, including: combinations of antioxidants, N-acetylcysteine, melatonin, L-arginine, myo-inositol, carnitine, selenium, vitamin E, vitamin B complex, vitamin C, vitamin D+calcium, CoQ10, and omega-3-polyunsaturated fatty acids versus placebo, no treatment/standard treatment or another antioxidant. Only 27 of the 63 included trials reported funding sources. Due to the very low-quality of the evidence we are uncertain whether antioxidants improve live birth rate compared with placebo or no treatment/standard treatment (odds ratio (OR) 1.81, 95% confidence interval (CI) 1.36 to 2.43; P < 0.001, I2 = 29%; 13 RCTs, 1227 women). This suggests that among subfertile women with an expected live birth rate of 19%, the rate among women using antioxidants would be between 24% and 36%. Low-quality evidence suggests that antioxidants may improve clinical pregnancy rate compared with placebo or no treatment/standard treatment (OR 1.65, 95% CI 1.43 to 1.89; P < 0.001, I2 = 63%; 35 RCTs, 5165 women). This suggests that among subfertile women with an expected clinical pregnancy rate of 19%, the rate among women using antioxidants would be between 25% and 30%. Heterogeneity was moderately high. Overall 28 trials reported on various adverse events in the meta-analysis. The evidence suggests that the use of antioxidants makes no difference between the groups in rates of miscarriage (OR 1.13, 95% CI 0.82 to 1.55; P = 0.46, I2 = 0%; 24 RCTs, 3229 women; low-quality evidence). There was also no evidence of a difference between the groups in rates of multiple pregnancy (OR 1.00, 95% CI 0.63 to 1.56; P = 0.99, I2 = 0%; 9 RCTs, 1886 women; low-quality evidence). There was also no evidence of a difference between the groups in rates of gastrointestinal disturbances (OR 1.55, 95% CI 0.47 to 5.10; P = 0.47, I2 = 0%; 3 RCTs, 343 women; low-quality evidence). Low-quality evidence showed that there was also no difference between the groups in rates of ectopic pregnancy (OR 1.40, 95% CI 0.27 to 7.20; P = 0.69, I2 = 0%; 4 RCTs, 404 women). In the antioxidant versus antioxidant comparison, low-quality evidence shows no difference in a lower dose of melatonin being associated with an increased live-birth rate compared with higher-dose melatonin (OR 0.94, 95% CI 0.41 to 2.15; P = 0.89, I2 = 0%; 2 RCTs, 140 women). This suggests that among subfertile women with an expected live-birth rate of 24%, the rate among women using a lower dose of melatonin compared to a higher dose would be between 12% and 40%. Similarly with clinical pregnancy, there was no evidence of a difference between the groups in rates between a lower and a higher dose of melatonin (OR 0.94, 95% CI 0.41 to 2.15; P = 0.89, I2 = 0%; 2 RCTs, 140 women). Three trials reported on miscarriage in the antioxidant versus antioxidant comparison (two used doses of melatonin and one compared N-acetylcysteine versus L-carnitine). There were no miscarriages in either melatonin trial. Multiple pregnancy and gastrointestinal disturbances were not reported, and ectopic pregnancy was reported by only one trial, with no events. The study comparing N-acetylcysteine with L-carnitine did not report live birth rate. Very low-quality evidence shows no evidence of a difference in clinical pregnancy (OR 0.81, 95% CI 0.33 to 2.00; 1 RCT, 164 women; low-quality evidence). Low quality evidence shows no difference in miscarriage (OR 1.54, 95% CI 0.42 to 5.67; 1 RCT, 164 women; low-quality evidence). The study did not report multiple pregnancy, gastrointestinal disturbances or ectopic pregnancy. The overall quality of evidence was limited by serious risk of bias associated with poor reporting of methods, imprecision and inconsistency. Authors' conclusions: In this review, there was low- to very low-quality evidence to show that taking an antioxidant may benefit subfertile women. Overall, there is no evidence of increased risk of miscarriage, multiple births, gastrointestinal effects or ectopic pregnancies, but evidence was of very low quality. At this time, there is limited evidence in support of supplemental oral antioxidants for subfertile women.
Article
Background: A couple may be considered to have fertility problems if they have been trying to conceive for over a year with no success. This may affect up to a quarter of all couples planning a child. It is estimated that for 40% to 50% of couples, subfertility may result from factors affecting women. Antioxidants are thought to reduce the oxidative stress brought on by these conditions. Currently, limited evidence suggests that antioxidants improve fertility, and trials have explored this area with varied results. This review assesses the evidence for the effectiveness of different antioxidants in female subfertility. Objectives: To determine whether supplementary oral antioxidants compared with placebo, no treatment/standard treatment or another antioxidant improve fertility outcomes for subfertile women. Search methods: We searched the following databases (from their inception to September 2016) with no language or date restriction: Cochrane Gynaecology and Fertility Group (CGFG) specialised register, the Cochrane Central Register of Studies (CENTRAL CRSO), MEDLINE, Embase, PsycINFO, CINAHL and AMED. We checked reference lists of appropriate studies and searched for ongoing trials in the clinical trials registers. Selection criteria: We included randomised controlled trials (RCTs) that compared any type, dose or combination of oral antioxidant supplement with placebo, no treatment or treatment with another antioxidant, among women attending a reproductive clinic. We excluded trials comparing antioxidants with fertility drugs alone and trials that only included fertile women attending a fertility clinic because of male partner infertility. Data collection and analysis: Two review authors independently selected eligible studies, extracted the data and assessed the risk of bias of the included studies. The primary review outcome was live birth; secondary outcomes included clinical pregnancy rates and adverse events. We pooled studies using a fixed-effect model, and calculated odds ratios (ORs) with 95% confidence intervals (CIs) for the dichotomous outcomes of live birth, clinical pregnancy and adverse events. We assessed the overall quality of the evidence by applying GRADE criteria. Main results: We included 50 trials involving 6510 women. Investigators compared oral antioxidants, including combinations of antioxidants, N-acetyl-cysteine, melatonin, L-arginine, myo-inositol, D-chiro-inositol, carnitine, selenium, vitamin E, vitamin B complex, vitamin C, vitamin D+calcium, CoQ10, pentoxifylline and omega-3-polyunsaturated fatty acids versus placebo, no treatment/standard treatment or another antioxidant.Very low-quality evidence suggests that antioxidants may be associated with an increased live birth rate compared with placebo or no treatment/standard treatment (OR 2.13, 95% CI 1.45 to 3.12, P > 0.001, 8 RCTs, 651 women, I(2) = 47%). This suggests that among subfertile women with an expected live birth rate of 20%, the rate among women using antioxidants would be between 26% and 43%.Very low-quality evidence suggests that antioxidants may be associated with an increased clinical pregnancy rate compared with placebo or no treatment/standard treatment (OR 1.52, 95% CI 1.31 to 1.76, P < 0.001, 26 RCTs, 4271 women, I(2) = 66%). This suggests that among subfertile women with an expected clinical pregnancy rate of 22%, the rate among women using antioxidants would be between 27% and 33%. Heterogeneity was moderately high.There was insufficient evidence to determine whether there was a difference between the groups in rates of miscarriage (OR 0.79, 95% CI 0.58 to 1.08, P = 0.14, 18 RCTs, 2834 women, I(2) = 23%, very low quality evidence). This suggests that, among subfertile women with an expected miscarriage rate of 7%, use of antioxidants would be expected to result in a miscarriage rate of between 4% and 7%. There was also insufficient evidence to determine whether there was a difference between the groups in rates of multiple pregnancy (OR 1.00, 95% CI 0.73 to 1.38, P = 0.98, 8 RCTs, 2163 women, I(2) = 4%, very low quality evidence). This suggests that among subfertile women with an expected multiple pregnancy rate of 8%, use of antioxidants would be expected to result in a multiple pregnancy rate between 6% and 11%. Likewise, there was insufficient evidence to determine whether there was a difference between the groups in rates of gastrointestinal disturbances (OR 1.55, 95% CI 0.47 to 5.10, P = 0.47, 3 RCTs, 343 women, I(2) = 0%, very low quality evidence). This suggests that among subfertile women with an expected gastrointestinal disturbance rate of 2%, use of antioxidants would be expected to result in a rate between 1% and 11%. Overall adverse events were reported by 35 trials in the meta-analysis, but there was insufficient evidence to draw any conclusions.Only one trial reported on live birth, clinical pregnancy or adverse effects in the antioxidant versus antioxidant comparison, and no conclusions could be drawn.Very low-quality evidence suggests that pentoxifylline may be associated with an increased clinical pregnancy rate compared with placebo or no treatment (OR 2.07, 95% CI 1.20 to 3.56, P = 0.009, 3 RCTs, 276 women, I(2) = 0%). This suggests that among subfertile women with an expected clinical pregnancy rate of 25%, the rate among women using pentoxifylline would be between 28% and 53%.There was insufficient evidence to determine whether there was a difference between the groups in rates of miscarriage (OR 1.34, 95% CI 0.46 to 3.90, P = 0.58, 3 RCTs, 276 women, I(2) = 0%) or multiple pregnancy (OR 0.78, 95% CI 0.20 to 3.09, one RCT, 112 women, very low quality evidence). This suggests that among subfertile women with an expected miscarriage rate of 4%, the rate among women using pentoxifylline would be between 2% and 15%. For multiple pregnancy, the data suggest that among subfertile women with an expected multiple pregnancy rate of 9%, the rate among women using pentoxifylline would be between 2% and 23%.The overall quality of evidence was limited by serious risk of bias associated with poor reporting of methods, imprecision and inconsistency. Authors' conclusions: In this review, there was very low-quality evidence to show that taking an antioxidant may provide benefit for subfertile women, but insufficient evidence to draw any conclusions about adverse events. At this time, there is limited evidence in support of supplemental oral antioxidants for subfertile women.
Chapter
There are long-recognized associations between female gender, fertility, and food, reflected in imagery of iconic goddesses and mothers. Nutrients may impact, and be impacted by, menstrual cycling, fertility, pregnancy, labor and delivery, lactation, and peri- and postmenopausal adaptations (Fontana and Torre, Nutrients 2016;8:87). In addition, reproductive function in women has long-lasting effects on other body systems, such as the skeletal system. It follows, therefore, that clinicians providing care for girls and women need a solid understanding of nutritional issues specific to females.
Article
Background Data on the effects of calcium, vitamins D and K co-supplementation on markers of insulin metabolism and lipid profiles among vitamin D-deficient women with polycystic ovary syndrome (PCOS) are scarce. Objective This study was done to determine the effects of calcium, vitamins D and K co-supplementation on markers of insulin metabolism and lipid profiles in vitamin D-deficient women with PCOS. Methods This randomized double-blind, placebo-controlled trial was conducted among 55 vitamin D-deficient women diagnosed with PCOS aged 18–40 years old. Subjects were randomly assigned into 2 groups to intake either 500 mg calcium, 200 IU vitamin D and 90 µg vitamin K supplements (n=28) or placebo (n=27) twice a day for 8 weeks. Results After the 8-week intervention, compared with the placebo, joint calcium, vitamins D and K supplementation resulted in significant decreases in serum insulin concentrations (−1.9±3.5 vs. +1.8±6.6 µIU/mL, P=0.01), homeostasis model of assessment-estimated insulin resistance (−0.4±0.7 vs. +0.4±1.4, P=0.01), homeostasis model of assessment-estimated b cell function (−7.9±14.7 vs. +7.0±30.3, P=0.02) and a significant increase in quantitative insulin sensitivity check index (+0.01±0.01 vs. −0.008±0.03, P=0.01). In addition, significant decreases in serum triglycerides (−23.4±71.3 vs. +9.9±39.5 mg/dL, P=0.03) and VLDL-cholesterol levels (−4.7±14.3 vs. +2.0±7.9 mg/dL, P=0.03) was observed following supplementation with combined calcium, vitamins D and K compared with the placebo. Conclusion Overall, calcium, vitamins D and K co-supplementation for 8 weeks among vitamin D-deficient women with PCOS had beneficial effects on markers of insulin metabolism, serum triglycerides and VLDL-cholesterol levels.
Article
Objective: This investigation was conducted to assess the effects of zinc supplementation on clinical response and metabolic status among pregnant women at risk for intrauterine growth restriction (IUGR). Methods: This randomized, double-blind, placebo-controlled, clinical trial was conducted among 52 women at risk for IUGR according to abnormal uterine artery Doppler waveform. Participants were randomly assigned to take either 233 mg Zinc Gluconate (containing 30 mg zinc) supplements (n = 26) or placebo (n = 26) for 10 weeks from 17–27 weeks of gestation. Fasting blood samples were taken at baseline and after the 10-week treatment to quantify related variables. Results: After the 10-week intervention, taking zinc led to a significant reduction in serum high sensitivity C-reactive protein (hs-CRP) (β −1.17 mg/L; 95% CI, −1.77, −0.57; p < 0.001) and plasma malondialdehyde (MDA) levels (β −0.23 µmol/L; 95% CI, −0.45, −0.02; p = 0.03); also a significant rise in total antioxidant capacity (TAC) (β 59.22 mmol/L; 95% CI, 25.07, 93.36; p = 0.001) was observed in comparison to placebo. In addition, zinc supplementation significantly reduced serum insulin (β −1.33 µIU/mL; 95% CI, −2.00, −0.67; p < 0.001) and insulin resistance (β −0.30; 95% CI, −0.44, −0.15; p < 0.001), and significantly increased insulin sensitivity (β 0.008; 95% CI, 0.003, 0.01; p < 0.001) compared with the placebo. Zinc supplementation did not influence pulsatility index (PI) and other metabolic parameters. Conclusion: Overall, zinc supplementation in pregnant women at risk for IUGR had beneficial effects on TAC, MDA, hs-CRP and insulin metabolism, but did not affect PI and other metabolic profiles.
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Zinc is known for anti-inflammatory and antioxidant roles. In this meta-analysis, we aim to evaluate the impact of zinc supplementation on inflammatory markers, acute-phase reactants, and serum zinc level during inflammatory and infectious diseases. PubMed, Scopus, and Web of Science databases were screened systematically with the terms "zinc supplementation" AND "CRP" OR "IL-1β" OR "IL-2" OR "IL-6" OR "IL-10" OR "IL-12" OR "TNF-α" OR "TGF-β" OR "IFN-γ" OR "WBC (clinical trial)" OR "macrophage (clinical trial)" OR "lymphocyte (clinical trial)" OR "neutrophil (clinical trial)" OR "virus (clinical trial)" OR "antiviral (clinical trial)" for all databases. A total of 2,258 publications were screened, and 73 articles had suitable data for the meta-analysis. Serum zinc level was significantly higher in supplementation group compared with controls [P = 0.0006, mean difference: 11.35 (4.84, 17.87)] (n = 37). Zinc supplementation downregulates acute-phase reactants, especially serum C-reactive protein (CRP) in adults [P < 0.00001, mean difference: -0.75 (-0.98, -0.52)] (n = 22) and pregnant women [FEM P < 0.00001, mean difference: -1.77 (-2.53, -1.00)] (n = 3) but not in children [REM P = 0.10, mean difference: -0.85 (-1.86, 0.17)] (n = 3). In subgroups analysis of chronic inflammatory diseases, serum CRP [REM P < 0.00001, mean difference: -0.57 (-0.76, -0.38)] were significantly lower in zinc-supplemented patients compared with no intervention group. Zinc supplementation (mg/day) correlated with serum interferon-gamma (IFN-γ) level (P = 0.018, r = 1,000). In the nonsupplemented group, serum zinc correlated with serum interleukin-6 (IL-6) level (P = 0.041, r = -0.829) and serum tumor necrosis factor alpha (TNF-α) level (P = 0.063, r = 0.730). Zinc intake correlated with serum zinc (P = 0.0428, r = 0.5115) and TNF-α (P = 0.0043, r = -0.9461). This meta-analysis shows that zinc supplementation improves CRP levels in adults and pregnant women. It might have modulatory effects on cytokine secretions and blood cells in inflammatory and infectious diseases. For the first time, we investigated the effects of zinc supplementation on inflammatory cytokine.
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More than one year has passed since the first cases of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome (SARS)-CoV-2 coronavirus were reported in Wuhan (China), rapidly evolving into a global pandemic. This infectious disease has become a major public health challenge in the world. Unfortunately, to date, no specific antivirals have been proven to be effective against COVID-19, and although a few vaccines are available, the mortality rate is not decreasing but is still increasing. One therapeutic strategy has been focused on infection prevention and control measures. In this regard, the use of nutraceutical supports may play a role against some aspect of the infection, particularly the inflammatory state and the immune system function of patients, thus representing a strategy to control the worst outcomes of this pandemic. For this reason, we performed an overview including meta-analyses and systematic reviews to assess the association among melatonin, vitamin C, vitamin D, zinc supplementation and inflammatory markers using three databases, namely, MEDLINE, PubMed Central and the Cochrane Library of Systematic Reviews. According to the evidence available, an intake of 50,000 IU/month of vitamin D showed efficacy in CRP. An amount of 1 to 2 g per day of vitamin C demonstrated efficacy both in CRP and endothelial function, and a dosage of melatonin ranging from 5 to 25 mg /day showed good evidence of efficacy in CRP, TNF and IL6. A dose of 50 mg/day of elemental zinc supplementation showed positive results in CRP. Based on the data reported in this review, the public health system could consider whether it is possible to supplement the current limited preventive measures through targeted nutraceutical large-scale administration.
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Based on the literature datа and the results of our studies, menstrual dysfunction in teen girls leads to disorders of the reproductive system in fertile age. Establishment of normal menstrual function in teen girls is an eff ective measure for the prevention of future reproductive health disorders, which leads to improved methods of menstrual disorders diagnostics in overweight girls by analyzing clinical and anamnestic data, biochemical markers, development of diagnostic algorithm and pathogenetically based correction of menstrual disorders. To gain this aim, it was proposed to include to the complex of conventional therapy, diet therapy and drugs myo-inositol (inofolic softgel) and metformin. Evaluation of the treatment eff ectiveness was performed on the regression dynamics of the disease main clinical symptom and the normalization of hormonal status indicators. The result of treatment was considered satisfactory when the patient had regular menstruation for 12 months on the background of the therapy, and the maintenance of irregular menstruation with a cycle duration of more than 38 days was unsatisfactory. As a result of treatment the body mass index has decreased in all the patients which received our complex of therapeutic measures, especially for obesity of the second and third degree what proves the eff ectiveness of complex treatment. The appointment of proposed complex of treatment measures for patients is pathogenetically based, because after treatment, previously detected insulin resistance decreased signifi cantly in all groups, but most and reliably in groups with obesity of the second and third degree and became almost within normal limits.
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Background: Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder with inflammatory and oxidative stress foundation in reproductive-age women. Some micronutrients have anti-oxidant effects. For the first time, the present study aimed to compare the dietary intake of these anti-oxidant micronutrients in four phenotypes of PCOS. Materials and Methods: 182 participants eligible for this five-group comparative study were selected by the convenience sampling method. Then they were classified into five groups according to the Rotterdam criteria: [H+O+P; A (n=41)], [H+P; B (n=33)], [O+P; C (n=40)], [H+O; D (n=37)] and control (without PCOS) (n=31). Dietary intake assessment of zinc, selenium, chromium and carotenoids was carried out by a 168 item Food Frequency Questionnaire. Statistical analysis was performed using SPSS22 software and Kruskal-Wallis (KW) test followed by appropriate post hoc test, Mann-Whitney U (MW). Significant P-value was considered <0.05 for KW test and <0.005 for MW (based on Bonferroni correction). Result: Dietary intakes of zinc and selenium were significantly lower in all phenotypes of PCOS than control group (MW;P <0.005). Chromium intake was significantly lower in phenotype D of PCOS compared to the control group (MW;P <0.001). No significant difference was found between PCOS phenotypes and the control group in terms of carotenoid intake (KW; P> 0.05). Conclusion: Regarding the research results, it is suggested that modification of the nutritional status of PCOS patients and the increased consumption of these antioxidant micronutrients in the diet could probably have protective effects on PCOS.
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Recently there is a focus on the antioxidants as adjuvant treatment of polycystic ovary syndrome (PCOS), the most endocrinopathy in reproductive age women. The aim of this review is answer to the question whether antioxidants are effective for managing of hormonal and metabolic problems in women with PCOS based on first degree evidences from Iran. A systematic review of clinical trials was done in Persian and international databases including PubMed, Scientific Information Database, Google Scholar, Iran Medex, and Magiran up to 2013. Keywords were including polycystic ovary syndrome, Iran, vitamin, antioxidant. From 440 potential studies found electronically, 11 studies; including 444 women in intervention and 390 women in control groups. Intervention in three studies was Calcium-vitamin D or calcitriol; in three studies was ω-3 fatty acids; in two studies was N-acetyl cysteine; in one study was folic acid; in one study was Zinc; and in one study was Soy. Finally, 11 studies that were relevant and met the inclusion criteria reviewed. There were 7 studies in English and 4 studies in Persian. We couldn't include all studies because all full texts were not accessible. The results showed that antioxidants and vitamins have positive effects on management of PCOS women. Although it seems more studies is necessary in this field.
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To study the impact of adrenal hyperandrogenism (AH; defined as DHEAS concentration >95th percentile of a healthy female control population) on cardiometabolic risk factors associated with polycystic ovary syndrome (PCOS). Cross-sectional study. Academic hospital. Two-hundred ninety-eight consecutive women with PCOS, of whom 120 were obese (body mass index [BMI] ≥30 kg/m(2)) and 178 nonobese (BMI <30 kg/m(2)). None. Comprehensive evaluation of cardiovascular risk factors, including 75-g oral glucose tolerance test, office blood pressure, lipid profile, and low-grade inflammatory markers. Patients with AH (AH-PCOS) had higher insulin circulating levels and lower insulin sensitivity than their counterparts without AH (non-AH-PCOS). Obesity, but not AH, was the main contributor to the presence of glucose tolerance disorders. Both obesity and AH increased the prevalence of prehypertension and hypertension. AH diminished high-density lipoprotein (HDL) levels in nonobese PCOS women in parallel with a decrease in total cholesterol levels, leading to a total to HDL cholesterol ratio similar to that of nonobese non-AH-PCOS patients. Furthermore, AH blunted the deleterious effect of obesity on the total cholesterol/HDL ratio, with the ratio of obese AH-PCOS patients being similar to that of nonobese PCOS patients with or without AH. The presence of AH in women with PCOS is associated with reduced insulin sensitivity and increased blood pressure but may have beneficial impact on the lipid profile. Obesity is the main determinant of the clustering of cardiovascular risk factors in PCOS women. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
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Acne vulgaris is the most common cutaneous disorder affecting adolescents and young adults. Some studies have reported an association between serum zinc levels and acne vulgaris. We aimed to evaluate the serum zinc level in patients with acne vulgaris and compare it with healthy controls. One hundred patients with acne vulgaris and 100 healthy controls were referred to our clinic. Acne severity was classified according to Global Acne Grading System (GAGS). Atomic absorption spectrophotometry was used to measure serum zinc levels. Mean serum level of zinc in acne patients and controls was 81.31 ± 17.63 μg/dl and 82.63 ± 17.49 μg/dl, respectively. Although the mean serum zinc level was lower in acne group, it was not statistically significant ( P = 0.598 ). There was a correlation between serum zinc levels with severity and type of acne lesions. The results of our study suggest that zinc levels may be related to the severity and type of acne lesions in patients with acne vulgaris. Relative decrease of serum zinc level in acne patients suggests a role for zinc in the pathogenesis of acne vulgaris.
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PCOS, and unexplained infertility are currently the most common diseases rendering large numbers of women infertile worldwide. Oxidative stress, due to its deleterious effects on proteins and nucleic acids, is postulated to be the one of the important mechanistic pathways in differential expression of proteins and in these diseases. The emerging field of proteomics has allowed identification of proteins involved in cell cycle, as antioxidants, extracellular matrix (ECM), cytoskeleton, and their linkage to oxidative stress in female infertility related diseases. The aim of this paper is to assess the association of oxidative stress and protein expression in the reproductive microenvironments such as endometrial fluid, peritoneal fluid, and follicular fluid, as well as reproductive tissues and serum. The review also highlights the literature that proposes the use of the fertility related proteins as potential biomarkers for noninvasive and early diagnosis of the aforementioned diseases rather than utilizing the more invasive methods used currently. The review will highlight the power of proteomic profiles identified in infertility related disease conditions and their linkage with underlying oxidative stress. The power of proteomics will be reviewed with regard to eliciting molecular mechanisms for early detection and management of these infertility related conditions.
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What are the dynamics of zinc (Zn) trafficking in sperm, at the testicular, epididymal and ejaculate levels? Zn transporters are peculiarly expressed in the cells of the germ line and Zn uptake is maximal at the post-epididymal phase, where Zn is involved in the regulation of sperm functions. Zn is known to influence several phases of sperm life, from germ cell development to spermiation. Zn trafficking across the membrane is allowed by specific families of transporters known as the ZnTs, which are involved in effluent release, and the Zips, which mediate uptake. We enrolled 10 normozoospermic healthy participants in an infertility survey programme, as well as 5 patients affected by testicular germ cell cancer, and 18 patients presenting with obstructive azoospermia, without mutations of the CFTR gene, and undergoing assisted reproductive technologies. The research study was performed at our University Clinic. Semen samples, or biopsies or fine needle aspirates from the testis or epididymis, were obtained from each of the participants. Protein expression of main members of the ZnT and Zip families of Zn transporters was examined in human testis and epididymis samples by immunofluorescence. Quantification of sperm Zn content was performed by flow cytometry, atomic absorption spectrometry (AA) and autometallography. Intratubular cells of the germ line displayed a high redundancy of Zip family members involved in Zn uptake, while ZnT transporters were more represented in epididymis. Testicular and epididymal spermatozoa contained less Zn than ejaculated spermatozoa (2.56 ± 0.51 and 12.58 ± 3.16 versus 40.48 ± 12.71 ng Zn/10(6)cells, respectively). Gain of hypermotility and acrosomal reaction were significantly linked to the loss of Zn content in ejaculated spermatozoa. This was an ancillary study performed on a small cohort of normozoospermic subjects. Although these results clarify the Zn trafficking during different phases of sperm life, no conclusive information can be drawn about the fertilizing potential of sperm, and the overall pregnancy outcomes, after Zn supplementation. Our data disclose the dynamics of Zn trafficking during over the sperm lifespan. No external funding was sought or obtained for this study. No conflict of interest is declared.
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Polycystic ovary syndrome (PCOS), or Stein-Leventhal syndrome, is a common endocrine disorder defined by two of the three following features: i) oligoovulation or anovulation, ii) clinical and/or biochemical signs of hyperandrogenism, or iii) polycystic ovaries, once the related endocrinological and gynaecological disorders have been excluded. PCOS does not exclusively involve the reproductive apparatus , it has a complex number of systemic relevancy symptoms. It leads to Metabolic Syndrome, with severe consequences on the cardiovascular apparatus. Many clinical studies have underlined the connection between PCOS and the cardiovascular risk profile of such female patients, due to a lipid/glucose altered metabolism, hypertension, systemic inflammatory condition (assessable by markers such as VES, TNF-alfa, citokines and C-reactive protein (hsPCR) levels), and vascular injuries. Considering the early onset of the disease, PCOS could be considered as a real cardiovascular risk factor which affects the quality of life seriously. The current review aimed to point out the main connections between PCOS and cardiovascular risk factors according to the latest findings coming from literature data analysis, and try to depict the great influences that such a common disease can have on the patients' health integrity.
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Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age that is associated with significant adverse short- and long-term health consequences. Multiple metabolic aberrations, such as insulin resistance (IR) and hyperinsulinaemia, high incidence of impaired glucose tolerance, visceral obesity, inflammation and endothelial dysfunction, hypertension and dyslipidemia are associated with the syndrome. Assessing the metabolic aberrations and their long term health impact in women with PCOS is challenging and becomes more important as therapeutic interventions currently available for the management of PCOS are not fully able to deal with all these consequences. Current therapeutic management of PCOS has incorporated new treatments resulting from the better understanding of the pathophysiology of the syndrome. The aim of this review is to summarize the effect of old, new and emerging therapies used in the management of PCOS, on the metabolic aberrations of PCOS.
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This trial aimed to evaluate the effects of zinc sulfate in comparison with placebo on markers of insulin resistance, oxidative stress, and inflammation in a sample of obese prepubescent children. This triple-masked, randomized, placebo-controlled, crossover trial was conducted among 60 obese Iranian children in 2008. Participants were randomly assigned to two groups of equal number; one group received 20  mg of elemental zinc and the other group received placebo on a regular daily basis for 8 weeks. After a 4-week washout period, the groups were crossed over. In addition to anthropometric measures and blood pressure, fasting plasma glucose, lipid profile, insulin, apolipoproteins A-1 (ApoA-I) and B, high-sensitivity C-reactive protein (hs-CRP), leptin, oxidized low-density lipoprotein (ox-LDL), and malondialdehyde were determined at all four stages of the study. Irrespective of the order of receiving zinc and placebo, in both groups, significant decrease was documented for Apo B/ApoA-I ratio, ox-LDL, leptin and malondialdehyde, total and LDL-cholesterol after receiving zinc without significant change after receiving placebo. In groups, hs-CRP and markers of insulin resistance decreased significantly after receiving zinc, but increased after receiving placebo. In both groups, the mean body mass index (BMI) Z-score remained high, after receiving zinc, the mean weight, BMI, BMI Z-score decreased significantly, whereas these values increased after receiving placebo. These results are particularly important in light of the deleterious consequences of childhood obesity and early changes in markers of inflammatory and oxidative stress. We suggest exploring the direct clinical application of zinc supplementation in childhood obesity in future studies.
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It has been reported that some alopecia areata patients have zinc deficiency. There have also been several reports published concerning oral zinc sulfate therapy, with encouraging results, in some alopecia areata patients. The purpose of this study was to evaluate the therapeutic effects of oral zinc supplementation for twelve weeks in alopecia areata patients who had a low serum zinc level. Oral zinc gluconate (50 mg/T/day) supplementation was given to alopecia areata patients without any other treatment for twelve weeks. The serum zinc level was measured before and after zinc supplementation. A four-point scale of hair regrowth was used to evaluate the therapeutic effect of oral zinc supplementation in these patients. Fifteen alopecia areata patients were enrolled in this study. After the therapy, the serum zinc levels increased significantly from 56.9 microg/ to 84.5 microg/dl. Positive therapeutic effects were observed for 9 out of 15 patients (66.7%) although this was not statistically significant. The serum zinc levels of the positive response group increased more than those of the negative response group (p=0.003). Zinc supplementation needs to be given to the alopecia areata patients who have a low serum zinc level. We suggest that zinc supplementation could become an adjuvant therapy for the alopecia areata patients with a low serum zinc level and for whom the traditional therapeutic methods have been unsuccessful.
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Alopecia areata (AA) is a recurrent, nonscarring type of hair loss considered to be an autoimmune process. Though its etiopathology is not fully understood, there are claims that imbalance of trace elements may trigger the onset of AA. The aim of the present study was to assess the levels of zinc, copper, and magnesium in the serum of AA patients. Fifty AA patients (34 men and 16 women), and fifty age and sex matched healthy control subjects were studied. Samples were analyzed using atomic absorption spectrometric methods. Serum zinc levels were significantly decreased (P < 0.05) in AA patients whose disease was extensive, prolonged, and resistant to treatment, whereas serum copper and magnesium levels showed insignificant rise compared to controls. We conclude that copper and magnesium levels are not altered in AA, but the decreased zinc levels found in our study may merit further investigation of the relationship.
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Malondialdehyde (MDA) is one of the most frequently used indicators of lipid peroxidation. To generate reliable reference intervals for plasma malondialdehyde (P-MDA), a reference sample group was established in Funen, Denmark. The group consisted of 213 individuals (107 men, 106 women), ages 20-79 years. P-MDA was measured in EDTA-treated plasma after derivatization by thiobarbituric acid (TBA) and separation on HPLC. UV detection was performed at 532 nm. A reference interval was calculated as recommended by IFCC with REFVAL 3.42. The estimated reference limits (0.025 and 0.975 fractals) for the group were 0.36 and 1.24 mumol/L. The data were analyzed for gender- and age-related differences. Analysis of variance showed no interaction between gender and age, but separate analyses showed an independent effect of gender (P = 0.03), but not of age (P = 0.11). Daily smokers had a slightly higher average concentration of P-MDA than nonsmokers (P = 0.05), and P-MDA correlated with daily exposure to cigarette smoke (r = 0.162; P = 0.03). A positive correlation was also demonstrated between P-MDA and weekly alcohol consumption (r = 0.153; P = 0.03). Within-subject and day-to-day variations of P-MDA indicated that the potential of P-MDA as a biomarker for individuals is questionable. However, on a group basis, the present data support that P-MDA may be a potential biomarker for oxidative stress.
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Malondialdehyde (MDA) is one of the most frequently used indicators of lipid peroxidation. To generate reliable reference intervals for plasma malondialdehyde (P-MDA), a reference sample group was established in Funen, Denmark. The group consisted of 213 individuals (107 men, 106 women), ages 20–79 years. P-MDA was measured in EDTA-treated plasma after derivatization by thiobarbituric acid (TBA) and separation on HPLC. UV detection was performed at 532 nm. A reference interval was calculated as recommended by IFCC with REFVAL 3.42. The estimated reference limits (0.025 and 0.975 fractals) for the group were 0.36 and 1.24 μmol/L. The data were analyzed for gender- and age-related differences. Analysis of variance showed no interaction between gender and age, but separate analyses showed an independent effect of gender (P = 0.03), but not of age (P = 0.11). Daily smokers had a slightly higher average concentration of P-MDA than nonsmokers (P = 0.05), and P-MDA correlated with daily exposure to cigarette smoke (r = 0.162; P = 0.03). A positive correlation was also demonstrated between P-MDA and weekly alcohol consumption (r = 0.153; P = 0.03). Within-subject and day-to-day variations of P-MDA indicated that the potential of P-MDA as a biomarker for individuals is questionable. However, on a group basis, the present data support that P-MDA may be a potential biomarker for oxidative stress.
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Since the 1990 National Institutes of Health-sponsored conference on polycystic ovary syndrome (PCOS), it has become appreciated that the syndrome encompasses a broader spectrum of signs and symptoms of ovarian dysfunction than those defined by the original diagnostic criteria. The 2003 Rotterdam consensus workshop concluded that PCOS is a syndrome of ovarian dysfunction along with the cardinal features hyperandrogenism and polycystic ovary (PCO) morphology. PCOS remains a syndrome, and as such no single diagnostic criterion (such as hyperandrogenism or PCO) is sufficient for clinical diagnosis. Its clinical manifestations may include menstrual irregularities, signs of androgen excess, and obesity. Insulin resistance and elevated serum LH levels are also common features in PCOS. PCOS is associated with an increased risk of type 2 diabetes and cardiovascular events.
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To investigate the serum concentrations of 11 heavy metals and trace elements in patients with polycystic ovary syndrome (PCOS). A total of 369 women (including 96 patients with PCOS) were studied. No differences with statistical significance in the median barium, cadmium, lead, arsenic, chromium, gallium, strontium, and vanadium concentrations were observed between the patients with PCOS and the control group. Serum nickel (Ni) (P = 0.000) and copper (Cu) (P = 0.000) levels were significantly higher, but zinc (Zn) levels (P = 0.009) were significantly lower in patients with PCOS compared with the control group. The results of the association between metal levels and hormone levels indicated that Ni, Cu, and Zn may play a role in the pathogenesis of PCOS related with reproductive hormone levels. The findings in the present study should be investigated with further trials in order to obtain new insights into PCOS.
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Spontaneous remission occurs in less than 10% of patients suffering from alopecia areata (AA) totalis for more than 2 years. The efficacy of PUVA therapy is controversial due to recurrence of hair loss after cessation. We report two cases presenting with AA totalis and AA universalis. After hair regrowth, relapse of hair loss occurred upon cessation of PUVA and zinc gluconate combination therapy. However, hair regrowth was noted upon the reintroduction of zinc gluconate and sulfur amino acids without PUVA in the first case and with episodic PUVA in the second case. The chronology of events appears to support the notion that zinc has a significant effect. Our findings suggest the possibility of a subgroup of zinc-responsive patients, but the identification of these patients remains difficult. Metallothioneins and zinc transporters regulating the entrance and exit of zinc in cells might play a key role. Combination therapy with immunomodulators may be administered to facilitate enhanced zinc-targeted action. Taking into account the safety profile of zinc, 30-40 mg/day of zinc metal may be used during at least 1 year, although we recommend to monitor its serum and hair levels. Studies with a larger number of patients are required to further investigate the therapeutic effect of zinc. © 2015 Wiley Periodicals, Inc.
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Low‑grade chronic inflammation is commonly found in patients with polycystic ovary syndrome (PCOS) who exhibit hyperandrogenism or hyperandrogenemia. Clinical studies have shown that hyperandrogenemia is closely correlated with low‑grade chronic inflammation. However, the mechanism underlying this correlation remains unclear. Recent studies have suggested that adipocytes increase the production of proinflammatory mediators such as interleukin‑6 (IL‑6) and macrophage chemotactic protein‑1 (MCP‑1) when the inflammatory signal transduction cascade system is activated by external stimuli. The present study aimed to evaluate the effects of testosterone on the innate signalling and expression of proinflammatory mediators in 3T3‑L1 adipocytes, which were or were not induced by lipopolysaccharide (LPS). The effects of testosterone on the expression of proinflammatory mediators, nuclear factor‑κB (NF‑κB), and extracellular signal‑regulated kinase 1/2 (ERK1/2) signalling pathways were investigated using an enzyme‑linked immunosorbent assay, reverse transcriptase‑polymerase chain reaction, western blot analysis and an electrophoresis mobility shift assay. Testosterone induces IL‑6 and MCP‑1, and enhances LPS‑induction of IL‑6 and MCP‑1. However, the effects are not simply additive, testosterone significantly enhanced the effects of LPS‑induced inflammation factors. Testosterone induces the phosphorylation of ERK1/2 and NF‑κB. The effect of testosterone on the expression of IL‑6 and MCP‑1 is inhibited by PD98059 , an ERK1/2 inhibitor, and PDTC, an NF‑κB inhibitor. The results indicate that testosterone enhances LPS‑induced IL‑6 and MCP‑1 expression by activating the ERK1/2/NF‑κB signalling pathways in 3T3‑L1 adipocytes.
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In the developed countries nearly 30% of the elderly are zinc deficient. Many chronic diseases seen in the elderly such as atherosclerosis, diabetes, neuro-degenerative disorders, Parkinson's disease and age related macular degeneration (AMD) may be due to chronic inflammation and increased oxidative stress. Zinc in human plays an important role in cell mediated immunity and is also an antioxidant and anti-inflammatory agent. Zinc supplementation studies in the elderly have shown decreased incidence of infections, decreased oxidative stress, and decreased generation of inflammatory cytokines. Decreased incidences of blindness in patients with AMD and increased atheroprotective effect have been observed in the zinc supplemented elderly. Zinc is a molecular signal for immune cells and many transcription factors involved in gene expression of inflammatory cytokines and adhesion molecules are regulated by zinc.
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Oxidative stress is a main factor in the pathogenesis of severe acute pancreatitis (SAP). The ability of zinc (Zn) to retard oxidative processes has been recognized for many years. This study aims to examine the levels of free oxygen radicals and antioxidant enzyme in SAP rats and know the effect of Zn supplementation on free oxygen radicals and antioxidant system in rats with SAP. Forty-five male Wistar rats were divided into three groups-the SAP group (n = 15), the Zn-treated group (n = 15), and the controlled group (n = 15). For the SAP group, sodium taurocholate is injected into the pancreatic duct to induce SAP; for the Zn-treated group, Zn (5 mg/kg) is subcutaneously injected immediately after injection of 5 % sodium taurocholate. Firstly, the activity of erythrocyte glutathione peroxidase (GSH-Px), erythrocyte superoxide dismutase (SOD), and the content of plasma malondialdehyde (MDA), which are the toxic products of oxidative stress, is measured. Secondly, the levels of free oxygen radicals in the liver and kidney are detected. The result showed that the activity of GSH-Px and SOD was lower in the SAP group than that in the controlled group, although the content of plasma MDA increased. However, the activity of SOD and GSH-Px in the Zn-treated group was not significantly decreased after comparing with the controlled group; in the mean time, the content of MDA was not significantly increased either. Moreover, the content of free radical in liver and kidney was higher in the SAP group compared with the controlled group, but the content of free radical in the Zn-treated group was not higher than that in the controlled group (p > 0.05). All of the above indicated that Zn may recover the activity of free radical-scavenging enzymes and decrease the content of free radical for the SAP group rats. In conclusion, the content of free radical increase may be one of the reasons that SAP rats are injured, and it is possible for Zn to be used to treat SAP through scavenging free radical and increasing the activity of SOD and GSH-Px of erythrocyte.
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Objectives: The aim of this work was to evaluate the effect of long term supplementation with two moderate dose of Zn on plasma and cellular red-ox status markers in elderly volunteers. Design, setting and subjects: In a double blind study 108 healthy volunteers, aged 70-85 years, were enrolled. They were randomly divided in 3 groups of treatment, receiving placebo, 15 mg/day and 30 mg/day of Zn for 6 months. Red-ox status markers were assessed at baseline and after 6 months evaluating carotenoids, vitamin A and E in plasma; glutathione (GSH), thiol groups (RSH), malondialdehyde (MDA), percentage of haemolysis and methemoglobin in erythrocytes. Results: Zn supplementation had no significant effects on red-ox status markers except for vitamin A levels (from 1.94±0.44 to 2.18±0.48 μM in volunteers receiving 15 mg of Zn and from 1.95±0.46 to 2.26±0.56 μM in volunteers receiving 30 mg of Zn), which increased proportionally to zinc dose. Conclusions: It appears that, differently from unhealthy populations, long-term supplementation with two moderate doses of Zn in a healthy elderly population, with an adequate Zn nutritive status and macro and micronutrients intakes in the range of normality, is an inefficient way to increase antioxidant defences.
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In this study, our objective was to evaluating the value of serum zinc levels as an etiologic and prognostic marker in patients with polycystic ovarian syndrome. We conducted a prospective study, including 53 women with polycystic ovarian syndrome and 33 healthy controls. We compared serum zinc levels, as well as clinical and metabolic features, of the cases. We also compared serum zinc levels between patients with polycystic ovarian syndrome with insulin resistance. Mean zinc levels were found to be significantly lower in patients with polycystic ovarian syndrome than healthy controls. Multiple logistic regression analysis of significant metabolic variables between polycystic ovarian syndrome and control groups (serum zinc level, body mass index, the ratio of triglyceride/high-density lipoprotein cholesterol, and homocysteine) revealed that zinc level was the most significant variable to predict polycystic ovarian syndrome. Mean serum zinc levels tended to be lower in patients with polycystic ovarian syndrome with impaired glucose tolerance than patients with normal glucose tolerance, but the difference was not statistically significant. In conclusion, zinc deficiency may play a role in the pathogenesis of polycystic ovarian syndrome and may be related with its long-term metabolic complications.
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Background Statins have multiple antiatherosclerotic effects, but can reduce blood plasma concentrations of minerals, including zinc. As zinc possesses antiinflammatory and antioxidant effects, low zinc status can promote injuries or inadequate tissue repair in endothelial cells. Metallothionein (MT) expression might modulate responses induced by statins in patients with atherosclerosis. However, research regarding mineral status and the use of statins is scarce. This study evaluated the effects of zinc supplementation on zinc status and expression of the zinc-dependent MT1F and MT2A genes in patients with atherosclerosis treated with rosuvastatin. Methods A double-blind, randomized clinical trial was performed with 54 participants treated with 10 mg rosuvastatin for 4 months with or without zinc supplementation (30 mg/day). Diet, l