Evaluation of Serum Selenium Levels in Turkish Women with Gestational Diabetes Mellitus, Glucose Intolerants, and Normal Controls
Department of Biochemistry, School of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, 46050, Turkey. Biological Trace Element Research
(Impact Factor: 1.75).
06/2008; 123(1-3):35-40. DOI: 10.1007/s12011-007-8087-2
The aim of the study was to investigate the association between serum selenium levels in patients with gestational diabetes mellitus (GDM) and glucose intolerants and compare them with those of glucose-tolerant pregnant women. This cross-sectional study was prospectively performed in a total of 178 pregnant women undergoing a 50-g oral glucose tolerance test between 24 and 28 weeks of gestation who were grouped according to their status of glucose tolerance as with gestational diabetes (group A, abnormal 1- and 3-h glucose tolerance test; n = 30), glucose intolerant (group B, abnormal 1-h but normal 3-h glucose tolerance test; n = 47), or normal controls (group C, normal 1-h glucose test; n = 101). Serum selenium levels were measured with a graphite furnace atomic absorption spectrophotometer using a matrix modifier. Median maternal age and gestational age at the time of diagnosis in group A (gestational age = 24.8 [24-27]), group B (gestational age = 24.7 [24-27]), and group C (gestational age = 25 [24-28]) did not differ. Patients with gestational diabetes mellitus and those with glucose intolerants had lower selenium level than that of the normal pregnant women (P < 0.001). There was a significant inverse correlation between selenium and blood glucose level, and also selenium supplementation might prove beneficial on patients with GDM and prevent or retard them from secondary complications of diabetes.
Available from: Mehri Jamilian
- "Several dietary   and nondietary   strategies have been proposed for management of GDM. Some studies have reported a significant inverse association between body selenium status and plasma glucose levels in patients with GDM  . "
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ABSTRACT: To our knowledge, no reports are available indicating the effects of selenium supplementation on metabolic parameters, inflammatory factors, and oxidative stress in gestational diabetes mellitus (GDM). The aim of this study was to assess the effects of selenium supplementation on metabolic status in pregnant women with GDM who were not on oral hypoglycemic agents.
This randomized, double-blind, placebo-controlled clinical trial was performed with 70 women with GDM. Patients were randomly assigned to receive either 200 μg selenium supplements as tablet (n = 35) or placebo (n = 35) for 6 wk from weeks 24 to 28 of gestation. Fasting plasma samples were taken at study baseline and after 6 wk of intervention to quantify related variables.
Selenium supplementation, compared with placebo, resulted in a significant reduction in fasting plasma glucose (-10.5 ± 11.9 versus +4.5 ± 12.9 mg/dL; P < 0.001), serum insulin levels (-1.98 ± 11.25 versus +5.26 ± 9.33 μIU/mL; P = 0.005), homeostasis model of assessment (HOMA)-insulin resistance (-0.84 ± 2.76 versus +1.47 ± 2.46; P < 0.001) and a significant increase in quantitative insulin sensitivity check index (+0.008 ± 0.03 versus -0.01 ± 0.01; P = 0.009). Additionally, a significant decrease in serum high-sensitivity C-reactive protein (hs-CRP) levels (-791.8 ± 2271.8 versus +500.5 ± 2563.3 ng/mL; P = 0.02) was seen after the administration of selenium supplements compared with placebo. Additionally, we observed a significant elevation in plasma glutathione (+52.14 ± 58.31 versus -39.93 ± 153.52 μmol/L; P = 0.002) and a significant reduction in plasma malondialdehyde levels (-0.01 ± 0.36 versus +0.67 ± 1.90 μmol/L; P = 0.04) after consumption of selenium supplements compared with placebo. We did not find any significant effect of taking selenium supplements on HOMA β-cell function, lipid profiles, plasma nitric oxide, or total antioxidant capacity concentrations.
Selenium supplementation in pregnant women with GDM demonstrated beneficial effects on glucose metabolism, hs-CRP levels, and biomarkers of oxidative stress.
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Available from: Aziz A Fallah
- "Several evidences indicate that serum selenium level decreases during pregnancy   . The probable reasons could be hemodilutional phenomenon in pregnancy, increased fetal requirement, and deposition in placenta   . In addition, due to increase of lipid peroxidation during pregnancy, the activity of antioxidants like glutathione and erythrocyte glutathione peroxidase increases; hence the level of serum Se decreases particularly in third trimester . "
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Results of the studies about association between serum selenium concentration and gestational hyperglycemia are inconsistent. Some studies have demonstrated that women with gestational diabetes mellitus (GDM) have lower Se concentrations while contrary results are reported in other studies.
The aim of this study is to compare the serum Se concentration in women with GDM and normoglycemic pregnant women via a systematic review and meta-analysis.
A computerized literature search on four databases (PubMed, Cochrane register of control trials, Scopus and Google scholar) was performed from inception through August 2013. Necessary data were extracted and random effects model was used to conduct the meta-analysis.
Six observational studies (containing 147 women with GDM and 360 normoglycemic pregnant women) were found, which had compared serum Se concentration in women suffering from GDM with normal pregnant ones. Our meta-analysis revealed that serum Se concentration was lower in women with GDM compared to normoglycemic pregnant women (Hedges = -1.34; 95% CI: -2.33–- 0.36; P< 0.01). Stratified meta-analysis demonstrated that concentration of Se in the sera of women with GDM was lower than normal pregnant women both in second and third trimesters, but the result was not significant in second trimester (second trimester: Hedges = - 0.68; 95% CI: - 1.60–0.25; P = 0.15, third trimester: Hedges = - 2.81; 95% CI: - 5.21–- 0.42; P< 0.05). It was also demonstrated that serum Se status was lower in pregnant women with impaired glucose tolerance (IGT) compared to normoglycemic pregnant women (Hedges = - 0.85; 95% CI: -1.18–-0.52).
The available evidences suggest that serum Se concentration is significantly lower in pregnant women with gestational hyperglycemia compared to normal pregnant women.
- "The current study showed no significant differences in zinc and selenium levels between pregnant women with gestational diabetes and controls. This finding is in contrast to previous reports where pregnant women with gestational diabetes were observed to have lower levels of zinc and selenium levels (Tan et al. 2001; Bo et al. 2005; Kilinc et al. 2008). The explanation for this discrepancy between studies is unclear. "
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