Randomized controlled trial of vitamin D supplement on endothelial function in patients with type 2 diabetes. Enhanced Oxidative Stress and Other Potential Biomarkers for Retinopathy in Type 2 Diabetics: Beneficial Effects of the Nutraceutic Supplements Effect of vitamin D supplementation on inflammation: protocol for a systematic review Effects of oral vitamin C supplementation on oxidative stress and inflammation status in haemodialysis patients. Effect of vitamin D supplementation on inflammation and nuclear factor kappa-B activity in overweight/obese adults: a randomized placebo-controlled trial Effect of chromium dinicocysteinate supplementation on circulating levels of insulin, TNF-α, oxidative stress, and insulin resistance in type 2 diabetic subjects: randomized, double-blind, placebo-controlled study. Effects of combination tocopherols and alpha lipoic acid therapy on oxidative stress and inflammatory biomarkers in chronic kidney disease. Comparative effects of dietary supplementation with red grape juice and vitamin E on production of superoxide by circulating neutrophil NADPH oxidase in hemodialysis patients. Effect of alpha-lipoic acid and vitamin E supplementation on oxidative stress, inflammation, and malnutrition in hemodialysis patients. Effect of Vitamin D Supplementation on Glucose Control and Inflammatory Response in Type II Diabetes: A Double Blind, Randomized Clinical Trial Effect of daily supplementation of fruits on oxidative stress indices and glycaemic status in type 2 diabetes mellitus. The effects of vitamin D and omega-3 fatty acids co-supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in patients with gestational diabetes Vitamin D supplementation affects serum high-sensitivity C-reactive protein, insulin resistance, and biomarkers of oxidative stress in pregnant women. A Randomized Controlled Clinical Trial Investigating the Effects of Omega-3 Fatty Acids and Vitamin E Co-Supplementation on Biomarkers of Oxidative Stress, Inflammation and Pregnancy Outcomes in Gestational Diabetes. [Diabetes mellitus--a free radical-associated disease. Results of adjuvant antioxidant supplementation]. Effects of vitamin D supplementation on markers of vascular function after myocardial infarction--a randomised controlled trial. Calcium-vitamin D cosupplementation influences circulating inflammatory biomarkers and adipocytokines in vitamin D-insufficient diabetics: a randomized controlled clinical trial.
BACKGROUND Suboptimal vitamin D status is associated with endothelial dysfunction and an increased risk of cardiovascular diseases but it is unclear whether vitamin D supplementation is beneficial . The aim was to investigate the effect of vitamin D supplementation on endothelial function in patients with type 2 diabetes mellitus ( DM ) . METHODS In a double-blind , placebo-controlled trial , we r and omized 100 type 2 DM patients to vitamin D supplement  ( 5000 IU/day , n = 50 ) or placebo ( controls , n = 50 ) for 12 weeks . Assessment of vascular function with brachial artery flow-mediated dilatation ( FMD ) , circulating levels of endothelial progenitor cells ( EPCs ) and brachial-ankle pulse wave velocity , and metabolic parameter , high-sensitivity C-reactive protein ( hsCRP ) and oxidative stress markers were performed before and after the supplementation . RESULTS After 12 weeks , vitamin D treated patients had significant increases in serum 25-hydroxyvitamin D [ 25(OH)D ] concentration ( treatment effect 34.7 ng/mL , 95 % CI 26.4 - 42.9 , P < 0.001 ) and serum ionized calcium ( treatment effect 0.037 mmol/L , 95 % CI 0.007 - 0.067 , P = 0.018 ) ; decreased serum parathyroid hormone concentration ( treatment effect -0.55 pmol/L , 95 % CI -1.08 to -0.02 , P = 0.042 ) compared to patients who received placebo . Nevertheless , vitamin D supplementation did not improve vascular function as determined by FMD , circulating EPC count or baPWV ( all P > 0.05 ) . Furthermore , hsCRP , oxidative stress markers , low- and high-density lipoprotein and glycated hemoglobin were also similar between two groups ( all P > 0.05 ) . CONCLUSION In patients with type 2 DM , 12 weeks oral supplementation of vitamin D did not significantly affect vascular function or serum biomarkers of inflammation and oxidative stress . CLINICAL TRIAL NUMBER HKCTR-867 , www.hk clinical trials.com We have studied the global risk of retinopathy in a Mediterranean population of type 2 diabetes mellitus ( T2DM ) patients , according to clinical , biochemical , and lifestyle biomarkers . The effects of the oral supplementation containing antioxidants/omega 3 fatty acids ( A/ω3 ) were also evaluated . Suitable participants were distributed into two main groups : ( 1 ) T2DMG ( with retinopathy ( + DR ) or without retinopathy ( −DR ) ) and ( 2 ) controls ( CG ) . Participants were r and omly assigned ( + A/ω3 ) or not ( −A/ω3 ) to the oral supplementation with a daily pill of Nutrof Omega ( R ) for 18 months . Data collected including demographics , anthropometrics , characteristics/lifestyle , ophthalmic examination ( best corrected visual acuity , ocular fundus photographs , and retinal thickness as assessed by optical coherence tomography ) , and blood parameters ( glucose , glycosylated hemoglobin , triglycerides , malondialdehyde , and total antioxidant capacity ) were registered , integrated , and statistically processed by the SPSS 15.0 program . Finally , 208 participants ( 130 diabetics ( 68 + DR/62 −DR ) and 78 controls ) completed the follow-up . Blood analyses confirmed that the T2DMG+DR patients had significantly higher oxidative stress ( p < 0.05 ) , inflammatory ( p < 0.05 ) , and vascular ( p < 0.001 ) risk markers than the T2DMG−DR and the CG . Furthermore , the A/ω3 oral supplementation positively changed the baseline parameters , presumptively by inducing metabolic activation and ameliorating the ocular health after 18 months of supplementation Introduction The extraskeletal role of vitamin D is being increasingly recognised . This has important clinical implication s , as vitamin D deficiency has reached epidemic proportions worldwide . Vitamin D has proposed anti-inflammatory properties , yet the role of vitamin D supplementation in reducing inflammation remains largely unknown . The purpose of this review is to investigate the impact of vitamin D supplementation on inflammation , and to identify relevant knowledge gaps in the field . Methods and analysis Medline , CINAHL , EMBASE and All EBM will be systematic ally search ed for r and omised controlled trials ( RCTs ) and systematic review s of RCTs , comparing vitamin D supplementation with placebo , usual care or other pharmacological or non-pharmacological interventions . One review er will assess articles for eligibility according to prespecified selection criteria , after which 2 independent review ers will perform data extraction and quality appraisal . Meta-analyses will be conducted where appropriate . Ethics and dissemination Formal ethical approval is not required as no primary data is collected . This systematic review will identify potential clinical implication s of vitamin D deficiency and supplementation , and will be disseminated through a peer- review ed publication and at conference meetings , to inform future research on the efficacy of vitamin D supplementation for inflammation and inflammatory diseases . PROSPERO registration number CRD42016037104 BACKGROUND There is increasing evidence for the presence of oxidative stress and vitamin C deficiency in dialysis patients . Limited data , however , are available regarding the effects of vitamin C supplementation on oxidative stress and inflammation markers in such patients . METHODS We ran a prospect i ve , r and omized , open-label trial to assess the effects of oral vitamin C supplementation ( 250 mg three times per week ) for 2 months on well-defined oxidative and inflammatory markers in 33 chronic haemodialysis ( HD ) patients . RESULTS Normalization of plasma total vitamin C and ascorbate levels by oral vitamin C supplementation did not modify plasma levels of carbonyls , C-reactive protein and albumin , or erythrocyte concentrations of reduced and oxidized glutathione . CONCLUSION Short-term oral vitamin C supplementation did not modify well-defined oxidative/antioxidative stress and inflammation markers in HD patients . Whether a higher oral dose or the intravenous route can modify these markers remains to be determined In-vitro studies suggest that vitamin D reduces inflammation by inhibiting nuclear factor kappa-B ( NFκB ) activity . Yet , no trials have examined the effects of vitamin D supplementation on NFκB activity in-vivo in humans . We conducted a double-blind r and omized trial ( RCT ) examining effects of vitamin D supplementation on inflammatory markers and NFκB activity in peripheral blood mononuclear cells ( P BMC s ) . Sixty-five overweight/obese , vitamin D-deficient ( 25-hydroxyvitamin D [ 25(OH)D ] ≤ 50 nmol/L ) adults were r and omized to a single 100,000 IU bolus followed by 4,000 IU daily cholecalciferol or matching placebo for 16 weeks . We measured BMI , % body fat , serum 25(OH)D , high-sensitivity C-reactive protein ( hsCRP ) , tumour necrosis factor ( TNF ) , monocyte chemoattractant protein-1 ( MCP-1 ) , interferon-gamma ( IFN-γ ) , several interleukins , and NFκB activity in P BMC s. Fifty-four participants completed the study . Serum 25(OH)D concentrations  increased with vitamin D supplementation compared to placebo ( p < 0.001 ) . Vitamin D and placebo groups did not differ in any inflammatory markers or NFκB activity ( all p > 0.05 ) . Results remained non-significant after adjustment for age , sex , and % body fat , and after further adjustment for sun exposure , physical activity , and dietary vitamin D intake . Although in-vitro studies report anti-inflammatory effects  of vitamin D , our RCT data show no effect of vitamin D supplementation on inflammatory markers or NFκB activity in-vivo in humans SCOPE Chromium and cysteine supplementation have been shown to improve glucose metabolism in animal studies . This study examined the hypothesis that chromium dinicocysteinate ( CDNC ) , a complex of chromium and l-cysteine , is beneficial in lowering oxidative stress , vascular inflammation , and glycemia in type 2 diabetic subjects . METHODS AND RESULTS Type 2 diabetic subjects enrolled in this study were given placebo for 1 month for stabilization and then r and omized into one of three groups : placebo ( P ) , chromium picolinate ( CP ) , or CDNC , after which they received daily oral supplementation for 3 months . Of the 100 patients enrolled in the study , 74 patients completed it . There were 25 patients in the P supplemented group , 25 in the CP supplemented and 24 in the CDNC supplemented group who completed the study . Blood markers of glycemia , vascular inflammation , HOMA insulin resistance , and oxidative stress were determined at r and omization and after 3 months of supplementation with P , CP , or CDNC . There was a significant decrease at 3 months in insulin resistance ( p = 0.02 ) and in the levels of protein oxidation ( p = 0.02 ) and TNF-α ( p = 0.01 ) in the CDNC supplemented cohort compared to baseline . However , there was no statistically significant change in these markers in the CP supplemented group compared to baseline . Insulin levels significantly decreased ( p = 0.01 ) for subjects receiving CDNC but not CP . There was no significant impact of supplementation on HbA(1c ) or glucose levels in either of the groups . CONCLUSION CDNC supplementation  lowers insulin resistance by reducing blood levels of TNF-α , insulin , and oxidative stress in type 2 diabetic subjects . Therefore , CDNC supplementation has potential as an adjunct therapy for individuals with type 2 diabetes OBJECTIVE Although increased oxidative stress and inflammation are highly prevalent in chronic kidney disease ( CKD ) , few studies have investigated whether oral antioxidant therapy can alter markers of inflammation or oxidative stress in patients with CKD . The purpose of this study was to investigate whether a combination of mixed tocopherols and alpha lipoic acid ( ALA ) would alter biomarkers of oxidative stress and inflammation in subjects with stage 3 to 4 CKD . METHODS This was a prospect i ve , r and omized , double-blind , placebo-controlled pilot trial . In all , 62 subjects were enrolled and were r and omly assigned to receive a combination of mixed tocopherols 666 IU/day , in addition to ALA 600 mg/day , or their matching placebos for a total of 8 weeks . Plasma F(2)-isoprostane and protein thiol concentration were measured as biomarkers of oxidative stress , and C-reactive protein and interleukin-6 concentration as biomarkers of systemic inflammation . RESULTS There were no significant differences in demographics , diabetic status , or estimated glomerular filtration rate between study treatment and placebo groups at baseline . Of the 62 r and omized subjects , 58 ( 93 % ) completed the study protocol . After 2 months of treatment , there were no significant changes in the concentrations of F(2)-isoprostanes , protein thiols , C-reactive protein , and interleukin-6 with respect to treatment with mixed tocopherols and ALA as compared with matching placebos , whether analyzed as intention to treat or as treated . Diabetic status and baseline body mass index did not influence the results . CONCLUSIONS Combination of oral mixed tocopherols and ALA treatment for 2 months does not influence biomarkers of oxidative stress and inflammation in patients with stage 3 to 4 CKD BACKGROUND Atherosclerotic cardiovascular disease is the most common cause of death among hemodialysis patients ; it has been attributed to increased oxidative stress , dyslipidemia , malnutrition , and chronic inflammation . Activation of neutrophils is a well-recognized feature in dialysis patients , and superoxide-anion production by neutrophil NADPH oxidase may contribute significantly to oxidative stress . OBJECTIVE The aim of the study was to compare the effects of dietary supplementation with concentrated red grape juice ( RGJ ) , a source of polyphenols , and vitamin E on neutrophil NADPH oxidase activity and other cardiovascular risk factors in hemodialysis patients . DESIGN Thirty-two patients undergoing hemodialysis were recruited and r and omly assigned to groups to receive dietary supplementation with RGJ , vitamin E , or both or a control condition without supplementation or placebo . Blood was obtained at baseline and on days 7 and 14 of treatment . RESULTS RGJ consumption but not vitamin E consumption reduced plasma concentrations of total cholesterol and apolipoprotein B and increased those of HDL cholesterol . Both RGJ and vitamin E reduced plasma concentrations of oxidized LDL and ex vivo neutrophil NADPH oxidase activity . These effects were intensified when the supplements were used in combination ; in that case , reductions in the inflammatory biomarkers intercellular adhesion molecule 1 and monocyte chemoattractant protein 1 also were observed . CONCLUSIONS Regular ingestion of concentrated RGJ by hemodialysis patients reduces neutrophil NADPH-oxidase activity and plasma concentrations of oxidized LDL and inflammatory biomarkers to a greater extent than does that of vitamin E. This effect of RGJ consumption may favor a reduction in cardiovascular risk INTRODUCTION Increased oxidative stress , inflammation , and malnutrition are present in hemodialysis patients and these factors exacerbate cardiovascular comorbidities . Vitamin E and alpha-lipoic acid ( ALA ) may have a protective role against cardiovascular disease risk factors via anti-oxidative and anti-inflammatory properties . The aim of this study was to evaluate the effect of ALA and vitamin E administration ( alone or combined ) on hemodialysis-induced stress oxidation , inflammation , and malnutrition . MATERIAL S AND METHODS In a r and omized placebo-controlled trial , we examined the effects of 2-month supplementation by vitamin E and ALA ( alone or combined ) on biomarkers of lipid peroxidation ( malondialdehyde ) , inflammation ( high-sensitivity C-Reactive protein and interleukin-6 ) , and malnutrition ( Subjective Global Assessment and body mass index ) in 85 hemodialysis patients receiving ALA ( 600 mg ) , vitamin E ( 400 IU ) , ALA and vitamin E , and placebo .  RESULTS After supplementation , no significant changes were observed in malondialdehyde level ; however , there was a decrease in the ALA and vitamin E group during the period of the study . Also , a nonsignificant decrease was seen in the high-sensitivity C-Reactive protein concentration of the interventional groups . Supplementation of vitamin E with and without ALA significantly reduced interleukin-6 concentration . A significant improvement was observed in malnutrition status of all groups . CONCLUSIONS Vitamin E and ALA supplementation , especially their combination , might improve inflammation and malnutrition status , which suggest it as a potential preventive strategy against CVD among end-stage renal disease patients Background : Diabetes mellitus ( DM ) and vitamin D deficiency are major health concerns around the world . Evidence suggests a possible role of vitamin D in improvement of insulin secretion and sensitivity . Objectives : We assessed whether vitamin D supplementation could be used in vitamin D deficient-type II diabetes to improve glucose metabolism , components of metabolic syndrome ( MetS ) and specific inflammatory biomarkers . Patients and Methods : A double blind , r and omized clinical trial was conducted in King Khalid University Hospital , Saudi Arabia to evaluate the effect of cholecalciferol supplementation on glycemic control , MetS components and specific inflammatory biomarkers including tumor necrosis factor-alpha ( TNF-α ) , Interleukin ( IL-6 ) , leptin , adiponectin and vascular cell adhesion molecule-1 ( VCAM-1 ) . Twenty-two patients with type II diabetes with insulin resistance , glycated hemoglobin ( HbA1c ) ≥ 6 ( 42 mmol/mol ) and serum 25(OH)D < 50 nmol/L were r and omized using a computer program to receive either supplementation with cholecalciferol ( 5000 IU/day ) or placebo for 12 weeks . The primary outcome was change in HbA1c levels from baseline . Results : Median [ IQR ] 25(OH)D levels increased significantly in the vitamin D group as 58.1 [ 48 , 67.3 ] nmol/L ( P = 0.002 ) . There was no significant difference in the change of HbA1c between the groups ( P = 0.5 ) with a decrease of -0.1 % [ -1 , 0.5 ] in the vitamin D group and an increase of 0.15 % [ 0.1 , 0.2 ] in the placebo group . A significant improvement was observed in the homeostasis model of assessment of β-cell activity ( HOMA-%B ) ( P = 0.03 ) with vitamin D supplementation compared to baseline . Conclusions : Vitamin D repletion for 12 weeks increased serum vitamin D concentrations and improved β-cell activity in vitamin D-deficient type II diabetes with no significant changes in HbA1c or insulin sensitivity This study sought to examine whether consumption of two low-calorie fruit/day for 3-months can effectively improve oxidative stress , anthropometry , blood pressure and glycaemic control in type 2 diabetes mellitus . Study involved 123 patients who were assigned to receive either st and ard care or with additional dietary therapy .  Dietary intervention result ed in significant reduction in malondialdehyde , plasma glucose , glycated haemoglobin and improvement in antioxidants like vitamin C and reduced glutathione when compared to controls . Mean plasma levels of vitamin C increased by 64 % ( p < 0.001 ) . There were no differences in waist circumference , waist-to-hip ratio , blood pressure , vitamin E and superoxide dismutase in the intervention group at follow-up . Diet rich in fruits can improve some antioxidants which are likely to reduce oxidative stress in type 2 diabetes . Regular consumption of fruits can lower the glycaemic status in these patients . The study supports the usefulness of plasma vitamin C as a biomarker for fruit intake Background This study was carried out to determine the effects of vitamin D and omega-3 fatty acids co- supplementation on biomarkers of inflammation , oxidative stress and pregnancy outcomes  in gestational diabetes ( GDM ) patients . Methods This r and omized , double-blind , placebo-controlled trial was conducted among 120 GDM women . Participants were r and omly divided into four groups to receive : 1 ) 1000 mg omega-3 fatty acids containing 180 mg eicosapentaenoic acid ( EPA ) and 120 mg docosahexaenoic acid ( DHA ) twice a day + vitamin D placebo ( n = 30 ) ; 2 ) 50,000 IU vitamin D every 2 weeks + omega-3 fatty acids placebo ( n = 30 ) ; 3 ) 50,000 IU vitamin D every 2 weeks + 1000 mg omega-3 fatty acids twice a day ( n = 30 ) and 4 ) vitamin D placebo + omega-3 fatty acids placebo ( n = 30 ) for 6 weeks . Results Subjects who received vitamin D plus omega-3 fatty acids supplements compared with vitamin D , omega-3 fatty acids and placebo had significantly decreased high-sensitivity C-reactive protein ( −2.0 ± 3.3 vs. -0.8 ± 4.4 , −1.3 ± 2.4 and + 0.9 ± 2.7 mg/L , respectively , P = 0.008 ) , malondialdehyde ( −0.5 ± 0.5 vs. −0.2 ± 0.5 , −0.3 ± 0.9 and + 0.5 ± 1.4 μmol/L , respectively , P < 0.001 ) , and increased total antioxidant capacity ( + 92.1 ± 70.1 vs. + 55.1 ± 123.6 , + 88.4 ± 95.2 and + 1.0 ± 90.8 mmol/L , respectively , P = 0.001 ) and glutathione ( + 95.7 ± 86.7 vs. + 23.0 ± 62.3 , + 30.0 ± 66.5 and −7.8 ± 126.5 μmol/L , respectively , P = 0.001 ) . In addition , vitamin D and omega-3 fatty acids co-supplementation , compared with vitamin D , omega-3 fatty acids and placebo , result ed in lower incidences of newborns ’ hyperbilirubinemiain ( P = 0.037 ) and newborns ’ hospitalization ( P = 0.037 ) . Conclusion Overall , vitamin D and omega-3 fatty acids co-supplementation for 6 weeks among GDM women had beneficial effects on some biomarkers of inflammation , oxidative stress and pregnancy outcomes Unfavorable metabolic profiles and oxidative stress in pregnancy are associated with several complications . This study was conducted to determine the effects of vitamin D supplementation on serum concentrations of high-sensitivity C-reactive protein ( hs-CRP ) , metabolic profiles , and biomarkers of oxidative stress in healthy pregnant women . This r and omized , double-blind , placebo-controlled clinical trial was conducted in 48 pregnant women aged 18 - 40 y old at 25 wk of gestation . Participants were r and omly assigned to receive either 400 IU/d cholecalciferol supplements ( n = 24 ) or placebo ( n = 24 ) for 9 wk . Fasting blood sample s were taken at study baseline and after 9 wk of intervention to quantify serum concentrations of hs-CRP , lipid concentrations , insulin , and biomarkers of oxidative stress . After 9 wk of intervention , the increases in serum 25-hydroxyvitamin D and calcium concentrations were greater in the vitamin D group ( + 3.7 μg/L and + 0.20 mg/dL , respectively ) than in the placebo group ( -1.2 μg/L and -0.12 mg/dL , respectively ; P < 0.001 for both ) . Vitamin D supplementation result ed in a significant decrease in serum hs-CRP ( vitamin D vs. placebo groups : -1.41 vs. + 1.50 μg/mL ; P-interaction = 0.01 ) and insulin concentrations ( vitamin D vs. placebo groups : -1.0 vs. + 2.6 μIU/mL ; P-interaction = 0.04 ) and a significant increase in the Quantitative Insulin Sensitivity Check Index score ( vitamin D vs. placebo groups : + 0.02 vs. -0.02 ; P-interaction = 0.006 ) , plasma total antioxidant capacity ( vitamin D vs. placebo groups : + 152 vs. -20 mmol/L ; P-interaction = 0.002 ) , and total glutathione concentrations ( vitamin D vs. placebo groups : + 205 vs. -32 μmol/L ; P-interaction = 0.02 ) compared with placebo . Intake of vitamin D supplements led to a significant decrease in fasting plasma glucose ( vitamin D vs. placebo groups : -0.65 vs. -0.12 mmol/L ; P-interaction = 0.01 ) , systolic blood pressure ( vitamin D vs. placebo groups : -0.2 vs. + 5.5 mm Hg ; P-interaction = 0.01 ) , and diastolic blood pressure ( vitamin D vs. placebo groups : -0.4 vs. + 3.1 mm Hg ; P-interaction = 0.01 ) compared with placebo . In conclusion , vitamin D supplementation for 9 wk among pregnant women has beneficial effects on metabolic status OBJECTIVES Limited data are available for assessing the effects of omega-3 fatty acids and vitamin E co-supplementation on metabolic profiles and pregnancy outcomes in gestational diabetes ( GDM ) . This study was design ed to determine the effects of omega-3 fatty acids and vitamin E co-supplementation on biomarkers of oxidative stress , inflammation and pregnancy outcomes in women with GDM . METHODS This r and omized , double-blind , placebo-controlled clinical trial was conducted in 60 patients with GDM who were not taking oral hypoglycemic agents . Patients were r and omly allocated to intake either 1000 mg omega-3 fatty acids from flaxseed oil plus 400 IU vitamin E supplements ( n=30 ) or placebo ( n=30 ) for 6 weeks . Fasting blood sample s were obtained from the women at the beginning of the study and after the 6-week intervention to quantify related markers . RESULTS After 6 weeks of intervention , omega-3 fatty acids and vitamin E co-supplementation , compared with the placebo , result ed in a significant rise in total antioxidant capacity ( TAC ) ( + 187.5±224.9 vs. -32.5±136.1 mmol/L ; p<0.001 ) ; nitric oxide ( NO ) ( + 5.0±7.7 vs. -12.0±28.0 µmol/L ; p=0.002 ) and a significant decrease in plasma malondialdehyde ( MDA ) concentrations ( -0.1±0.9 vs. + 0.6±1.4 µmol/L ; p=0.03 ) . Co-supplementation with omega-3 fatty acids and vitamin E showed no detectable changes in plasma glutathione and serum high-sensitivity C-reactive protein levels . Joint omega-3 fatty acids and vitamin E supplementation result ed in lower incidences of hyperbilirubinemia in newborns ( 10.3 % vs. 33.3 % ; p=0.03 ) . CONCLUSIONS Overall , omega-3 fatty acids and vitamin E co-supplementation for 6 weeks in women with GDM had beneficial effects on plasma TAC , MDA and NO and on the incidence of the newborns ' hyperbilirubinemia Our investigations carried out in patients with diabetes mellitus revealed oxidative stress loads . The study presented here was to clarify whether a therapy with antioxidants can contribute to an improvement of prognosis .  80 patients affected with a long term diabetic late syndrome were r and omised and arranged to 4 groups of n = 20 each . In contrast to a control group these patients received 600 mg of alpha lipoic acid or 100 micrograms of selenium ( sodium selenite ) daily or 1200 IE of D-alpha-tocopherol respectively for a time of 3 months . In comparison with the control group all groups treated in an antioxidative way showed significantly diminished serum concentrations of thiobarbituric acid reactive substances and of urinary albumin excretion rates . The symptoms of distal symmetric neuropathy measured according to the thermo- and vibration sensitivity also improved in a highly significant manner . The results prove that oxidative stress plays a promoting role in developing of long term diabetic late complications and that a therapy with adjuvant antioxidants may lead to a regression of diabetic late complications BACKGROUND Low vitamin D levels are common , and are associated with a higher incidence of future vascular events . We tested whether vitamin D supplementation could improve endothelial function and other markers of vascular function in patients with a history of myocardial infa rct ion . METHODS Parallel group , placebo-controlled , double-blind r and omised trial . Patients with a history of myocardial infa rct ion were r and omised to receive 100,000 units of oral vitamin D3 or placebo at baseline , 2 months and 4 months . Outcomes were measured at baseline , 2 and 6 months . Reactive hyperaemia index on fingertip plethysmography was the primary outcome . Secondary outcome measures included blood pressure , cholesterol , C-reactive protein , von Willebr and factor , tumour necrosis factor alpha , E-selectin , B-type natriuretic peptide , thrombomodulin and 25-hydroxyvitamin D levels . RESULTS 75 patients were r and omised , mean age 66 years . 74/75 ( 99 % ) completed 6 month follow-up . 25 hydroxyvitamin D levels increased in the intervention group relative to placebo ( + 13 vs + 1 nmol/L , p=0.04 ) . There was no between-group difference in change in reactive hyperaemia index between baseline and 6 months ( -0.18 vs -0.07 , p=0.40 ) . Of the secondary outcomes , only C-reactive protein showed a significant decline in the intervention arm relative to placebo at 6 months ( -1.3 vs 2.0mg/L , p=0.03 ) . Systolic blood pressure ( + 1.4 vs + 2.3 mmHg , p=0.79 ) , diastolic blood pressure ( + 2.0 vs + 0.8 mmHg , p=0.54 ) and total cholesterol ( + 0.26 vs + 0.24 mmol/L , p=0.88 ) showed no between-group difference at 6 months . CONCLUSIONS Supplementation with vitamin D did not improve markers of vascular function in patients with a history of myocardial infa rct ion CONTEXT To the best of our knowledge , no study has examined the effects of vitamin D-calcium cosupplementation on inflammatory biomarkers and adipocytokines in vitamin D-insufficient type 2 diabetics . OBJECTIVE This study was performed to assess the effects of vitamin D and calcium supplementation on inflammatory biomarkers and adipocytokines in vitamin D-insufficient people with type 2 diabetes . METHODS Totally , 118 diabetic patients were enrolled in this r and omized , placebo-controlled clinical trial . After matching for age , sex , body mass index , type and dose of hypoglycemic agents , and duration of diabetes , subjects were r and omly assigned into 4 groups receiving the following : 1 ) 50000 IU/wk vitamin D + calcium placebo ; 2 ) 1000 mg/d calcium + vitamin D placebo ; 3 ) 50 000 IU/wk vitamin D + 1000 mg/d calcium ; or 4 ) vitamin D placebo + calcium placebo for 8 weeks . Blood sampling was done for the quantification of inflammatory biomarkers and adipocytokines at the study baseline and after 8 weeks of intervention . RESULTS Calcium ( changes from baseline : -75 ± 19 ng/ml , P = .01 ) and vitamin D alone ( -56 ± 19 ng/mL , P = .01 ) and joint calcium-vitamin D supplementation ( -92 ± 19 ng/mL , P = .01 ) result ed in a significant reduction in serum leptin levels compared with placebo ( -9 ± 18 ng/mL ) . This was also the case for serum IL-6 , such that calcium ( -2 ± 1 pg/mL , P < .001 ) and vitamin D alone ( -4 ± 1 pg/mL , P < .001 ) and their combination ( -4 ± 1 pg/mL , P < .001 ) led to significant reductions compared with placebo ( 3 ± 1 pg/mL ) . After adjustment for potential confounders , individuals in the calcium ( -3.1 ± 1.3 , P < .05 ) , vitamin D ( -3.1 ± 1.3 , P < .05 ) , and joint calcium-vitamin D groups ( -3.4 ± 1.3 , P < .05 ) had greater reductions in serum TNF-α concentrations compared with placebo ( 0.1 ± 1.2 ) . Individuals who received joint calcium-vitamin D supplements tended to have a decrease in serum high-sensitivity C-reactive protein levels compared with placebo after controlling for baseline levels ( -1.14 ± 0.25 vs 0.02 ± 0.24 ng/mL , P = .09 ) . CONCLUSION Joint calcium-vitamin D supplementation might improve systemic inflammation through decreasing IL-6 and TNF-α concentrations in vitamin D-insufficient people with type 2 diabetes
Overall , this meta- analysis shows that in diabetic patients , taking vitamin D had significant effects on hs-CRP and MDA levels , and significantly increased NO , TAC and GSH levels
In this systematic review and meta- analysis of r and omized controlled trials ( RCTs ) , the effects of vitamin D supplementation on biomarkers of inflammation and oxidative stress in diabetic patients are summarized .