title: Effects of selenium supplementation on glucose homeostasis, inflammation, and oxidative stress in gestational diabetes: Randomized, double-blind, placebo-controlled trial.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Selenium supplementation in pregnant women with GDM demonstrated beneficial effects on glucose metabolism, hs-CRP levels, and biomarkers of oxidative stress.
authors.affiliation: Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran.
authors.forename: Zatollah
authors.initials: Z
authors.lastname: Asemi
authors.affiliation: Department of Gynecology and Obstetrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Mehri
authors.initials: M
authors.lastname: Jamilian
authors.affiliation: Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, I.R. Iran.
authors.forename: Elaheh
authors.initials: E
authors.lastname: Mesdaghinia
authors.affiliation: Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: Esmaillzadeh@hlth.mui.ac.ir.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Esmaillzadeh
mesh_terms: D000328:Adult; D000975:Antioxidants / Q000494:pharmacology*; D001786:Blood Glucose / Q000187:drug effects*; D002097:C-Reactive Protein / Q000187:drug effects; D016640:Diabetes, Gestational / Q000097:blood / Q000188:drug therapy*; D019587:Dietary Supplements; D004311:Double-Blind Method; D005215:Fasting / Q000097:blood; D005260:Female; D005978:Glutathione / Q000097:blood; D006706:Homeostasis / Q000187:drug effects; D006801:Humans; D007333:Insulin Resistance; D018384:Oxidative Stress / Q000187:drug effects*; D011247:Pregnancy; D012643:Selenium / Q000494:pharmacology*
chemical_list: D000975:Antioxidants; D001786:Blood Glucose; D002097:C-Reactive Protein; D005978:Glutathione; D012643:Selenium
keywords: Gestational diabetes; Pregnant women; Selenium; Supplementation