Intensive Medical Nutrition Therapy Alone or with Added Metformin to Prevent Gestational Diabetes Mellitus among High-Risk Mexican Women: A Randomized Clinical Trial.

The aim of this study was to examine the efficacy of intensive medical nutrition therapy (MNT) plus metformin in preventing gestational diabetes mellitus (GDM) among high-risk Mexican women. An open-label randomized clinical trial was conducted. Inclusion criteria were pregnant women with three or more GDM risk factors: Latino ethnic group, maternal age >35 years, body mass index >25 kg/m2, insulin resistance, and a history of previous GDM, prediabetes, a macrosomic neonate, polycystic ovarian syndrome, or a first-degree relative with type 2 diabetes. Women before 15 weeks of gestation were assigned to group 1 (n = 45): intensive MNT-plus metformin (850 mg twice/day) or group 2 (n = 45): intensive MNT without metformin. Intensive MNT included individual dietary counseling, with ≤50% of total energy from high carbohydrates. The primary outcome was the GDM incidence according to the International Association of Diabetes Pregnancy Study Groups criteria. There were no significant differences in baseline characteristics and adverse perinatal outcomes between the groups. The GDM incidence was n = 11 (24.4%) in the MNT plus metformin group versus n = 7 (15.5%) in the MNT without metformin group: p = 0.42 (RR: 1.57 [95% CI: 0.67-3.68]). There is no benefit in adding metformin to intensive MNT to prevent GDM among high-risk Mexican women. Clinical trials registration: NCT01675310.

Effect of vitamins C and E supplementation on peripheral oxidative stress markers and pregnancy rate in women with endometriosis.

OBJECTIVE: To determine whether vitamins C and E supplementation lowers oxidative stress marker levels and improves pregnancy rate in women with endometriosis. METHODS: Thirty-four women with endometriosis received a bar containing vitamins C and E (343 mg and 84 mg, respectively) or placebo for 6 months. Plasma and peritoneal fluid levels of malondialdehyde (MDA) and lipid hydroperoxides (LOOHs) were measured for all women and compared between the 2 groups. Data were analyzed by the t test or 1-way analysis of variance for parametric data and the Mann-Whitney rank sum test or Kruskall-Wallis test for nonparametric data. The Fisher exact test was used to compare pregnancy rates. RESULTS: After 4 months, the study group had lower levels of MDA and LOOHs than the control group, and the difference became statistically significant in the fourth month for MDA levels and in the sixth month for LOOH levels. The postintervention pregnancy rates were 19% and 12% in the supplementation and placebo groups, respectively, but the difference was not significant. CONCLUSIONS: Vitamins C and E supplementation was associated with a decrease in the concentration of oxidative stress markers in women with endometriosis. The pregnancy rate, however, did not improve during or after the intervention.

[Endometriosis and deficient intake of antioxidants molecules related to peripheral and peritoneal oxidative stress]. / Endometriosis y consumo deficiente de moléculas antioxidantes relacionado con estrés oxidante periférico y peritoneal.

OBJECTIVE: To evaluate the antioxidant intake and the lipoperoxidation status in plasma and peritoneal fluid of women with endometriosis. PATIENTS AND METHODS: The study was carried out in 48 women with endometriosis obtained at the Sterility Clinic from the National Institute of Perinatology. The antioxidant intake was evaluated applying the Questionnaire Assessment of Antioxidants and Retinol Intakes in Mexican women validated by the National Institute of Public Health. The lipoperoxidation status was determined in plasma and peritoneal fluid with the malondyaldehyde method. Results were analyzed by ANOVA of Kruskal-Wallis. RESULTS: The antioxidant intake (vitamin C, vitamin E, selenium and zinc) of women with endometriosis showed a significative statistical difference when data was compared with the control group, including total group and those stratified in pathology stages. The lipoperoxidation status in plasma and peritoneal fluid of women with endometriosis, analyzed in group, did not show statistical difference versus healthy women. When data was stratified according to the pathology severity, the percentage of lipoperoxidation status increased in plasma in the severe grade of endometriosis and in peritoneal fluid in the moderate and severe grades. CONCLUSIONS: The antioxidant intake in women with endometriosis showed an inverse correlation with the pathology intensity. As endometriosis severity intensifies, a less intake of antioxidants is present. There is a positive association between the pathology development and the lipoperoxidation status.