The Effects of Omega-3 Fatty Acids and Vitamin E Co-Supplementation on Indices of Insulin Resistance and Hormonal Parameters in Patients with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial

Faraneh Afshar Ebrahimi; Mansooreh Samimi; Fatemeh Foroozanfard; Mehri Jamilian; Hossein Akbari; Elham Rahmani; Shahnaz Ahmadi; Mohsen Taghizadeh; Mohammad Reza Memarzadeh; Zatollah Asemi

doi:10.1055/s-0042-117773

Experimental and Clinical Endocrinology & Diabetes, Inhaltsverzeichnis

Exp Clin Endocrinol Diabetes 2017; 125(06): 353-359
DOI: 10.1055/s-0042-117773

Article

The Effects of Omega-3 Fatty Acids and Vitamin E Co-Supplementation on Indices of Insulin Resistance and Hormonal Parameters in Patients with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial

Faraneh Afshar Ebrahimi

¹Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, I.R. Iran

,

Mansooreh Samimi

¹Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, I.R. Iran

,

Fatemeh Foroozanfard

¹Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, I.R. Iran

,

Mehri Jamilian

²Endocrinology and Metabolism Research Center, Department of Gynecology and Obstetrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran

,

Hossein Akbari

³Department of Biostatistics, Kashan University of Medical Sciences, Kashan, I.R. Iran

,

Elham Rahmani

⁴Department of Gynecology and Obstetrics, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran

,

Shahnaz Ahmadi

⁵Department of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

,

Mohsen Taghizadeh

⁶Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran

,

Mohammad Reza Memarzadeh

⁷Barij Medicinal Plants Research Center, Kashan, I.R. Iran

,

Zatollah Asemi

⁶Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran

› Institutsangaben

Abstract

Objective

This study was conducted to determine the effects of omega-3 fatty acids and vitamin E co-supplementation on indices of insulin resistance and hormonal parameters in women with polycystic ovary syndrome (PCOS).

Methods

This randomized double-blind, placebo-controlled trial was done on 68 women diagnosed with PCOS according to the Rotterdam criteria aged 18–40 years old. Participants were randomly assigned into 2 groups to receive either 1 000 mg omega-3 fatty acids from flaxseed oil containing 400 mg α-Linolenic acid plus 400 IU vitamin E supplements (n=34) or placebo (n=34) for 12 weeks. Hormonal parameters were quantified at the beginning of the study and after 12-week intervention.

Results

After 12 weeks of intervention, compared to the placebo, omega-3 fatty acids and vitamin E co-supplementation resulted in a significant decrease in insulin (−1.0±3.5 vs. +2.7±6.6 µIU/mL, P=0.004), homeostasis model of assessment-estimated insulin resistance (−0.2±0.8 vs. +0.6±1.5, P=0.005), homeostasis model of assessment-estimated B cell function (−4.3±14.3 vs. +10.5±24.5, P=0.004) and a significant increase in quantitative insulin sensitivity check index (+0.006±0.02 vs. −0.01±0.04, P=0.008). Supplementation with omega-3 fatty acids plus vitamin E led to significant reductions in serum total testosterone (−0.5±0.7 vs. −0.1±0.5 ng/mL, P=0.008) and free testosterone (−1.2±2.1 vs. −0.2±1.7, P=0.04) compared to the placebo group. We did not observe any significant effect of omega-3 fatty acids and vitamin E co-supplementation on fasting plasma glucose and other hormonal profiles.

Conclusions

Omega-3 fatty acids and vitamin E co-supplementation for 12 weeks in PCOS women significantly improved indices of insulin resistance, total and free testosterone.

Key words

supplementation - insulin resistance - hormonal parameters - polycystic ovary syndrome

Volltext

Referenzen

References
1 Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr Rev 1997; 18: 774-800
2 Tsilchorozidou T, Overton C, Conway GS. The pathophysiology of polycystic ovary syndrome. Clin Endocrinol (Oxf) 2004; 60: 1-17
3 Jamil AS, Alalaf SK, Al-Tawil NG. et al. A case-control observational study of insulin resistance and metabolic syndrome among the four phenotypes of polycystic ovary syndrome based on Rotterdam criteria. Reprod Health 2015; 12: 7
4 Boudreaux MY, Talbott EO, Kip KE. et al. Risk of T2DM and impaired fasting glucose among PCOS subjects: results of an 8-year follow-up. Curr Diab Rep 2006; 6: 77-83
5 Talbott E, Clerici A, Berga SL. et al. Adverse lipid and coronary heart disease risk profiles in young women with polycystic ovary syndrome: results of a case-control study. J Clin Epidemiol 1998; 51: 415-422
6 Asemi Z, Samimi M, Tabassi Z. et al. Effects of DASH diet on lipid profiles and biomarkers of oxidative stress in overweight and obese women with polycystic ovary syndrome: a randomized clinical trial. Nutrition 2014; 30: 1287-1293
7 Asemi Z, Esmaillzadeh A. DASH diet, insulin resistance, and serum hs-CRP in polycystic ovary syndrome: a randomized controlled clinical trial. Horm Metab Res 2015; 47: 232-238
8 Roche HM. Fatty acids and the metabolic syndrome. Proc Nutr Soc 2005; 64: 23-29
9 Mohammadi E, Rafraf M, Farzadi L. et al. Effects of omega-3 fatty acids supplementation on serum adiponectin levels and some metabolic risk factors in women with polycystic ovary syndrome. Asia Pac J Clin Nutr 2012; 21: 511-518
10 Liepa GU, Sengupta A, Karsies D. Polycystic ovary syndrome (PCOS) and other androgen excess-related conditions: can changes in dietary intake make a difference?. Nutr Clin Pract 2008; 23: 63-71
11 Phelan N, O’Connor A, Kyaw Tun T. et al. Hormonal and metabolic effects of polyunsaturated fatty acids in young women with polycystic ovary syndrome: results from a cross-sectional analysis and a randomized, placebo-controlled, crossover trial. Am J Clin Nutr 2011; 93: 652-662
12 Rafraf M, Mohammadi E, Asghari-Jafarabadi M. et al. Omega-3 fatty acids improve glucose metabolism without effects on obesity values and serum visfatin levels in women with polycystic ovary syndrome. J Am Coll Nutr 2012; 31: 361-368
13 Paolisso G, D’Amore A, Giugliano D. et al. Pharmacologic doses of vitamin E improve insulin action in healthy subjects and non-insulin-dependent diabetic patients. Am J Clin Nutr 1993; 57: 650-656
14 Delarue J, Guillodo MP, Guillerm S. et al. Fish oil attenuates adrenergic overactivity without altering glucose metabolism during an oral glucose load in haemodialysis patients. Br J Nutr 2008; 99: 1041-1047
15 Barbagallo M, Dominguez LJ, Tagliamonte MR. et al. Effects of vitamin E and glutathione on glucose metabolism: role of magnesium. Hypertension 1999; 34: 1002-1006
16 Asemi Z, Soleimani A, Bahmani F. et al. Effect of the omega-3 fatty acid plus vitamin E supplementation on subjective global assessment score, glucose metabolism, and lipid concentrations in chronic hemodialysis patients. Mol Nutr Food Res 2016; 60: 390-398
17 Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group . Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004; 81: 19-25
18 Huang A, Brennan K, Azziz R. Prevalence of hyperandrogenemia in the polycystic ovary syndrome diagnosed by the National Institutes of Health 1990 criteria. Fertil Steril 2010; 93: 1938-1941
19 Ainsworth BE, Haskell WL, Whitt MC. et al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 2000; 32: S498-S504
20 Taghizadeh M, Jamilian M, Mazloomi M. et al. A randomized-controlled clinical trial investigating the effect of omega-3 fatty acids and vitamin E co-supplementation on markers of insulin metabolism and lipid profiles in gestational diabetes. J Clin Lipidol 2016; 10: 386-393
21 Hatch R, Rosenfield RL, Kim MH. et al. Hirsutism: implications, etiology, and management. Am J Obstet Gynecol 1981; 140: 815-830
22 Pisprasert V, Ingram KH, Lopez-Davila MF. et al. Limitations in the use of indices using glucose and insulin levels to predict insulin sensitivity: impact of race and gender and superiority of the indices derived from oral glucose tolerance test in African Americans. Diabetes Care 2013; 36: 845-853
23 Asemi Z, Foroozanfard F, Hashemi T. et al. Calcium plus vitamin D supplementation affects glucose metabolism and lipid concentrations in overweight and obese vitamin D deficient women with polycystic ovary syndrome. Clin Nutr 2015; 34: 586-592
24 Hutchins AM, Brown BD, Cunnane SC. et al. Daily flaxseed consumption improves glycemic control in obese men and women with pre-diabetes: a randomized study. Nutr Res 2013; 33: 367-375
25 Nestel PJ, Pomeroy SE, Sasahara T. et al. Arterial compliance in obese subjects is improved with dietary plant n-3 fatty acid from flaxseed oil despite increased LDL oxidizability. Arterioscler Thromb Vasc Biol 1997; 17: 1163-1170
26 D’Adamo E, Marcovecchio ML, Giannini C. et al. Improved oxidative stress and cardio-metabolic status in obese prepubertal children with liver steatosis treated with lifestyle combined with Vitamin E. Free Radic Res 2013; 47: 146-153
27 Barre DE, Mizier-Barre KA, Griscti O. et al. High dose flaxseed oil supplementation may affect fasting blood serum glucose management in human type 2 diabetics. J Oleo Sci 2008; 57: 269-273
28 Manning PJ, Sutherland WH, Williams SM. et al. The effect of lipoic acid and vitamin E therapies in individuals with the metabolic syndrome. Nutr Metab Cardiovasc Dis 2013; 23: 543-549
29 Glintborg D, Henriksen JE, Andersen M. et al. Prevalence of endocrine diseases and abnormal glucose tolerance tests in 340 Caucasian premenopausal women with hirsutism as the referral diagnosis. Fertil Steril 2004; 82: 1570-1579
30 Wu JH, Cahill LE, Mozaffarian D. Effect of fish oil on circulating adiponectin: a systematic review and meta-analysis of randomized controlled trials. J Clin Endocrinol Metab 2013; 98: 2451-2459
31 Yamauchi T, Kamon J, Minokoshi Y. et al. Adiponectin stimulates glucose utilization and fatty-acid oxidation by activating AMP-activated protein kinase. Nat Med 2002; 8: 1288-1295
32 Altavilla D, Deodato B, Campo GM. et al. IRFI 042, a novel dual vitamin E-like antioxidant, inhibits activation of nuclear factor-kappaB and reduces the inflammatory response in myocardial ischemia-reperfusion injury. Cardiovasc Res 2000; 47: 515-528
33 Nadjarzadeh A, Dehghani Firouzabadi R, Vaziri N. et al. The effect of omega-3 supplementation on androgen profile and menstrual status in women with polycystic ovary syndrome: A randomized clinical trial. Iran J Reprod Med 2013; 11: 665-672
34 Akinsete JA, Ion G, Witte TR. et al. Consumption of high omega-3 fatty acid diet suppressed prostate tumorigenesis in C3(1) Tag mice. Carcinogenesis 2012; 33: 140-148
35 Cussons AJ, Watts GF, Mori TA. et al. Omega-3 fatty acid supplementation decreases liver fat content in polycystic ovary syndrome: a randomized controlled trial employing proton magnetic resonance spectroscopy. J Clin Endocrinol Metab 2009; 94: 3842-3848
36 Oner G, Muderris II. Efficacy of omega-3 in the treatment of polycystic ovary syndrome. J Obstet Gynaecol 2013; 33: 289-291