van der Pligt Paige, Wadley Glenn D, Lee I-Lynn, Ebrahimi Sara, Spiteri Sheree, Dennis Kim, Mason Shaun
Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3220, Australia.
Department of Nutrition and Dietetics, Western Health, Footscray, Australia.
Curr Nutr Rep. 2025 Mar 14;14(1):45. doi: 10.1007/s13668-025-00636-1.
Gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy globally. Hyperglycaemia and associated production of reactive oxygen species can lead to oxidative stress in pregnancy. However, the potential effectiveness of increased antioxidant intake in the management of GDM has not been widely examined. Its usefulness alongside medical nutrition therapy (MNT) for assisting glycaemic control in women with GDM is poorly understood. This review aimed to establish the effect of antioxidant supplementation on the risk and management of gestational diabetes mellitus (GDM).
A systematic review of intervention studies was conducted based on PRISMA guidelines. Databases searched were MEDLINE, CINAHL, Global Health, Scopus, Embase and Cochrane until September 2024. Random effects meta-analyses using Cochrane Review Manager software to establish the effect of antioxidant supplementation on glucose outcomes in women with GDM were conducted. A total of 13 studies (1380 participants) were included in the review with four different antioxidants used (selenium (n = 3); alpha-lipoic (n = 4); zinc (n = 5); e-3-gallate (n = 1)). Significant pre-post differences between antioxidant supplementation and control groups were found for fasting insulin (SMD, 95%CI) (-0.97 [-1.69 -0.24]; p = 0.009, HOMA-IR (-0.90 [-1.25, -0.54]; p < 0.0000, HOMA-B (-0.86 [-1.05, -0.67]; p < 0.00001 and QUICKI (1.09 [0.32,1.87]; p = 0.005 Heterogeneity was substantial (I > 50%, p < 0.05) for all models except for HOMA-B (I = 0%, p > 0.05). Antioxidant supplementation has possible benefit as an adjunct therapy to current dietary management for women with GDM. Further clinical trials are needed to establish the preferred type and dosage of antioxidants likely to be effective.
妊娠期糖尿病（GDM）是全球范围内最常见的妊娠医学并发症。高血糖及相关活性氧的产生可导致孕期氧化应激。然而，增加抗氧化剂摄入量在GDM管理中的潜在有效性尚未得到广泛研究。其与医学营养治疗（MNT）协同用于协助GDM女性控制血糖的作用也知之甚少。本综述旨在确定补充抗氧化剂对妊娠期糖尿病（GDM）风险及管理的影响。
基于PRISMA指南对干预研究进行了系统综述。检索的数据库包括MEDLINE、CINAHL、Global Health、Scopus、Embase和Cochrane，检索截至2024年9月。使用Cochrane Review Manager软件进行随机效应荟萃分析，以确定补充抗氧化剂对GDM女性血糖结果的影响。本综述共纳入13项研究（1380名参与者），使用了四种不同的抗氧化剂（硒（n = 3）；α-硫辛酸（n = 4）；锌（n = 5）；e-3-没食子酸酯（n = 1））。抗氧化剂补充组与对照组之间在空腹胰岛素（标准化均值差，95%置信区间）（-0.97 [-1.69 -0.24]；p = 0.009）、胰岛素抵抗指数（HOMA-IR）（-0.90 [-1.25, -0.54]；p < 0.0000）、胰岛β细胞功能指数（HOMA-B）（-0.86 [-1.05, -0.67]；p < 0.00001）和定量胰岛素敏感性检查指数（QUICKI）（1.09 [0.32,1.87]；p = 0.005）方面存在显著的前后差异。除HOMA-B（I = 0%，p > 0.05）外，所有模型的异质性均较大（I>50%，p < 0.05）。补充抗氧化剂作为GDM女性当前饮食管理的辅助治疗可能有益。需要进一步的临床试验来确定可能有效的抗氧化剂的首选类型和剂量。
