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Dietary antioxidative supplements and diabetic retinopathy; a systematic review.

ABSTRACT: Purpose:There is controversial data regarding the effects of dietary antioxidative supplements on diabetic retinopathy (DR). We conducted a systematic review of both observational and randomized controlled clinical trials (RCTs) to clarify whether they are effective or not. Methods:All observational and RCTs conducted by antioxidative supplements on DR published up to 1 January 2018 in PubMed, Web of Sciences, Scopus and Cochrane Library databases were included. Exclusion criteria were animal studies, and studies conducted in Type 1 diabetes mellitus (T1DM), children or pregnant women. Main outcome measures were reporting the incidence or progression of DR in T2DM by assessment of visual fields, and measurements of oxidative and antioxidative biomarkers. The quality of reporting of included articles and risk of bias were assessed. Results:Finally, we reached 14 observational studies and 7 RCTs that conducted on 256,259 subjects. Due to severe methodological heterogeneity, only qualitative synthesis was carried. All studies were reported a significantly lower level of antioxidants and higher level of oxidative stress biomarkers in DR compared with others. There was an inverse significant correlation between vitamin C and malondialdehyde (MDA) (r?=?-0.81) or DNA damage (r?=?-0.41). These figures were statistically significant between vitamin E and MDA (r?=?0.77) or superoxide dismutase (r?=?0.44). Coefficient of correlation between MDA and zinc (-0.82), coenzyme Q10 (0.56), and magnesium (-0.73) was significant. Multi-oxidants trials were shown non-significant beneficial effects on DR. Conclusions:Although our study supports the positive effects of antioxidative supplements on DR, more high quality studies are needed to confirm.

SUBMITTER: Tabatabaei-Malazy O

PROVIDER: S-EPMC6915253 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Dietary antioxidative supplements and diabetic retinopathy; a systematic review.

Tabatabaei-Malazy Ozra O Ardeshirlarijani Edris E Namazi Nazli N Nikfar Shekoufeh S Jalili Reza Baradar RB Larijani Bagher B

Journal of diabetes and metabolic disorders 20190830 2

<h4>Purpose</h4>There is controversial data regarding the effects of dietary antioxidative supplements on diabetic retinopathy (DR). We conducted a systematic review of both observational and randomized controlled clinical trials (RCTs) to clarify whether they are effective or not.<h4>Methods</h4>All observational and RCTs conducted by antioxidative supplements on DR published up to 1 January 2018 in PubMed, Web of Sciences, Scopus and Cochrane Library databases were included. Exclusion criteria ...[more]

PMID: 31890694

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Project description:Background: Diabetic retinopathy is a common microvascular complication in diabetic patients and is considered the main cause of visual loss worldwide. Periodontitis is a chronic inflammatory condition, which compromises dental supporting tissues. The chronic bacterial challenge in periodontitis is a persistent source of inflammatory mediators that may be associated with insulin resistance, increasing the risk of complications of diabetes mellitus. This systematic review aimed to summarize the evidence in the association between diabetic retinopathy and periodontitis. Methods: This review was registered under the number CRD 42019142267. A search strategy in five electronic databases and a gray literature source was performed based on the PECO acronym. After data extraction, the qualitative synthesis and risk of bias analyses were performed using the Newcastle-Ottawa scale. The level of evidence of all studies taken together was evaluated through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results: Out of the 253 citations screened, five cross-sectional studies met the eligibility criteria and were included in the qualitative analysis, in which two were judged to be of good quality, one as fair quality, and two as poor quality. Among the included studies, a significant relationship between the severity of periodontitis (CAL > 5 mm) and the severity of diabetic retinopathy (p < 0.05) was reported by four studies. Also, an association between both diseases in non-obese adults was found after adjustments [OR 2.206 (1.114-4.366); p = 0.0232). However, the analysis of evidence by GRADE assessment was rated as low. Conclusions: Although the results of individual studies suggest an association between diabetic retinopathy and periodontitis, the quality of the body of evidence was judged to be low by the GRADE approach. Further studies with larger sample sizes, adequate models of cofounders' adjustments, and prospective analysis of periodontitis and diabetes conditions ought to be conducted to clarify this association.

Project description:Dietary supplements based on algae, known for their nutritional value and bioactive properties, are popular products among consumers today. While commercial algal products are regarded safe by numerous studies, information about the production and origin of such products is scarce. In addition, dietary supplements are not as strictly regulated as food and medicinal drugs. We characterized different algal products (kelps: Laminariales, Spirulina spp., Chlorella spp., and Aphanizomenon flos-aquae), obtained on Slovenian market, based on their elemental composition (X-ray fluorescence, inductively coupled plasma-mass spectrometry), antioxidative potential [DPPH (2,2-diphenyl-1-picrylhydrazyl) assay, total phenolic content], and stable isotope values [carbon (C), nitrogen (N), and sulfur (S); elemental analyzer isotope ratio mass spectrometry (EA-IRMS) method]. Antioxidative potential is consistent among products of the same type, with A. flos-aquae samples having 4.4 times higher antioxidative potential compared to Chlorella spp. and 2.7 times higher compared to Spirulina spp. Levels of toxic trace elements (arsenic, cadmium, mercury, and lead) are below the maximum allowed values and as such do not pose risk to consumers' health. Samples of Spirulina spp. have relatively high δ15N (7.4 ‰ ± 4.4‰) values, which indicate use of organic nitrogen sources in certain samples. Likewise, different elemental composition and isotopic ratios of stable elements (C, N, and S) for the samples with Spirulina spp. or Chlorella spp. are the consequence of using different nutrient sources and algae-growing techniques. Statistical analysis (principal component analysis) has confirmed that all tested A. flos-aquae samples originate from the same source, supposedly Klamath Lake (Oregon, USA). Hawaiian Spirulina pacifica can also be differentiated from all the other samples because of its characteristically high metal content (iron, manganese, zinc, cobalt, nickel, vanadium). Chlorella spp. and Spirulina spp. require further analyses with larger number of samples, as differentiation is not possible based on results of this study.

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Dietary antioxidative supplements and diabetic retinopathy; a systematic review.

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Dietary antioxidative supplements and diabetic retinopathy; a systematic review.

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