Zinc supplementation affects favorably the frequency of migraine attacks: a double-blind randomized placebo-controlled clinical trial.

BACKGROUND: Observational studies have shown a link between zinc deficiency and migraine headaches. We aimed to examine the effect of zinc supplementation on the characteristics of migraine attacks in patients with migraine. METHODS: This randomized clinical trial was conducted on 80 patients with migraine. Patients were randomly assigned to receive either zinc sulfate (220 mg/d zinc sulfate) or placebo (lactose) for 8 weeks. Anthropometric measures, serum zinc concentrations, and characteristics of migraine attacks (headache severity, frequency and duration of migraine attacks, and headache daily results) were assessed at baseline and end of the trial. RESULTS: Compared with the placebo, zinc supplementation resulted in a significant reduction in headache severity (- 1.75 ± 1.79 vs. -0.80 ± 1.57; P = 0.01) and migraine attacks frequency (- 2.55 ± 4.32 vs. -0.42 ± 4.24; P = 0.02) in migraine patients. However, the observed reduction for headache severity became statistically non-significant when the analysis was adjusted for potential confounders and baseline values of headache severity. Other characteristics of migraine attacks including the duration of attacks and headache daily results were not altered following zinc supplementation either before or after controlling for covariates. CONCLUSION: Zinc supplementation had a beneficial effect on the frequency of migraine attacks in migraine patients. Additional well-designed clinical trials with a long period of intervention and different dosages of zinc are required. TRIAL REGISTRATION CODE: IRCT20121216011763N23 at www.irct.ir .

The MTHFR C677T polymorphism influences the efficacy of folic acid supplementation on the nerve conduction studies in patients with diabetic polyneuropathy; A randomized, double blind, placebo-controlled study.

BACKGROUND: Among patients with diabetic polyneuropathy, the status of folic acid, homocysteine, and nerve conduction studies (NCS) variations has been associated with methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms. The objective of the present study is to assess B9 vitamin supplementation associated with MTHRF C677T polymorphism can be effective on NCS variations in patients. MATERIALS AND METHODS: This study is a randomized, double-blind, placebo-controlled study. Patients were randomly allocated to either intervention (1 mg of folic acid, n = 40) or placebo (n = 40) groups based on parallel group design. Blood samples were taken to determine the serum levels of folic acid and homocysteine. The NCS data were collected for the assessment of diabetic neuropathy. Genotyping was performed for C677T polymorphism of the MTHFR gene. RESULTS: Four months after intervention, patients significantly observed change of serum folic acid and homocysteine levels based on C677T genotypes in the MTHFR gene. The amplitude of sensory peroneal nerve between intervention and placebo groups with CC genotype was significantly different (2.8 ± 1.6 vs. 1.9 ± 1.1). However, peak latency and amplitude of sensory sural nerve between CC (3.8 ± 1.8 vs. 4.0 ± 1.5 for peak latency and 3.5 ± 1.0 vs. 2.5 ± 1.0 for amplitude; and CT + TT genotypes (3.7 ± 1.7 vs. 3.9 ± 1.3 for peak latency and 3.2 ± 1.0 vs. 2.3 ± 1.1 for amplitude) were significant. Furthermore, significant difference for variables of motor tibial nerve and motor peroneal nerve amplitude was observed in different groups of MTHFR C677T genotypes (5.4 ± 2.9 vs. 4.6 ± 3.2 for onset-latency of tibial nerve between CC genotype; 4.8 ± 2.8 vs. 4.6 ± 3.2 for onset-latency of tibial nerve between CT + TT genotype; 0.6 ± 0.2 vs. 0.3 ± 0.1 for amplitude of tibial nerve between CC genotype; 0.5 ± 0.3 vs. 0.3 ± 0.2 for amplitude of tibial nerve between CT + TT genotype; 26.0 ± 13.3 vs. 23.2 ± 13.4 for velocity of tibial nerve between CC genotype; 26.0 ± 13.7 vs. 23.1 ± 9.6 for velocity of tibial nerve between CT + TT genotype; 1.6 ± 1.0 vs. 0.9 ± 0.7 for amplitude of peroneal nerve between CC genotype; 1.4 ± 0.7 vs. 0.9 ± 0.5 for amplitude of peroneal nerve between CT + TT genotype). CONCLUSION: The study determined that MTHFR C677T polymorphism effects the efficacy of folic acid supplementation on serum folic acid, homocysteine levels and some NCS parameters in diabetic polyneuropathy patients.

Effect of folic acid supplementation on nerve conduction velocity in diabetic polyneuropathy patients.

OBJECTIVES: In diabetic polyneuropathy (DPN) patients, the effect of folic acid and homocysteine has been related to components of nerve conduction velocity (NCV). The objective of this study was to determine the effect of folic acid supplementation on NCV in DPN patients. METHODS: Patients were randomized to receive either 1 mg of folic acid (n = 40) or placebo (n = 40) for 16 weeks. Blood samples were collected to assess serum folic acid and homocysteine concentrations, and NCV was performed for assessment of diabetic neuropathy. RESULTS: At 16 weeks, in the supplemented group, serum levels of folic acid (p < 0.001) increased, homocysteine concentrations decreased (p < 0.001), with no change in serum vitamin B12 levels. There was a significant increase in sensory sural amplitude (p < 0.001), and components of motor nerves, including amplitude (p = 0.001) and velocity (p < 0.001), but decreased onset latency of peroneal (p = 0.019) and tibial (p = 0.011) motor nerves. CONCLUSION: Our data suggest that supplementation with 1 mg of folic acid for 16 weeks may be useful for enhancing NCV in DPN patients.

Association Between BMI and Inflammation Among Diabetic Polyneuropathy Patients.

BACKGROUND: Inflammation is defined as body tissues response to harmful stimuli. Obesity-related inflammation leads to increased risk chronic diseases including diabetic polyneuropathy (DPN). The present study was performed to determine association between body mass index (BMI) and inflammatory markers including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in DPN patients. METHODS: In this cross-sectional study, 200 DPN patients with a mean (SD) of age 58.76 (9.53) years were selected. All patients completed the questionnaire including demographic data and chronic disease history. In addition, anthropometric measures and clinical laboratory tests were taken. Multivariate linear regression was used to detect the association between BMI, CRP, and ESR levels. RESULTS: BMI was associated with increase in ESR and CRP levels (ß-ESR = 4.67, P < 0.001 and ß-CRP = 0.71, P < 0.001). Also, this association remained after adjustment for other different variables. CONCLUSIONS: These findings indicate that higher BMI is related to increase inflammatory markers including CRP and ESR in DPN patients. Therapies for DPN and reducing inflammation should target the weight loss among obese patients.

Fruit and vegetable intake and cognitive impairment: a systematic review and meta-analysis of observational studies.

BACKGROUND/OBJECTIVES: Epidemiological studies investigating the association between fruit and vegetable consumption and cognitive function have produced inconclusive findings. The aim of this review was to systematically investigate if increased fruit and vegetable consumption is linked with decreased risk of cognitive impairment (CI). METHODS: We conducted a systematic literature search using four databases (PubMed, Embase, Cochrane Library, and Scopus) in October 2016 and identified cohort and cross-sectional studies, which estimated the risk of CI for fruit and vegetable consumption. The pooled odds ratio (OR) and 95% confidence interval (CI) were estimated by using a random effects model. RESULTS: The six studies meeting inclusion criteria offered 10 effect sizes and the total of 17,537 participants in the analysis. Increased fruit and vegetable intake was associated with reduced risk of CI (OR: 0.79; 95% CI: 0.67-0.93; P = 0.006). The subgroup analysis demonstrated that in studies conducted in China (but not in Western countries), the corresponding reduction in risk of CI risk was significant (OR: 0.74; 95% CI: 0.61, 0.89; P = 0.002) and the relationship between fruits, vegetables, and CI did not differ by study design, type of exposure, and gender. CONCLUSION: Increased fruit and vegetable consumption is associated with the reduced risk of CI; however, such association might be dependent on the geographical region. Further prospective studies specifically designed to compare vegetables and fruit varieties, and also to determine the recommended amounts to prevent CI are warranted.

Effect of Vitamin D supplementation on symptoms and C-reactive protein in migraine patients.

BACKGROUND: Migarine is the most common headache around the world including Iran. In recent years, Vitamin D deficiency has been shown to a global health problem. A few studies have been determined inverse association between serum levels of Vitamin D with a headache. So, in this study, we investigated the effect of Vitamin D supplementation on symptoms and C-reactive protein (CRP) among patients with migraine. MATERIALS AND METHODS: This study was randomized, double-blind, and controlled-placebo clinical trial. Sixty-five migraine patients aged 10-61 years were included for analysis. Vitamin D was administrated for 10 weeks with 50,000 IU dosage of Vitamin D per week. Multivariate analysis of covariate and univariate analysis of covariate were done to determine the effects of Vitamin D supplementation on symptoms, including severity, duration, frequency of headache, and the headache diary result (HDR). RESULTS: Mean headache frequency and HDR had significant difference among two groups (5.9 ± 7.0 vs. 7.0 ± 6.0, P = 0.06 and 85.0 ± 134.2 vs. 132.1 ± 147.1, P = 0.04). But, a mean difference of headache frequency was marginally significant (P = 0.06). These values were lower among the intervention group compared to placebo group. The association was not observed between CRP with migraine disease. CONCLUSION: In this study, we shown Vitamin D supplementation may be useful in decreasing frequency of headache attacks and HDR among patients with migraine.

The relationship between serum levels of vitamin D and migraine.

BACKGROUND: Migraine is common worldwide. In recent years, vitamin D deficiency has been determined as a global health problem. A few studies have shown inverse relationship between serum vitamin D levels and headache. Thus, in this study, we assessed relationship between serum vitamin D levels with migraine. MATERIALS AND METHODS: The present study was a cross-sectional. Seventy-six migraine patients aged 10-61 years were included. The multiple linear regression was used to show association between serum 25-0H-D3 and migraine. Adjustments were performed for age, sex, waist circumference, body mass index (BMI), number of chronic diseases, and education level. RESULTS: The positive weak relationship was observed between serum vitamin D and headache diary result (P = 0.042, r = 0.19). But, no significant relationship was observed between serum vitamin D and migraine severity (P = 0.741). CONCLUSION: High levels of serum 25-OH-D3 was related to higher headache diary result. After adjustment for confounding variables, this significant association remained. No significant relationship was shown between serum vitamin D and migraine severity.

The association between serum vitamin d levels with general and abdominal obesity among patients with migraine.

BACKGROUND: Obesity is a common health problem around the world. Studies have shown inverse relationship between serum vitamin D levels with obesity among patients and healthy population. The aim of this present study is to examine the relationship between serum vitamin D levels with general and abdominal obesity among migraine patients. METHODS: The present study is a cross-sectional and 66 migraine patients aged 19-61 years were included for analysis. Partial correlation was performed to assess association between serum 25-OH-D with general and abdominal obesity. Adjustments were performed for age, sex, and education. RESULTS: No relationship was found between serum levels of vitamin D with general and abdominal obesity. However, a significant association was shown between waist circumferences (WC) with body mass index (BMI). CONCLUSIONS: Serum levels of 25-OH-D were not associated with WC and BMI. Furthermore, after adjustment for confounder variables, no association was observed.