Oral herbal supplement containing magnesium sulfate improve metabolic control and insulin resistance in non-diabetic overweight patients: A randomized double blind clinical trial.

Background: Magnesium deficiency plays a key role in obesity and decreases insulin sensitivity. In our previous study, significant evidence was provided for the contribution of oral Mg supplement that could improve insulin sensitivity and body weight in animal trials. The purpose of the present study was to investigate the effects of an herbal supplement containing 300 mg magnesium sulfate on lipid profile, as well as insulin resistance and secretion in overweight patients. Methods: Seventy overweight non-diabetic volunteers with Body Mass Index (BMI) >28 kg/m2 were included in a randomized double blind placebo-controlled clinical trial (ethic number HUMS REC.1394.57) and registered in Iranian Registry of Clinical Trials (IRCT2012110124756N2 with registration number 24756). They received either placebo or an herbal supplement capsule containing 300 mg magnesium sulfate (MgSO4) for 6 months on a daily basis. Metabolic control, lipid profile and magnesium status were determined at baseline and every three months. Student t-test, repeated measure ANOVA and ANCOVA were used to compare the groups. Results: There was no significant difference between groups before intervention, but daily Mg supplement for 6 months significantly improved fasting insulin level (6.71±0.11 to 6.27±0.3 three months after Mg therapy, p<0.01 vs. 6.41±0.11 in control group (5.83±0.063) six months after Mg therapy, p< 0.0001), HOMA-IR (1.52±0.03 )in control group to 1.36±0.03 after three months Mg therapy, p<0.05 vs 1.37±0.05 in control group to 1.22±0.02 six months after Mg therapy, p< 0.05), high density lipoprotein cholesterol (HDL) (43.57±0.82 in control group to 43.91±1.92 three months after Mg therapy, p<0.001vs 43.57±0.82 in control group to 46±0.88 six months after Mg therapy, <0.01), triglyceride (TG) (163.17±6.1 in control group to 141.2±5.84 six months after g therapy, p<0.05) and low density lipoprotein cholesterol (LDL) (112.62±3.41 in control group to 104.42±2.35 six months after Mg therapy, p<0.05). Conclusion: Oral herbal supplement containing MgSO4 (300 mg/day) could improve plasma insulin level, lipid profile, and insulin resistance in non-diabetic overweight volunteers.

Oral magnesium supplementation in type II diabetic patients.

BACKGROUND: Magnesium is the second most abundant intracellular cation. It plays an important role in insulin homeostasis and glucose metabolism through multiple enzymatic reactions. With increasing data on magnesium deficiency in diabetic patients and epidemiological studies demonstrating magnesium deficiency as a risk factor for diabetes, it is logical to search for its possible beneficial effects on diabetes control and prevention. We aimed to determine whether oral magnesium supplementation improves metabolic control, lipid profile and blood pressure in patients with type II diabetes. METHODS: Fifty four patients with type II diabetes were included in a randomized double blind placebocontrolled clinical trial.Patients received either placebo or 300 mg elemental magnesium (as magnesium sulfate -MgSo4-) daily, for 3 months. Metabolic control, lipid profile, blood pressure, magnesium status, hepatic enzymes, hemoglobin concentration, and anthropometric indices were determined in the beginning and at the end of the study. RESULTS: Daily administration of 300 mg elemental magnesium for 3 months, significantly improved fasting blood glucose (183.9±15.43 to 125.8±6.52 vs. 196.5±28.12 to 136.5±7.94, p< 0.0001), 2-hour post prandial glucose (239.1±74.75 to 189.1±60mg/dl vs. 246.4±97.37 to 247.8±86.74mg/dl, p< 0.01), lipid profile, blood pressure and hepatic enzymes. CONCLUSION: Oral magnesium supplementation with proper dosage has beneficial effects on blood glucose, lipid profile, and blood pressure in patients with type II diabetes.

Thyroid dysfunction and autoantibodies association with hypertensive disorders during pregnancy.

BACKGROUND: Thyroid dysfunction and autoimmunity are relatively common in reproductive age and have been associated with adverse health outcomes for both mother and child, including hypertensive disorders during pregnancy. Objective. To survey the relation between thyroid dysfunction and autoimmunity and incidence and severity of pregnancy-induced hypertensive disorders. METHOD: In this case control study 48 hypertensive patients in 4 subgroups (gestational hypertension, mild preeclampsia, severe preeclampsia, eclampsia) and 50 normotensive ones were studied. The samples were nulliparous and matched based on age and gestational age and none of them had previous history of hypertensive or thyroid disorders and other underlying systemic diseases or took medication that might affect thyroid function. Their venous blood samples were collected using electrochemiluminescence and ELISA method and thyroid hormones and TSH and autoantibodies were measured. RESULTS: Hypertensive patients had significant lower T3 concentration compared with normotensive ones with mean T3 values 152.5 ± 48.93 ng/dL, 175.36 ± 58.07 ng/dL respectively. Anti-TPO concentration is higher in control group 6.07 ± 9.02 IU/mL compared with 2.27 ± 2.94 IU/mL in cases. CONCLUSION: The severity of preeclampsia and eclampsia was not associated with thyroid function tests. The only significant value was low T3 level among pregnancy, induced hypertensive patients.

Serum paraoxonase activity before and after treatment of thyrotoxicosis.

OBJECTIVE: Antioxidant effects of paraoxonase, a high density lipoprotein (HDL)-associated enzyme that inhibits low density lipoprotein cholesterol (LDL-C) oxidation in human serum, have been reported. Patients with thyroid dysfunction are more susceptible to oxidative stress, and may show enhanced LDL-C oxidation. The purpose of this study was to evaluate serum paraoxonase activity in patients with hyperthyroidism before and after treatment with methimazole (MMI). DESIGN AND PATIENTS: Twenty-four hyperthyroid patients (15 women and nine men, aged 43.0 +/- 12.9 years) and 23 age- and sex-matched healthy controls were studied. Serum paraoxonase activity, lipid, lipoprotein and apolipoprotein levels were measured in fasting samples. Patients were treated with MMI 20-30 mg daily for the first month, and 5-10 mg daily thereafter, and re-evaluated after 6-9 months of treatment. RESULTS: Significantly lower serum paraoxonase activity was present in hyperthyroid patients before treatment compared with the controls (43.4 +/- 21.9 vs. 72.6 +/- 41.2 U/ml, P < 0.005). After a mean follow-up of 7.3 months, 15 patients became euthyroid (treated) and nine were still hyperthyroid. After follow-up, serum paraoxonase activity had increased to 62.2 +/- 37.4 U/ml in those who became euthyroid (P < 0.05 compared with baseline). In patients who were still hyperthyroid serum paraoxonase was unchanged from baseline, at 43.2 +/- 23.2 U/ml. CONCLUSION: Serum paraoxonase is reduced in patients with hyperthyroidism and reverts to normal after euthyroidism is attained. Reduced serum paraoxonase activity in thyrotoxicosis might predispose lipids to oxidation.

Association of lipids, lipoproteins, apolipoproteins and paraoxonase enzyme activity with premature coronary artery disease.

BACKGROUND AND DESIGN: The association of serum apolipoprotein (apo) A-I and apo B concentrations and paraoxonase (PON) enzyme activity with angiographically determined coronary artery disease (CAD) was investigated in Iranian non-diabetic patients with premature CAD and control participants in a sex- and age-matched case-control study. METHODS: The study population consisted of 59 non-diabetic patients with premature CAD and 55 CAD control participants. Premature CAD was defined as the presence of angiographically proven coronary stenosis (> or =50% involvement) in men and women younger than 55 and 65 years, respectively. Apolipoprotein concentrations were measured by immunoturbidometric assay and paraoxonase/arylesterase activities by spectrophotometric assay of p-nitrophenol/phenol production following addition of paraoxon/phenylacetate to serum. RESULTS: In CAD patients, increased concentrations of total cholesterol (215 +/- 43 compared with 193 +/- 43, P < 0.001), low-density lipoprotein cholesterol (137 +/- 46 compared with 116 +/- 39, P < 0.05) and apo B (102 +/- 24 compared with 84 +/- 17, P < 0.001) and a decreased ratio of apo A-I/apo B (1.7 +/- 0.4 compared with 2.0 +/- 0.6, P < 0.001) were observed compared to the control group. Other study variables were not significantly different between the two groups. On multiple logistic regression analysis, the only marker for discrimination between the CAD+ group and the CAD- control group was apo B level. CONCLUSIONS: In Iranian non-diabetic patients with premature CAD, the concentration of apo B is a better marker than traditional lipids in discriminating between CAD+ and CAD- patients. The lack of significant difference in PON activity between CAD patients and control participants supports the concept of interethnic variability in PON activity and gene polymorphism observed in other studies.