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Changes in Bone Turnover, Inflammatory, Oxidative Stress, and Metabolic Markers in Women Consuming Iron plus Vitamin D Supplements: a Randomized Clinical Trial.

Biological trace element research
July 1, 2021
Behnaz Abiri et al. (8 authors)
Journal ArticleRandomized Controlled TrialHuman StudyClinical
Study Details

Study Goal

The researchers aimed to determine whether combining vitamin D and iron supplementation, compared to vitamin D alone, could improve bone turnover, inflammatory, oxidative stress, and metabolic markers in women with iron deficiency and vitamin D insufficiency.

Results Summary

Iron-vitamin D co-supplementation did not show added benefits for improving bone turnover, inflammatory, oxidative stress, or metabolic markers compared to vitamin D alone. Vitamin D alone had some detrimental effects on inflammatory and metabolic markers, while iron supplementation improved certain hematological parameters.

Population

87 women aged 18-45 years with hemoglobin ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL (vitamin D deficiency/insufficiency).

Effective Dosage

27 mg/day iron plus 1000 IU/day vitamin D3.

Duration

12 weeks.

Interactions

None mentioned.

Extracted Claims (29)
InterventionDirectionEndpointPopulationDosageImpactClaim #
1000 IU/day vitamin D3 plus 27 mg/day iron (D-Fe)
decrease
red blood cells (RBC)
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
significant decrease
#1
1000 IU/day vitamin D3 plus 27 mg/day iron (D-Fe)
decrease
hematocrit (Hct)
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
significant decrease
#2
1000 IU/day vitamin D3 plus 27 mg/day iron (D-Fe)
increase
mean corpuscular hemoglobin concentration (MCHC)
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
increases
#3
1000 IU/day vitamin D3 plus 27 mg/day iron (D-Fe)
increase
25OHD
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
increases
#4
1000 IU/day vitamin D3 plus 27 mg/day iron (D-Fe)
increase
osteocalcin
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
increases
#5
1000 IU/day vitamin D3 plus 27 mg/day iron (D-Fe)
increase
high-density cholesterol (HDL)
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
increases
#6
1000 IU/day vitamin D3 plus 27 mg/day iron (D-Fe)
increase
fasting blood sugar (FBS)
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
increases
#7
vitamin D3 plus placebo supplements (D-P)
decrease
red blood cells (RBC)
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
significant decrease
#8
vitamin D3 plus placebo supplements (D-P)
decrease
hemoglobin (Hb)
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
significant decrease
#9
vitamin D3 plus placebo supplements (D-P)
decrease
hematocrit (Hct)
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
significant decrease
#10
vitamin D3 plus placebo supplements (D-P)
decrease
mean corpuscular volume (MCV)
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
significant decrease
#11
vitamin D3 plus placebo supplements (D-P)
decrease
mean corpuscular hemoglobin (MCH)
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
significant decrease
#12
vitamin D3 plus placebo supplements (D-P)
decrease
mean corpuscular hemoglobin concentration (MCHC)
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
significant decrease
#13
vitamin D3 plus placebo supplements (D-P)
decrease
serum ferritin
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
significant decrease
#14
vitamin D3 plus placebo supplements (D-P)
decrease
low-density cholesterol (LDL)
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
significant decrease
#15
vitamin D3 plus placebo supplements (D-P)
increase
25OHD
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
increases
#16
vitamin D3 plus placebo supplements (D-P)
increase
osteocalcin
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
increases
#17
vitamin D3 plus placebo supplements (D-P)
increase
C-terminal telopeptide (CTX)
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
increases
#18
vitamin D3 plus placebo supplements (D-P)
increase
triglyceride (TG)
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
increases
#19
vitamin D3 plus placebo supplements (D-P)
increase
fasting blood sugar (FBS)
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
increases
#20
vitamin D3 plus placebo supplements (D-P)
increase
interleukin-6 (IL-6)
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
increases
#21
vitamin D3 plus placebo supplements (D-P)
increase
osteocalcin
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
between-group increases
#22
vitamin D3 plus placebo supplements (D-P)
increase
interleukin-6 (IL-6)
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
between-group increases
#23
vitamin D3 plus placebo supplements (D-P)
decrease
red blood cells (RBC)
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
decreases
#24
vitamin D3 plus placebo supplements (D-P)
decrease
hemoglobin (Hb)
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
decreases
#25
vitamin D3 plus placebo supplements (D-P)
decrease
hematocrit (Hct)
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
decreases
#26
vitamin D3 plus placebo supplements (D-P)
decrease
mean corpuscular volume (MCV)
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
decreases
#27
iron-vitamin D co-supplementation
no change
bone turnover, inflammatory, oxidative stress, and metabolic markers
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
does not yield added benefits
#28
vitamin D alone
increase
inflammatory and metabolic markers
women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years
-
may have some detrimental effects
#29
Abstract

We aimed to investigate whether combination of vitamin D and iron supplementation, comparing vitamin D alone, could modify bone turnover, inflammatory, oxidative stress, and metabolic markers. Eighty-seven women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years were randomly assigned into two groups: (1) receiving either 1000 IU/day vitamin D3 plus 27 mg/day iron (D-Fe); (2) vitamin D3 plus placebo supplements (D-P), for 12 weeks. In D-Fe group, significant decrease in red blood cells (RBC) (P = 0.001) and hematocrit (Hct) (P = 0.004) and increases in mean corpuscular hemoglobin concentration (MCHC) (P = 0.001), 25OHD (P < 0.001), osteocalcin (P < 0.001), high-density cholesterol (HDL) (P = 0.041), and fasting blood sugar (FBS) (P < 0.001) were observed. D-P group showed significant decrease in RBC (P < 0.001), Hb (P < 0.001), Hct (P < 0.001), mean corpuscular volume (MCV) (P = 0.004), mean corpuscular hemoglobin (MCH) (P < 0.001), MCHC (P = 0.005), serum ferritin (P < 0.001), and low-density cholesterol (LDL) (P = 0.016) and increases of 25OHD (P < 0.001), osteocalcin (P < 0.001), C-terminal telopeptide (CTX) (P = 0.025), triglyceride (TG) (P = 0.004), FBS (P < 0.001), and interleukin-6 (IL-6) (P = 0.001) at week 12. After the intervention, the D-P group had between-group increases in mean change in the osteocalcin (P = 0.007) and IL-6 (P = 0.033), and decreases in the RBC (P < 0.001), Hb (P < 0.001), Hct (P < 0.001), and MCV (P = 0.001), compared with the D-Fe group. There were significant between-group changes in MCH (P < 0.001), MCHC (P < 0.001), ferritin (P < 0.001), and serum iron (P = 0.018). Iron-vitamin D co-supplementation does not yield added benefits for improvement of bone turnover, inflammatory, oxidative stress, and metabolic markers, whereas, vitamin D alone may have some detrimental effects on inflammatory and metabolic markers. IRCT registration number: IRCT201409082365N9.

Medical Subject Headings (MeSH)
Bone RemodelingDietary SupplementsDouble-Blind MethodFemaleHumansIronOxidative StressVitamin D
Study Links
Quality Scores
Safety85
Efficacy60/10
Quality80/10
Citation Metrics
Total Citations1
Citations/Year0.3
Relative Citation Ratio0.09
NIH Percentile4.2%
Research Impact Scores
APT Score0.05
Weight Score2.13
Normalized Score0.74
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