Effect of different nutrients on blood glucose, inflammatory response and oxidative stress in gestational diabetes mellitus: a network meta-analysis.

We searched PubMed, Web of Science, Embase, The Cochrane Library, China Biomedical Literature Database, and other databases from inception to June 2023. The included studies were randomized controlled trials (RCTs). The studies were screened by four authors, divided into two independent pairs. A total of 18 studies were included, including 1362 patients, involving 12 intervention measures. The different nutrients had a significant effect on improving blood glucose, reducing inflammation levels, and reducing oxidative stress compared to placebo( P <0.05). Cumulative probability ranking showed that vitamin A+ vitamin D+ vitamin E ranked first in lowering fasting blood glucose [SMD=41.30, 95% CI (2.07,825.60)] and postprandial 2-hour blood glucose [SMD=15.19, 95% CI (4.16,55.53)]. In terms of insulin resistance index, the first highest probability ranking is vitamin D [SMD=5.12,95%CI(0.76,34.54)]. In terms of reducing the hs-CRP level, the first in probability ranking is VE [SMD=2.58,95%CI(1.87,3.55)]. The results of cumulative probability ranking showed that Mg+Zn+Ca+VD ranked first in reducing TNF-α [SMD=1.90,95% CI (0.40,9.08)] and IL-6 [SMD=1.83,95% CI (0.37,9.12)]. In terms of reducing MDA levels, the first ranked probability is VB1 [SMD=4.99,95%CI(1.85,13.46)]. Cumulative probability ranking results showed that Ca+VD ranked first in reducing TAC[SMD=0.66,95% CI (0.38,1.15)] and GSH [SMD=1.39,95% CI (0.43,4.56)]. In conclusion, nutritional interventions has significant effects on improving blood glucose, inflammatory levels, and oxidative stress in patients with gestational diabetes. Due to the high uncertainty in the results and differences in the number and quality of studies included, the reliability of the conclusions still needs to be validated by conducting large-sample, high-quality randomised controlled trial studies.