DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20212147

Association of serum vitamin D levels with gestational diabetes mellitus

Sharmeen Mahmood, Hasna Hena Pervin, Shereen Yousuf

Abstract


Background: This study was done to evaluate the association of serum vitamin D level with GDM (n=30) and without GDM (n=30). The age and body mass index of the participants along with their gestational age, gravidity and parity were harmonized. The serum vitamin D levels and blood glucose were investigated. The results revealed that, normal pregnant women had significantly higher vitamin D level than their GDM counterparts.

Methods: This case-control study was conducted on healthy pregnant women attending routine antenatal care at Bangabandhu Sheikh Mujib medical university from January 2019 to December 2019 recruited at third trimester of gestation. We measured maternal serum vitamin D status (25[OH]D) in third trimester of pregnancy. GDM was diagnosed according to the American diabetes association. guidelines. Vitamin D status was defined as, vitamin D sufficiency (≥30 or ≥75 nmol/L), insufficiency (20-30 and 50-75 nmol/L), were used to categories participants according to their 25[OH]D concentrations. We calculated adjusted odds ratios and 95% confidence intervals (CIs) using logistic regression.

Results: The mean serum vitamin D level was lower in case group case 23.4 (17.4±35.1) compared to that in control group 29.7 (15.4±39.8) and the difference between the 2 groups was statistically significant (p≤0.001). Sufficient level of vitamin D was more in control group (66.7%) than that of case group (26.1%). Insufficient level of vitamin D was higher in case (73.3%) group than that of control (33.3%) group. These findings were significant (p=0.021). Respondents with insufficient level of vitamin D have 3.1 times more chance to develop GDM.

Conclusions: Serum vitamin D level is reduced in pregnant women having GDM.


Keywords


Vitamin D, Gestational diabetes mellitus, Pregnancy

Full Text:

PDF

References


National Institution of Health. Office of Dietary Supplements. 2010. Available at: http://books.nap.ed u/openbook.php.record_id=5776&page. Accessed on October 5, 2010.

Holick MF. Vitamin D. The underappreciated D-lightful hormone that is important for skeletal and cellular health. Curr. Opin Endocrinol. Diabetes Obes. 2002;9:87-98.

Autier P, Boniol M, Pizot C, Mullie P. Vitamin D status and ill health: A systematic review. Lancet Diabetes Endocrinol. 2014;2:76-89.

Holick MF. Vitamin D: Importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr. 2004;79:362-71.

Grover SR, Morley R. Vitamin D deficiency in veiled or dark-skinned pregnant women. Med J Aust. 2001;175:251-2.

Sachan A, Gupta R, Das V, Agarwal A, Awasthi PK, Bhatia V. High prevalence of vitamin D deficiency among pregnant women and their newborns in northern India. Am J Clin Nutr. 2005;81:1060-4.

Brannon PM. Vitamin D and adverse pregnancy outcomes: Beyond bone health and growth. Proc Nutr Soc. 2012;71:205-12.

Bener A, AL-Hamaq AOAA, Saleh NM. Association between vitamin D insufficiency and adverse pregnancy outcome: Global comparisons. Int J Womens Health. 2013;5:523-31.

Bodnar LM, Catov JM, Zmuda JM, Cooper ME, Parrott MS, Roberts JM et al. Maternal Serum 25-Hydroxyvitamin D Concentrations Are Associated with Small-for-Gestational Age Births in White Women. J Nutr. 2010;140:999-1006.

Carrapato M. The offspring of gestational diabetes. J Perinat Med. 2003;31:5-11.

Sivaraman SC, Vinnamala S, Jenkins D. Gestational Diabetes and Future Risk of Diabetes. J Clin Med Res. 2013;5:92-6.

Javaid M, Crozier S, Harvey N, Gale C, Dennison E, Boucher B. Maternal vitamin D status during pregnancy and childhood bone mass at age 9 years: a longitudinal study. Lancet. 2006;367:36-43.

Park S, Yoon HK, Ryu HM, Han YJ, Lee SW, Park BK. Maternal vitamin D deficiency in early pregnancy is not associated with gestational diabetes mellitus development or pregnancy outcomes in Korean pregnant women in a prospective study. J Nutr Sci Vitaminol. 2014;60:269-75.

Lacroix M, Battista MC, Doyon M, Houde G, Menard J, Ardilouze JL et al. Lower vitamin D levels at first trimester are associated with higher risk of developing gestational diabetes mellitus. Acta Diabetol. 2014;51:609-16.

Zhang C, Qiu C, Hu FB, David RM, van Dam RM, Bralley A. Maternal plasma 25-hydroxyvitamin D concentrations and the risk for gestational diabetes mellitus. PLoS ONE. 2008;3:e3752.

Zhang MX, Pan GT, Guo JF, Li BY, Qin LQ, Zhang ZL. Vitamin D deficiency increases the risk of gestational diabetes mellitus: a meta-analysis of observational studies. Nutrients. 2015;7:8366-75.

Ritu G, Ajay G. Vitamin D deficiency in India: prevalence, causalities and interventions. Nutrients. 2014;6:729-75.

Shahgheibi S, Farhadifar F, Pouya B. The effect of vitamin D supplementation on gestational diabetes in high-risk women: Results from a randomized placebo-controlled trial. J Res Med Sci. 2016;2016:21-2.

Dwarkanath P, Vinotha P, Thomas T, Joseph S, Thomas A, Shirley G et al. Relationship of Early Vitamin D Concentrations and Gestational Diabetes Mellitus in Indian Pregnant Women. Front Nutr. 2019;6:116.

Jamilian M, Samimi M, Ebrahimi FA. The effects of vitamin D and omega-3 fatty acid co-supplementation on glycemic control and lipid concentrations in patients with gestational diabetes. J Clin Lipidol. 2017;11:459-68.

American Diabetes Association. Gestational diabetes mellitus. Diabetes Care. 2004;27:S88-90.

Chowdhury NA, Hossain MZ, Mia MM, Hoque S, Chowdhury NA, Sultana R, Nizhu LN. Vitamin D Status of Adults in the Outpatient Department in Bangladesh. J Dhaka Med Coll. 2018;27(1):94-7.

Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr. 2000;72(3):690-3.

Cheng S, Massaro JM, Fox CS. Adiposity, cardiometabolic risk, and vitamin D status: the Framingham Heart Study. Diabetes. 2010;59(1):242-8.

Metzger BE, Buchanan TA, Coustan DR. Summaryn and recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes Care. 2007;30(2):S251-60.

Jenum AK, Sommer C, Sletner L, Morkrid K, Baerug A, Mosdol A. Adiposity and hyperglycaemia in pregnancy and related health outcomes in European ethnic minorities of Asian and African origin: a review. Food Nutr Res. 2013;57(1):18889.

Aghajafari F, Nagulesapillai T, Ronksley PE, Tough SC, O’Beirne M, Rabi DM. Association between maternal serum 25-hydroxyvitamin D Level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies. Br Med J. 2013;346:f1169.

Wei SQ, Qi HP, Luo ZC, Fraser WD. Maternal vitamin D status and adverse pregnancy outcomes: a systematic review and meta-analysis. J Matern Fetal Neonatal Med. 2013;26:889-99.

Hu L, Zhang Y, Wang X. Maternal Vitamin D Status and risk of gestational diabetes: a meta-analysis. Cell Physiol Biochem. 2018;45:291-300.

Poel YH, Hummel P, Lips P, Stam F, Van der Ploeg T, Simsek S. Vitamin D and gestational diabetes: a systematic review and meta-analysis. Euro J Internal Med. 2012;23:465-9.

Roth DE, Leung M, Mesfin E, Qamar H, Watterworth J, Papp E. Vitamin D supplementation during pregnancy: state of the evidence from a systematic review of randomised trials. BMJ. 2017;359:j5237.

Clifton-Bligh RJ, McElduff P, McElduff A. Maternal vitamin D deficiency, ethnicity and gestational diabetes. Diabet Med. 2008;24:27-32.

Maghbooli Z, Hossein-Nezhad A, Karimi F. Correlation between vitamin D3 deficiency and insulin resistance in pregnancy. Diabetes Metab Res Rev. 2008;24:27-32.

Arnold DL, Enquobahrie DA, Qiu C, Huang J, Grote N, Vander Stoep N et al. Wiliams Early Pregnancy Maternal Vitamin D Concentrations and Risk of Gestational Diabetes Mellitus. Paediatr Perinat Epidemiol. 2015;29(3):200-10.

McManus R, Summers K, De Vrijer B, Cohen N, Thompson A, Giroux I. Maternal, umbilical arterial and umbilical venous 25-hydroxyvitamin D and adipoctyokine concentrations in pregnancies with and without gestational diabetes. Clin Endocrinol. 2014;80:635-41.

Baker AM, Haeri S, Camargo CA, Stuebe AM, Boggess KA. First-trimester maternal vitamin D status and risk for gestational diabetes (GDM) a nested case-control study. Diabetes/Metabolism Research and Rev. 2012;28:164-8.

Park S, Yoon H-K, Ryu H-M, Han YJ, Lee SW, Park BK et al. Maternal vitamin D deficiency in early pregnancy is not associated with gestational diabetes mellitus development or pregnancy outcomes in Korean pregnant women in a prospective study. J Nutr Sci Vitaminol. 2014;60:269-75.

Schneuer FJ, Roberts CL, Gulbert C, Simpson JM, Algert CS, Khambalia AZ et al. Effects of maternal serum 25-hydroxyvitamin D concentations in the first trimester on subsequent pregnancy outcomes in an Australian population. Am J Clin Nutr. 2014;99:287-95.

Whitelaw DC, Scally AJ, Tuffnell DJ, Davies TJ, Fraser WD, Bhopal RS et al. Associations of circulating calcium and 25-hydroxyvitamin D with glucose metabolism in pregnancy: a cross-sectional study in European and South Asian women. J Clin Endocrinol Meta. 2014;99:938-46.

Wei S-Q, Qi H-P, Luo Z-C, Fraser WD. Maternal vitamin D status and adverse pregnancy outcomes: a systematic review and meta-analysis. J Maternal-fetal Neonatal Med. 2013;26:889-99.

Zhou J, Su L, Liu M, Liu Y, Cao X, Wang Z et al. Associations between 25-hydroxyvitamin D levels and pregnancy outcomes: a prospective observational study in southern China. Eur J Clin Nutr. 2014;68:925-30.