25-hydroxyvitamin-d-2 and Diabetes--Gestational

This article presents an overview of the most recent scientific evidence of the role of maternal vitamin D on pregnancy outcomes, with a particular emphasis on those articles in the English-language literature published between 1 January 2013 and 1 July 2014 in PubMed.. Low levels of vitamin D status, as measured by 25-hydroxyvitamin D [25(OH)D], are common in pregnant women. Meta-analysis of observational studies has demonstrated positive associations between vitamin D status and adverse pregnancy outcomes such as preeclampsia, gestational diabetes mellitus, preterm birth and small-for-gestational age. There was heterogeneity among studies in terms of design, population, geographic location, definitions of exposure and outcome, gestational age at sampling, confounding factors and approach to analyses. Randomized controlled trials (RCTs) indicate that vitamin D supplementation during pregnancy optimizes maternal and neonatal vitamin D status.. Recent evidence supports that low maternal vitamin D status is associated with an increased risk of adverse pregnancy outcomes. Interventional studies demonstrate that vitamin D supplementation during pregnancy optimizes maternal and neonatal vitamin D status. Large, well designed, multicentre RCTs are required to determine whether vitamin D supplementation in pregnant women with low vitamin D status reduces the risk of adverse pregnancy outcomes.

Topics: 25-Hydroxyvitamin D 2; Calcifediol; Diabetes, Gestational; Dietary Supplements; Evidence-Based Medicine; Female; Fetal Growth Retardation; Global Health; Humans; Maternal Nutritional Physiological Phenomena; Nutritional Status; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Premature Birth; Risk Factors; Vitamin D; Vitamin D Deficiency

To investigate the association of VitD with GDM, and examine the potential modifying effect of prepregnancy BMI in Chinese pregnant women.. 3318 pregnant women underwent oral glucose tolerance test (OGTT) were selected from Zhoushan Pregnant Women Cohort. Plasma VitD levels were measured in the first (T1) and/or second trimester (T2). Multiple linear and logistic regression models were used for evaluating the association of VitD with GDM.. Prepregnancy BMI was positively associated with all three time-point glucose of OGTT. 25(OH)D level in T1 (β = -0.003) and T2 (β = -0.004), and its change from T1 to T2 (β = -0.004) were significantly and inversely associated with fasting blood glucose (FBG) of OGTT, but not 1-h and 2-h postload blood glucose of OGTT, respectively. The negative associations of VitD and FBG were stronger among overweight/obese women. VitD deficiency (25(OH)D < 20 ng/ml) in T2 was associated with an increased risk of GDM with increased FBG, GDM subtype 1 (OR: 2.10) and subtype 3 (OR: 2.19). Moreover, prepregnancy BMI modified this effect on GDM subtype 1 (BMI < 24: OR = 1.42; BMI ≥ 24: OR = 9.61, P for interaction = 0.002). Lower VitD increment from T1 to T2 was associated with a higher risk for GDM among overweight/obese women. Additionally, GDM prevalence fluctuated with the season, i.e. lower in summer/fall and higher in winter/spring.. Maternal VitD deficiency was associated with a higher risk of GDM subtype with increased FBG, and the risk is much greater among overweight/obesity women. The lower the VitD increment during pregnancy, the greater the risk of GDM, especially in overweight/obesity women. Furthermore, seasonal variation of GDM may be exhibited as a critical confounder in the association of VitD and GDM.

Topics: 25-Hydroxyvitamin D 2; Adult; Biomarkers; Blood Glucose; Body Mass Index; Calcifediol; Diabetes, Gestational; Fasting; Female; Glucose Tolerance Test; Humans; Obesity; Pregnancy; Pregnancy Trimesters; Prospective Studies; Risk Assessment; Risk Factors; Seasons; Vitamin D Deficiency

To prospectively and longitudinally investigate vitamin D status during early to mid-pregnancy in relation to gestational diabetes mellitus (GDM) risk.. In a nested case-control study of 107 GDM cases and 214 controls within the Fetal Growth Studies-Singleton Cohort, plasma levels of 25-hydroxyvitamin D2 and D3 (25(OH)D) and vitamin D binding protein were measured at gestational weeks 10 to 14, 15 to 26, 23 to 31, and 33 to 39; we further calculated total, free, and bioavailable 25(OH)D. Conditional logistic regression models and linear mixed-effects models were used.. We observed a threshold effect for the relation of vitamin D biomarkers with GDM risk. Vitamin D deficiency (<50 nmol/L) at 10 to 14 gestational weeks was associated with a 2.82-fold increased risk for GDM [odds ratio (OR) = 2.82, 95% confidence interval (CI): 1.15-6.93]. Women with persistent vitamin D deficiency at 10 to 14 and 15 to 26 weeks of gestation had a 4.46-fold elevated risk for GDM compared with women persistently non-deficient (OR = 4.46, 95% CI: 1.15-17.3).. Maternal vitamin D deficiency as early as the first trimester of pregnancy was associated with an elevated risk of GDM. The association was stronger for women who were persistently deficient through the second trimester. Assessment of vitamin D status in early pregnancy may be clinically important and valuable for improving risk stratification and developing effective interventions for the primary prevention of GDM.

Topics: 25-Hydroxyvitamin D 2; Adult; Calcifediol; Case-Control Studies; Diabetes, Gestational; Female; Humans; Logistic Models; Longitudinal Studies; Odds Ratio; Pregnancy; Pregnancy Complications; Pregnancy Trimester, First; Risk Factors; Vitamin D Deficiency; Vitamin D-Binding Protein; Young Adult

To measure total 25-hydroxyvitamin D levels in women in mid-pregnancy who participated in the Belfast centre of the Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) observational study, and to investigate the associations between levels of 25-hydroxyvitamin D and markers of gestational diabetes mellitus and lipid biomarkers.. A total of 1585 pregnant women had serum samples available for measurement. Participants were recruited from the Royal Jubilee Maternity Hospital, Belfast, Northern Ireland, at 24-32 weeks' gestation, as part of the HAPO study. 25-hydroxyvitamin D concentrations were measured using liquid chromatography tandem mass spectrometry. Glucose, C-peptide and lipid levels were previously analysed in a central laboratory. Statistical analysis was performed.. The median (interquartile range) 25-hydroxyvitamin D concentration during pregnancy was 38.6 (24.1-60.7) nmol/l, with 65.8% of women being vitamin D-deficient (≤50 nmol/l). In regression analysis, the association between maternal 25-hydroxyvitamin D and fasting plasma glucose levels approached significance [regression coefficient -0.017 (95% CI -0.034 to 0.001); P=0.06], and a significant positive association was observed between maternal 25-hydroxyvitamin D and β-cell function [1.013 (95% CI 1.001 to 1.024); P=0.031]. Maternal 25-hydroxyvitamin D level was positively associated with HDL [0.047 (95% CI 0.021 to 0.073) P≤ 0.001] and total cholesterol [0.085 (95% CI 0.002 to 0.167); P=0.044] in regression analysis.. These results indicate a high prevalence of vitamin D deficiency during pregnancy, which requires identification and treatment; however, only weak associations were observed between 25-hydroxyvitamin D level and markers of glucose and insulin metabolism. This would suggest that these are of doubtful clinical significance.

Topics: 25-Hydroxyvitamin D 2; Adolescent; Adult; Blood Glucose; C-Peptide; Calcifediol; Cholesterol; Chromatography, Liquid; Diabetes, Gestational; Diet; Female; Humans; Northern Ireland; Pregnancy; Pregnancy Complications; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Tandem Mass Spectrometry; Vitamin D; Vitamin D Deficiency; White People; Young Adult

Maternal vitamin D deficiency has been implicated in adverse pregnancy outcomes. However, the association between vitamin D and inflammation, particularly adipokines, remains unexplored in pregnancy.. In 102 overweight or obese pregnant women at high-risk of gestational diabetes mellitus (GDM), we investigated relationships between maternal 25-hydroxyvitamin D (25(OH)D) concentrations at 12-15 wk gestation (baseline) and serum lipids, inflammatory markers, novel adipokines (omentin-1, visfatin, high molecular weight (HMW) adiponectin), and subsequent pregnancy outcomes (GDM, preeclampsia, preterm birth [PTB]). After adjustment for maternal factors (age, BMI, parity, ethnicity, and smoking status), baseline 25(OH)D concentrations were inversely associated with total cholesterol and triglycerides, and positively associated with HMW-adiponectin. Higher baseline 25(OH)D concentrations were associated with decreased fasting and 1-h post-OGTT glucose and reduced risk of GDM at 26-28 wk, as well as with longer gestation and reduced risk of PTB upon additional adjustment for caesarean section. Adding HMW-adiponectin to the multivariable models attenuated most associations, and HMW-adiponectin was a significant predictor in the models.. Our findings suggest that lower maternal 25(OH)D concentrations in overweight/obese pregnant women at high-risk of GDM are associated with increased cardiometabolic risks during pregnancy and adverse pregnancy outcomes, and that these associations may be mediated by HMW-adiponectin.

Topics: 25-Hydroxyvitamin D 2; Adiponectin; Adult; Biomarkers; Body Mass Index; Calcifediol; Cardiovascular Diseases; Cohort Studies; Cross-Sectional Studies; Diabetes, Gestational; Female; Hospitals, Teaching; Humans; Maternal Nutritional Physiological Phenomena; Molecular Weight; Obesity; Overweight; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnancy Trimester, Second; Risk; Victoria; Vitamin D Deficiency

Vitamin D insufficiency and deficiency have been associated with an increased risk of adverse pregnancy outcomes. Controversy remains as findings have been inconsistent between disparate populations. The aim of this study was to investigate the relationship between vitamin D status and pregnancy outcomes in a large, prospective pregnancy cohort. 25-Hydroxyvitamin D concentration was analysed in serum samples collected at 15 weeks of gestation from 1710 New Zealand women participating in a large, observational study. Associations between vitamin D status and pre-eclampsia, preterm birth, small for gestational age (SGA) and gestational diabetes were investigated. The mean 25-hydroxyvitamin D concentration was 72·9 nmol/l. In all, 23 % had 25-hydroxyvitamin D concentrations 75 nmol/l (OR 2·3; 95 % CI 1·1, 5·1). However, this effect was not significant when adjustments were made for BMI and ethnicity (OR 1·8; 95 % CI 0·8, 4·2). 25-Hydroxyvitamin D concentration at 15 weeks was not associated with development of pre-eclampsia, spontaneous preterm birth or SGA infants. Pregnancy complications were low in this largely vitamin D-replete population.

Topics: 25-Hydroxyvitamin D 2; Biomarkers; Calcifediol; Cohort Studies; Diabetes, Gestational; Female; Fetal Growth Retardation; Humans; Incidence; Maternal Nutritional Physiological Phenomena; New Zealand; Nutritional Status; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnancy Trimester, Second; Premature Birth; Prevalence; Prospective Studies; Risk; Severity of Illness Index; Vitamin D Deficiency