Wei Bao1,2, Yiqing Song3, Kimberly A Bertrand4, Deirdre K Tobias5,6, Sjurdur F Olsen7, Jorge E Chavarro6,8,9, James L Mills2, Frank B Hu6,8,9, Cuilin Zhang2. 1. Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA. 2. Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA. 3. Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA. 4. Slone Epidemiology Center, Boston University, Boston, Massachusetts, USA. 5. Department of Medicine, Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. 6. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. 7. Department of Epidemiology Research, Centre for Fetal Programming, Statens Serum Institut, Copenhagen, Denmark. 8. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. 9. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Abstract
BACKGROUND: Vitamin D may play a pivotal role in regulating insulin secretion and insulin sensitivity. However, the effect of vitamin D intake, either from the diet or from supplements, on the development of gestational diabetes mellitus (GDM) remains unclear. We prospectively examined the association of prepregnancy habitual intake of vitamin D from diet and supplements with the risk of incident GDM in a well-established cohort. METHODS: The present study was performed on 21 356 singleton pregnancies from 15 225 women in the Nurses' Health Study II cohort. Diet information, including vitamin D intake from food sources and supplements, was assessed in 1991 and every 4 years thereafter by validated food frequency questionnaires. Log-binomial models with generalized estimating equations were used to estimate relative risks (RRs) and 95% confidence intervals (CIs). RESULTS: During 10 years of follow-up, 865 incident GDM cases were documented. After adjustment for age, parity, race/ethnicity, family history of diabetes, dietary and lifestyle factors, and body mass index, the RRs (95% CIs) of GDM risk associated with supplemental vitamin D intake of 0, 1-399, and ≥400 IU/day were 1.00 (reference), 0.80 (0.67-0.96), and 0.71 (0.56-0.90), respectively (Ptrend = 0.002). Dietary and total vitamin D intakes were also inversely associated with GDM risk, but the associations were not statistically significant. CONCLUSIONS: Prepregnancy supplemental vitamin D intake was significantly and inversely associated with risk of GDM. This study indicates potential benefits of increasing vitamin D intake from supplements in the prevention of GDM in women of reproductive age.
BACKGROUND:Vitamin D may play a pivotal role in regulating insulin secretion and insulin sensitivity. However, the effect of vitamin D intake, either from the diet or from supplements, on the development of gestational diabetes mellitus (GDM) remains unclear. We prospectively examined the association of prepregnancy habitual intake of vitamin D from diet and supplements with the risk of incident GDM in a well-established cohort. METHODS: The present study was performed on 21 356 singleton pregnancies from 15 225 women in the Nurses' Health Study II cohort. Diet information, including vitamin D intake from food sources and supplements, was assessed in 1991 and every 4 years thereafter by validated food frequency questionnaires. Log-binomial models with generalized estimating equations were used to estimate relative risks (RRs) and 95% confidence intervals (CIs). RESULTS: During 10 years of follow-up, 865 incident GDM cases were documented. After adjustment for age, parity, race/ethnicity, family history of diabetes, dietary and lifestyle factors, and body mass index, the RRs (95% CIs) of GDM risk associated with supplemental vitamin D intake of 0, 1-399, and ≥400 IU/day were 1.00 (reference), 0.80 (0.67-0.96), and 0.71 (0.56-0.90), respectively (Ptrend = 0.002). Dietary and total vitamin D intakes were also inversely associated with GDM risk, but the associations were not statistically significant. CONCLUSIONS: Prepregnancy supplemental vitamin D intake was significantly and inversely associated with risk of GDM. This study indicates potential benefits of increasing vitamin D intake from supplements in the prevention of GDM in women of reproductive age.
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