Jin Xia1, Yiqing Song1, Shristi Rawal2,3, Jing Wu4, Stefanie N Hinkle2, Michael Y Tsai5, Cuilin Zhang2. 1. Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana. 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. 3. Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers University, Newark, New Jersey. 4. Glotech Inc., Rockville, Maryland. 5. Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesota.
Abstract
AIM: To prospectively and longitudinally investigate vitamin D status during early to mid-pregnancy in relation to gestational diabetes mellitus (GDM) risk. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. Published 2019. This article is a U.S. Government work and is in the public domain in the USA.
AIM: To prospectively and longitudinally investigate vitamin D status during early to mid-pregnancy in relation to gestational diabetes mellitus (GDM) risk. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. Published 2019. This article is a U.S. Government work and is in the public domain in the USA.
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