Eleonora Salakos1, Tioka Rabeony2, Marie Courbebaisse3, Joëlle Taieb4, Vassilis Tsatsaris5, Jean Guibourdenche6, Marie-Victoire Senat7, Hazar Haidar8, Jacques C Jani9, Dragos Barglazan10, Emeline Maisonneuve11, Marie-Clotilde Haguet12, Norbert Winer13, Damien Masson14, Caroline Elie2, Jean-Claude Souberbielle15, Alexandra Benachi16. 1. Gynécologie-Obstétrique, Hôpital Antoine-Béclère, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Sud, Clamart, France. Electronic address: e.salakos@gmail.com. 2. URC/CIC Paris Descartes Necker Cochin, Hôpital Necker-Enfants Malades, AP-HP, Paris, France. 3. Service de Physiologie-Explorations Fonctionnelles Rénales, Hôpital Européen Georges Pompidou, AP-HP, Université Paris Descartes, INSERM U1151, Paris, France. 4. Biochimie, Hôpital Antoine-Béclère, AP-HP, Université Paris-Sud, Clamart, France. 5. Fondation PremUp, Paris, France; Maternité Port-Royal, Hôpîtal Cochin, AP-HP, Université René Descartes, Paris, France. 6. Biochimie Hormonale, Hôpital Cochin, AP-HP, Université René Descartes, Paris, France. 7. Gynécologie-Obstétrique, Hôpital Bicêtre, AP-HP, Université Paris-Sud, Kremlin Bicêtre, France. 8. Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Hôpital Bicêtre, Hôpital Bicêtre, AP-HP, Université Paris-Sud, Kremlin Bicêtre, France. 9. Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium. 10. Department of Clinical Chemistry, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium. 11. Service de Médecine Fœtale, Hôpital Armand Trousseau, UPMC-Sorbonne Université, Paris, France. 12. Biochimie, Hôpital Trousseau, Hôpital Armand Trousseau, UPMC-Sorbonne Université, Paris, France. 13. Department of Gynecology and Obstetrics, Nantes University Hospital, 44000, France. 14. Department of Biochemistry, Nantes University Hospital Hotel-Dieu, Nantes 44000, France. 15. Laboratoire d'Explorations Fonctionnelles, Hôpital Necker-Enfants Malades, AP-HP, Paris, France. 16. Gynécologie-Obstétrique, Hôpital Antoine-Béclère, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Sud, Clamart, France; Fondation PremUp, Paris, France.
Abstract
BACKGROUND & AIMS: Gestational diabetes mellitus (GDM) is one of the most frequent medical complications during pregnancy. It has been associated with many adverse pregnancy, fetal and neonatal outcomes, as well as with an increased risk for mothers and children in the long term. There is a growing interest in vitamin D and its potential role in the development of metabolic disorders. However, the medical literature is not consensual. The aim of this study was to assess the risk of GDM according to vitamin D status during the first trimester. METHODS: This study is a nested case-control study performed from a multicenter prospective observational cohort of pregnant women assessed for 25-hydroxyvitamin D levels (25OHD). Three hundred ninety-three patients were included in the initial cohort. After applying exclusion criteria, a total of 1191 pregnant women were included. Two hundred fifty women with GDM (cases) were matched to 941 women without GDM (controls) for parity, age, body mass index before pregnancy, the season of conception, and phototype. This study was funded by a grant from the "Programme Hospitalier de Recherche Publique 2010". RESULTS: The GDM risk was significantly greater for patients with 25OHD levels <20 ng/mL (OR = 1∙42, 95% CI 1∙06-1∙91; p = 0∙021). However, there was no significant relationship with other thresholds. The study of 25OHD levels with the more precise cutting of 5 units intervals showed a variable relationship with GDM risk, as the risk was low for very low 25OHD levels, increased for moderated levels, decreased for normal levels, and finally increased for higher levels. CONCLUSION: According to our study, there seems to be no linear relationship between GDM and 25OHD levels in the first trimester of pregnancy since GDM risk does not continuously decrease as 25OHD concentrations increase. Our results most probably highlight the absence of an association between 25OHD levels and GDM risk.
BACKGROUND & AIMS:Gestational diabetes mellitus (GDM) is one of the most frequent medical complications during pregnancy. It has been associated with many adverse pregnancy, fetal and neonatal outcomes, as well as with an increased risk for mothers and children in the long term. There is a growing interest in vitamin D and its potential role in the development of metabolic disorders. However, the medical literature is not consensual. The aim of this study was to assess the risk of GDM according to vitamin D status during the first trimester. METHODS: This study is a nested case-control study performed from a multicenter prospective observational cohort of pregnant women assessed for 25-hydroxyvitamin D levels (25OHD). Three hundred ninety-three patients were included in the initial cohort. After applying exclusion criteria, a total of 1191 pregnant women were included. Two hundred fifty women with GDM (cases) were matched to 941 women without GDM (controls) for parity, age, body mass index before pregnancy, the season of conception, and phototype. This study was funded by a grant from the "Programme Hospitalier de Recherche Publique 2010". RESULTS: The GDM risk was significantly greater for patients with 25OHD levels <20 ng/mL (OR = 1∙42, 95% CI 1∙06-1∙91; p = 0∙021). However, there was no significant relationship with other thresholds. The study of 25OHD levels with the more precise cutting of 5 units intervals showed a variable relationship with GDM risk, as the risk was low for very low 25OHD levels, increased for moderated levels, decreased for normal levels, and finally increased for higher levels. CONCLUSION: According to our study, there seems to be no linear relationship between GDM and 25OHD levels in the first trimester of pregnancy since GDM risk does not continuously decrease as 25OHD concentrations increase. Our results most probably highlight the absence of an association between 25OHD levels and GDM risk.