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Keller A, Varela Vazquez C, Dangol R, Damm P, Heitmann BL, Händel MN. The Role of Vitamin D in the Development of Diabetes Post Gestational Diabetes Mellitus: A Systematic Literature Review. Nutrients 2020; 12:nu12061733. [PMID: 32531957 PMCID: PMC7352830 DOI: 10.3390/nu12061733] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/31/2020] [Accepted: 06/01/2020] [Indexed: 12/16/2022] Open
Abstract
Women diagnosed with gestational diabetes mellitus (GDM) are more likely to later develop diabetes. Evidence from some previous reviews suggests that low vitamin D status during pregnancy increases the risk of developing GDM, but whether vitamin D during pregnancy also influences the risk of diabetes post GDM is less well studied. Thus, the aim of this systematic literature review was to summarize the current available literature on that topic. This review considered observational studies and randomized controlled trials (RCTs). Five databases were searched. The risk of bias of the included studies was assessed. A total of six studies were included: three observational studies and three RCTs. Findings were inconsistent across the six included studies. However, when considering RCTs only, the findings more strongly suggested that vitamin D supplementation during and after pregnancy did not have an influence on markers of diabetes development or diabetes development post GDM. This systematic review highlights inconsistent findings on the associations between vitamin D supplementation or concentration during and after pregnancy and markers of diabetes development or diabetes development post GDM; and although results from randomized interventional studies more strongly suggested no associations, the conclusion holds a high degree of uncertainty.
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Affiliation(s)
- Amélie Keller
- Research Unit for Dietary Studies at The Parker Institute, Bispebjerg and Frederiksberg Hospital, Part of the Copenhagen University Hospital, 2000 Frederiksberg, Denmark; (C.V.V.); (R.D.); (B.L.H.); (M.N.H.)
- Correspondence: ; Tel.: +45-35-327-848
| | - Carmen Varela Vazquez
- Research Unit for Dietary Studies at The Parker Institute, Bispebjerg and Frederiksberg Hospital, Part of the Copenhagen University Hospital, 2000 Frederiksberg, Denmark; (C.V.V.); (R.D.); (B.L.H.); (M.N.H.)
- Department of Clinical Psychology and Psychobiology, University of Barcelona, 08035 Barcelona, Spain
| | - Rojina Dangol
- Research Unit for Dietary Studies at The Parker Institute, Bispebjerg and Frederiksberg Hospital, Part of the Copenhagen University Hospital, 2000 Frederiksberg, Denmark; (C.V.V.); (R.D.); (B.L.H.); (M.N.H.)
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet, 2100 Copenhagen, Denmark;
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Berit Lilienthal Heitmann
- Research Unit for Dietary Studies at The Parker Institute, Bispebjerg and Frederiksberg Hospital, Part of the Copenhagen University Hospital, 2000 Frederiksberg, Denmark; (C.V.V.); (R.D.); (B.L.H.); (M.N.H.)
- Department of Public Health, Section for General Practice, University of Copenhagen, 2014 Copenhagen, Denmark
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia
| | - Mina Nicole Händel
- Research Unit for Dietary Studies at The Parker Institute, Bispebjerg and Frederiksberg Hospital, Part of the Copenhagen University Hospital, 2000 Frederiksberg, Denmark; (C.V.V.); (R.D.); (B.L.H.); (M.N.H.)
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Relationship between vitamin D status in the first trimester of pregnancy and gestational diabetes mellitus - A nested case-control study. Clin Nutr 2020; 40:79-86. [PMID: 32448701 DOI: 10.1016/j.clnu.2020.04.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 03/09/2020] [Accepted: 04/19/2020] [Indexed: 02/08/2023]
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.
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Assessing a method and reference material for quantification of vitamin D binding protein during pregnancy. CLINICAL MASS SPECTROMETRY 2020; 16:11-17. [DOI: 10.1016/j.clinms.2020.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 01/07/2020] [Accepted: 01/20/2020] [Indexed: 12/28/2022]
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Grant WB, Al Anouti F, Moukayed M. Targeted 25-hydroxyvitamin D concentration measurements and vitamin D 3 supplementation can have important patient and public health benefits. Eur J Clin Nutr 2020; 74:366-376. [PMID: 31996793 DOI: 10.1038/s41430-020-0564-0] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/08/2020] [Accepted: 01/15/2020] [Indexed: 02/06/2023]
Abstract
Over the past two decades, many studies reported the benefits of higher 25-hydroxyvitamin D [25(OH)D] concentrations for nonskeletal effects. Researchers found significant benefits in reducing risk of acute respiratory tract infections, many types of cancer, type 2 diabetes mellitus, premature death, and adverse pregnancy and birth outcomes. In addition, 25(OH)D concentrations are low for various reasons in several categories of people, including the obese, those with dark skin living at higher latitudes, the elderly, and those who do not eat much eggs, fish, meat, or vitamin D fortified milk. Measuring 25(OH)D concentrations is one way to both increase the awareness of vitamin D's importance in maintaining good health and to encourage vitamin D supplementation or increased solar ultraviolet-B exposure to sustain well-being throughout life by reducing disease incidence. Although 20 ng/ml seems adequate to reduce risk of skeletal problems and acute respiratory tract infections, concentrations above 30 ng/ml have been associated with reduced risk of cancer, type 2 diabetes mellitus, and adverse pregnancy and birth outcomes. Thus, judicious testing of 25(OH)D concentrations could reduce disease incidence and make treatment expenditures more cost-effective.
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Affiliation(s)
- William B Grant
- Director, Sunlight, Nutrition and Health Research Center, P.O. Box 641603, San Francisco, CA, 94164-1603, USA.
| | - Fatme Al Anouti
- College of Natural and Health Sciences, Department of Public Health and Nutrition, Zayed University, P.O. Box 4783, Abu Dhabi, UAE
| | - Meis Moukayed
- School of Arts and Sciences, American University in Dubai, P.O. Box 28282, Dubai, UAE
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Jin S, Sha L, Dong J, Yi J, Liu Y, Guo Z, Hu B. Effects of Nutritional Strategies on Glucose Homeostasis in Gestational Diabetes Mellitus: A Systematic Review and Network Meta-Analysis. J Diabetes Res 2020; 2020:6062478. [PMID: 32185236 PMCID: PMC7060856 DOI: 10.1155/2020/6062478] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 02/03/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy, and nutritional therapy is the basis of GDM treatment. However, the effects of different forms of nutritional supplementation on improving gestational diabetes are uncertain. OBJECTIVE We conducted a network meta-analysis to evaluate the effects of supplementation with different nutrients on glucose metabolism in women with GDM. METHODS We conducted a literature search using PubMed, EMBASE, and the Cochrane Library to identify randomized controlled trials (RCTs) comparing the differences between different nutritional strategies in women with GDM. The Cochrane tool was used to assess the risk of bias. Pairwise meta-analysis and network meta-analysis were used to compare and rank the effects of nutritional strategies for the improvement of fasting plasma glucose (FPG), serum insulin, and homeostasis model assessment-insulin resistance (HOMA-IR). RESULTS We included thirteen RCTs with a total of 754 participants. Compared with placebo, omega-3, magnesium, vitamin D, zinc, and probiotics were more beneficial for improving FPG, serum insulin, and HOMA-IR. Network analysis showed that vitamin D supplementation was superior to omega-3 (-3.64 mg/dL, 95% CI: -5.77 to -1.51), zinc (-5.71 mg/dL, 95% CI: -10.19 to -1.23), probiotics (-6.76 mg/dL, 95% CI: -10.02 to -3.50), and placebo (-12.13 mg/dL, 95% CI: -14.55 to -9.70) for improving FPG. Magnesium supplementation was more beneficial for decreasing serum insulin compared with probiotics (-5.10 μIU/mL, 95% CI: -9.32 to -0.88) and placebo (-7.80 μIU/mL, 95% CI: -9.32 to -0.88) and placebo (-7.80 . CONCLUSION Vitamin D supplementation significantly reduced FPG and regulated HOMA-IR. Magnesium supplementation was superior in decreasing serum insulin than supplementation with other nutrients. Nutrient supplementation seemed to have an effect on glucose homeostasis maintenance in patients with GDM and may be considered an adjunctive therapy.
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Affiliation(s)
- Shixiao Jin
- Department of Nursing, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, China
| | - Liyan Sha
- Department of Nursing, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, China
| | - Jianli Dong
- Department of International Medicine, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, China
| | - Jing Yi
- Department of Nursing, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, China
| | - Yang Liu
- Department of Nursing, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, China
| | - Zhongxian Guo
- Department of Nursing, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, China
| | - Bing Hu
- Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Dalian Medical University, Dalian 116000, China
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Harreiter J, Desoye G, van Poppel MNM, Kautzky-Willer A, Dunne F, Corcoy R, Devlieger R, Simmons D, Adelantado JM, Damm P, Mathiesen ER, Jensen DM, Anderson LLT, Lapolla A, Dalfrà MG, Bertolotto A, Wender-Ozegowska E, Zawiejska A, Hill DJ, Snoek FJ. The Effects of Lifestyle and/or Vitamin D Supplementation Interventions on Pregnancy Outcomes: What Have We Learned from the DALI Studies? Curr Diab Rep 2019; 19:162. [PMID: 31845115 DOI: 10.1007/s11892-019-1282-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW The DALI (vitamin D and lifestyle intervention in the prevention of gestational diabetes mellitus (GDM)) study aimed to prevent GDM with lifestyle interventions or Vitamin D supplementation (1600 IU/day). This review summarizes the learnings from the DALI studies among pregnant women with a BMI ≥ 29 kg/m2. RECENT FINDINGS Women diagnosed with GDM earlier in pregnancy had a worse metabolic profile than those diagnosed later. A combined physical activity (PA) and healthy eating (HE) lifestyle intervention improved both behaviours, limited gestational weight gain (GWG) and was cost-effective. Although GDM risk was unchanged, neonatal adiposity was reduced due to less sedentary time. Neither PA nor HE alone limited GWG or GDM risk. Fasting glucose was higher with HE only intervention, and lower with Vitamin D supplementation. Our combined intervention did not prevent GDM, but was cost-effective, limited GWG and reduced neonatal adiposity.
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Affiliation(s)
- Jürgen Harreiter
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Gernot Desoye
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | | | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | | | - Rosa Corcoy
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Roland Devlieger
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - David Simmons
- Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, England.
- School of Medicine, Macarthur Clinical School, Western Sydney University, Locked Bag 1797, Campbelltown, NSW, 2751, Australia.
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Li S, Hou Y, Yan X, Wang Y, Shi C, Wu X, Liu H, Zhang L, Zhang X, Liu J, Zhang M, Zhang Q, Tang N. Joint effects of folate and vitamin B 12 imbalance with maternal characteristics on gestational diabetes mellitus. J Diabetes 2019; 11:744-751. [PMID: 30614647 DOI: 10.1111/1753-0407.12899] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 12/14/2018] [Accepted: 01/03/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND This study examined whether folate and vitamin B12 imbalance is associated with gestational diabetes mellitus (GDM) and explored interactions between B vitamin imbalance and maternal risk factors for GDM. METHODS A cross-sectional study was performed in 406 Chinese pregnant women. Serum folate, vitamin B12 , and blood glucose concentrations were measured at 24 to 28 weeks gestation during GDM screening. A diagnosis of GDM was made based on International Association of Diabetes and Pregnancy Study Groups criteria (fasting plasma glucose [FPG] ≥5.1 mM, 1-hour plasma glucose ≥10.0 mM, or 2-hour plasma glucose ≥8.5 mM). Binary logistic regression was used to obtain odds ratios (ORs) after controlling for different confounders. RESULTS Higher folate levels were associated with higher glucose concentrations and a higher risk of GDM (OR 1.98; 95% confidence interval [CI] 1.00-3.90), whereas higher vitamin B12 levels were associated with lower FPG and a lower risk of GDM (OR 0.30; 95% CI 0.15-0.60). A higher folate: vitamin B12 ratio was associated with higher glucose and a higher risk of GDM (OR 3.08; 95% CI 1.63-5.83). The presence of both a higher folate: vitamin B12 ratio and advanced age further increased the OR to 2.13 (95% CI 1.09-4.15) with a significant additive interaction. Furthermore, a higher folate: vitamin B12 ratio and a higher prepregnancy body mass index (pp-BMI) were synergistically associated with an increased risk of GDM (OR 3.03; 95% CI 1.40-6.57). CONCLUSIONS An imbalance between folate and vitamin B12 , represented by a higher folate: vitamin B12 ratio, was highly associated with GDM risk, and this association could be further modified by maternal age and pp-BMI.
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Affiliation(s)
- Shuying Li
- Key Laboratory of Hormones and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Yaxing Hou
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xinxin Yan
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yuwen Wang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Chen Shi
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xiaoyan Wu
- Beichen District Women's and Children's Health Center, Tianjin, China
| | - Huihuan Liu
- Beichen District Women's and Children's Health Center, Tianjin, China
| | - Liwen Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xumei Zhang
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Juan Liu
- Department of Biomedical Information and Library, Tianjin Medical University, Tianjin, China
| | - Ming Zhang
- Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Qiang Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Naijun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
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Can a Simple Dietary Screening in Early Pregnancy Identify Dietary Habits Associated with Gestational Diabetes? Nutrients 2019; 11:nu11081868. [PMID: 31405206 PMCID: PMC6722606 DOI: 10.3390/nu11081868] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/04/2019] [Accepted: 08/09/2019] [Indexed: 12/05/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is predominantly a lifestyle disease, with diet being an important modifiable risk factor. A major obstacle for the prevention in clinical practice is the complexity of assessing diet. In a cohort of 1651 Icelandic women, this study examined whether a short 40-item dietary screening questionnaire administered in the 1st trimester could identify dietary habits associated with GDM. The dietary variables were aggregated into predefined binary factors reflecting inadequate or optimal intake and stepwise backward elimination was used to identify a reduced set of factors that best predicted GDM. Those binary factors were then aggregated into a risk score (range: 0–7), that was mostly characterised by frequent consumption of soft drinks, sweets, cookies, ice creams and processed meat. The women with poor dietary habits (score ≥ 5, n = 302), had a higher risk of GDM (RR = 1.38; 95%CI = 3, 85) compared with women with a more optimal diet (score ≤ 2, n = 407). In parallel, a pilot (n = 100) intervention was conducted among overweight and obese women examining the effect of internet-based personalized feedback on diet quality. Simple feedback was given in accordance with the answers provided in the screening questionnaire in 1st trimester. At the endpoint, the improvements in diet quality were observed by, as an example, soft drink consumption being reduced by ~1 L/week on average in the intervention group compared to the controls. Our results suggest that a simple dietary screening tool administered in the 1st trimester could identify dietary habits associated with GMD. This tool should be easy to use in a clinical setting, and with simple individualized feedback, improvements in diet may be achieved.
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A simple model to predict risk of gestational diabetes mellitus from 8 to 20 weeks of gestation in Chinese women. BMC Pregnancy Childbirth 2019; 19:252. [PMID: 31324151 PMCID: PMC6642502 DOI: 10.1186/s12884-019-2374-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 06/24/2019] [Indexed: 12/25/2022] Open
Abstract
Background Gestational diabetes mellitus (GDM) is associated with adverse perinatal outcomes. Screening for GDM and applying adequate interventions may reduce the risk of adverse outcomes. However, the diagnosis of GDM depends largely on tests performed in late second trimester. The aim of the present study was to bulid a simple model to predict GDM in early pregnancy in Chinese women using biochemical markers and machine learning algorithm. Methods Data on a total of 4771 pregnant women in early gestation were used to fit the GDM risk-prediction model. Predictive maternal factors were selected through Bayesian adaptive sampling. Selected maternal factors were incorporated into a multivariate Bayesian logistic regression using Markov Chain Monte Carlo simulation. The area under receiver operating characteristic curve (AUC) was used to assess discrimination. Results The prevalence of GDM was 12.8%. From 8th to 20th week of gestation fasting plasma glucose (FPG) levels decreased slightly and triglyceride (TG) levels increased slightly. These levels were correlated with those of other lipid metabolites. The risk of GDM could be predicted with maternal age, prepregnancy body mass index (BMI), FPG and TG with a predictive accuracy of 0.64 and an AUC of 0.766 (95% CI 0.731, 0.801). Conclusions This GDM prediction model is simple and potentially applicable in Chinese women. Further validation is necessary. Electronic supplementary material The online version of this article (10.1186/s12884-019-2374-8) contains supplementary material, which is available to authorized users.
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Long-term vitamin D and high-dose n-3 fatty acids' supplementation improve markers of cardiometabolic risk in type 2 diabetic patients with CHD. Br J Nutr 2019; 122:423-430. [PMID: 31309919 DOI: 10.1017/s0007114519001132] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This study was performed to evaluate the effects of vitamin D and n-3 fatty acids' co-supplementation on markers of cardiometabolic risk in diabetic patients with CHD. This randomised, double-blinded, placebo-controlled trial was conducted among sixty-one vitamin D-deficient diabetic patients with CHD. At baseline, the range of serum 25-hydroxyvitamin D levels in study participants was 6·3-19·9 ng/ml. Subjects were randomly assigned into two groups either taking 50 000 IU vitamin D supplements every 2 weeks plus 2× 1000 mg/d n-3 fatty acids from flaxseed oil (n 30) or placebo (n 31) for 6 months. Vitamin D and n-3 fatty acids' co-supplementation significantly reduced mean (P = 0·01) and maximum levels of left carotid intima-media thickness (CIMT) (P = 0·004), and mean (P = 0·02) and maximum levels of right CIMT (P = 0·003) compared with the placebo. In addition, co-supplementation led to a significant reduction in fasting plasma glucose (β -0·40 mmol/l; 95 % CI -0·77, -0·03; P = 0·03), insulin (β -1·66 μIU/ml; 95 % CI -2·43, -0·89; P < 0·001), insulin resistance (β -0·49; 95 % CI -0·72, -0·25; P < 0·001) and LDL-cholesterol (β -0·21 mmol/l; 95 % CI -0·41, -0·01; P = 0·04), and a significant increase in insulin sensitivity (β +0·008; 95 % CI 0·004, 0·01; P = 0·001) and HDL-cholesterol (β +0·09 mmol/l; 95 % CI 0·01, 0·17; P = 0·02) compared with the placebo. Additionally, high-sensitivity C-reactive protein (β -1·56 mg/l; 95 % CI -2·65, -0·48; P = 0·005) was reduced in the supplemented group compared with the placebo group. Overall, vitamin D and n-3 fatty acids' co-supplementation had beneficial effects on markers of cardiometabolic risk.
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Association between vitamin D status during pregnancy and total gestational weight gain and postpartum weight retention: a prospective cohort. Eur J Clin Nutr 2019; 74:126-134. [PMID: 31308475 DOI: 10.1038/s41430-019-0465-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/05/2019] [Accepted: 06/19/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To evaluate the association between vitamin D status during pregnancy and total gestational weight gain (GWG), GWG rates and postpartum weight retention. METHODS Prospective cohort of 163 women from Rio de Janeiro was followed at 5th-13th (baseline), 20th-26th, 30th-36th gestational weeks and at 30-62 days postpartum. Plasma 25-hydroxyvitamin D [25(OH)D] was evaluated during each trimester and was categorized as adequate (≥50 nmol/L) or inadequate (<50 nmol/L). GWG (kg) was calculated as the difference between the weight measured at baseline and 36th-42th gestational weeks. GWG rates (kg/week) were calculated between each visit. Postpartum weight retention (kg) was analysed as the difference between weights measured at 30-62 days postpartum and 5th-13th gestational weeks. Statistical analyses were performed using linear regression models that included interaction terms between vitamin D status and first trimester body mass index (BMI) (<25/≥25 kg/m2). Confounders were selected based on a directed acyclic graph. RESULTS The prevalence of vitamin D inadequacy was 16.6%, 9.9% and 10.6% in the first, second and third trimesters, respectively. Overweight women with vitamin D inadequacy in the first (β = 3.70; 95% CI 0.09; 7.31, p-value = 0.045) and third trimester (β = 4.59, 95% CI 0.07; 9.10, p-value = 0.047) presented higher increases in total GWG than did women with vitamin D adequacy. This association was also observed between first trimester vitamin D status and GWG rates between visits 1 and 2 (β = 0.17; 95% CI 0.13; 0.36, p-value = 0.07). CONCLUSIONS There was an interaction effect of first trimester BMI (≥25 kg/m2) on the association between first and third trimester vitamin D status and GWG.
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Current Resources for Evidence-Based Practice, July 2019. J Obstet Gynecol Neonatal Nurs 2019; 48:478-491. [PMID: 31194933 DOI: 10.1016/j.jogn.2019.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ojo O, Weldon SM, Thompson T, Vargo EJ. The Effect of Vitamin D Supplementation on Glycaemic Control in Women with Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101716. [PMID: 31100793 PMCID: PMC6572053 DOI: 10.3390/ijerph16101716] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 05/12/2019] [Accepted: 05/14/2019] [Indexed: 12/25/2022]
Abstract
Vitamin D deficiency is highly prevalent amongst pregnant women and is linked to a range of adverse complications, including gestational diabetes. However, there is no consensus among researchers regarding the impact of vitamin D supplementation in alleviating adverse effects in gestational diabetes. The objective of this systematic review and meta-analysis was to determine whether supplementation of vitamin D given to women with gestational diabetes can promote glycaemic control. EMBASE and PubMed were searched up to November, 2018. The selection criteria included randomised controlled trials of the effect of vitamin D supplementation (1000-4762 IU/day) on pregnant women with gestational diabetes mellitus. Study data and outcome measures (fasting blood glucose, glycated haemoglobin and serum insulin) were extracted from included studies. Random-effects models were used for meta-analyses. Heterogeneity tests, and analysis of the risk of bias were conducted. Most of the studies were graded as having either low risk or moderate risk of bias although two studies had a high risk of bias in the areas of blinding of participants and personnel, and incomplete outcome data. On the other hand, the heterogeneity statistic (I2) ranged from 0-41% in the studies included. Five randomised controlled trials were selected for this review and meta-analysis (involving a total of 173 participants supplemented with vitamin D and 153 participants as control drawn from the studies). Vitamin D supplementation was associated with a decrease in fasting blood glucose by a mean of 0.46 mmol/L (-0.68, -0.25) (p < 0.001), glycated haemoglobin by a mean of 0.37% (-0.65, -0.08) (p < 0.01) and serum insulin concentration by mean of 4.10 µIU/mL (-5.50, -2.71) (p < 0.001) compared to controls. This review shows evidence that vitamin D supplementation has the potential to promote glycaemic control in women with Gestational Diabetes Mellitus (GDM). However, due to the limited number of studies in the meta-analysis, the conclusion should be interpreted with caution. Further studies are needed to fully understand the exact mechanism by which vitamin D influences glucose metabolism.
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Affiliation(s)
- Omorogieva Ojo
- Department of Adult Nursing and Paramedic Science, University of Greenwich, London SE9 2UG, UK.
| | - Sharon M Weldon
- Department of Adult Nursing and Paramedic Science, University of Greenwich, London SE9 2UG, UK.
- Barts Health NHS Trust, The Royal London Hospital, Whitechapel Rd, Whitechapel E1 1BB, UK.
| | - Trevor Thompson
- Department of Psychology, University of Greenwich, London SE10 9LS, UK.
| | - Elisabeth J Vargo
- Department of Adult Nursing and Paramedic Science, University of Greenwich, London SE9 2UG, UK.
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The DALI vitamin D randomized controlled trial for gestational diabetes mellitus prevention: No major benefit shown besides vitamin D sufficiency. Clin Nutr 2019; 39:976-984. [PMID: 31053513 DOI: 10.1016/j.clnu.2019.04.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS As vitamin D deficiency is associated with an increased risk of gestational diabetes mellitus (GDM), we aimed to test vitamin D supplementation as a strategy to reduce GDM risk (evaluated after fasting plasma glucose (FPG), insulin resistance and weight gain) in pregnant overweight/obese women. METHODS The DALI vitamin D multicenter study enrolled women with prepregnancy body mass index (BMI) ≥ 29 kg/m2, ≤19 + 6 weeks of gestation and without GDM. Participants were randomized to receive 1600 IU/day vitamin D3 or placebo (each with or without lifestyle intervention) on top of (multi)vitamins supplements. Women were assessed for vitamin D status (sufficiency defined as serum 25-hydroxyvitamin D (25(OH)D) ≥ 50 nmol/l), FPG, insulin resistance and weight at baseline, 24-28 and 35-37 weeks. Linear or logistic regression analyses were performed to assess intervention effects. RESULTS Average baseline serum 25(OH)D was ≥50 nmol/l across all study sites. In the vitamin D intervention arm (n = 79), 97% of participants achieved target serum vitamin 25(OH)D (≥50 nmol/l) at 24-28 weeks and 98% at 35-37 weeks vs 74% and 78% respectively in the placebo arm (n = 75, p < 0.001). A small but significantly lower FPG (-0.14 mmol/l; CI95 -0.28, -0.00) was observed at 35-37 weeks with the vitamin D intervention without any additional difference in metabolic status, perinatal outcomes or adverse event rates. CONCLUSION In the DALI vitamin D trial, supplementation with 1600 IU vitamin D3/day achieved vitamin D sufficiency in virtually all pregnant women and a small effect in FPG at 35-37 weeks. The potential of vitamin D supplementation for GDM prevention in vitamin D sufficient populations appears to be limited. TRIAL REGISTRATION NUMBER ISRCTN70595832.
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Ciebiera M, Wojtyła C, Łukaszuk K, Zgliczyńska M, Zaręba K, Rawski W, Jakiel G. The role of vitamin D in perinatology. An up-to-date review. Arch Med Sci 2019; 17:992-1005. [PMID: 34336027 PMCID: PMC8314414 DOI: 10.5114/aoms.2019.81747] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 07/05/2018] [Indexed: 02/06/2023] Open
Abstract
The role of vitamin D in perinatology is a subject of major interest in current medicine. There is growing evidence about the role of maternal vitamin D levels in pregnancy outcomes. The aim of this review is to summarize the current literature about the role of vitamin D in perinatology. Evidence from this review suggests associations between low levels of maternal vitamin D and higher risk of certain obstetrical complications. Vitamin D has been found to be related to preeclampsia, gestational diabetes mellitus, low birth weight, and preterm birth. The current literature supports vitamin D supplementation in pregnant women, but more high-quality data are necessary. The problem that remains is how to achieve an optimal 25-hydroxyvitamin D level. To determine the real benefits of vitamin D supplementation in pregnancy, we need high-quality trials in larger groups.
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Affiliation(s)
- Michał Ciebiera
- Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Cezary Wojtyła
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
- European Observatory of Health Inequalities, State University of Applied Sciences, Kalisz, Poland
| | - Krzysztof Łukaszuk
- Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
| | - Magdalena Zgliczyńska
- Students’ Scientific Association at the First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Kornelia Zaręba
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Wojciech Rawski
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Grzegorz Jakiel
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
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Khorasani ZM, Bonakdaran S, Rafieie HP. The Relationship Between Vitamin D Deficiency and Insulin Resistance in Pregnant Women with Gestational Diabetes. Curr Diabetes Rev 2019; 15:414-419. [PMID: 30387399 DOI: 10.2174/1573399814666181102100816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/16/2018] [Accepted: 10/29/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diabetes Mellitus is one of the most common medical disorders in pregnancy. The possibility of vitamin D deficiency as a pathogenesis for impaired glucose tolerance tests show a probable role of vitamin D in insulin secretion and reduction of insulin resistance. This study was assigned to evaluate relation between serum vitamin D level and insulin resistance in Gestational Diabetes Mellitus (GDM). METHODS This cross sectional study was done throughout one year between 2015-2016 in GDM patients (age, 20-40 years). After history taking and physical examination, the laboratory tests including : Fasting Blood Sugar (FBS), Glucose Tolerance Test (GTT), calcium, phosphorous, parathormone, 25(OH) vitamin D, insulin, HbA1C, TG, LDL, HDL were performed for all patients. Insulin resistance was calculated according to HOMA-IR formula. Vitamin D level was compared between patients with and without insulin resistance. RESULTS This research was performed in 93 GDM patients with average age (30.3 ± 5.6). Thirty eight patients with insulin resistance and 55 patients without insulin resistance were detected. The prevalence of vitamin D deficiency was 91.4% in all patients. There was no significant difference in vitamin D levels between insulin resistant and non insulin resistant group (P-value=0.51). In all variable parameters, only FBS and triglyceride level in insulin resistant group were more than non insulin resistant group (P-value<0.05). CONCLUSION Obtained results showed not significant relationship between vitamin D deficiency and insulin resistance in GDM patients.
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Affiliation(s)
| | - Shokoufeh Bonakdaran
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hasan Pour Rafieie
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Zhu B, Huang K, Yan S, Hao J, Zhu P, Chen Y, Ye A, Tao F. VDR Variants rather than Early Pregnancy Vitamin D Concentrations Are Associated with the Risk of Gestational Diabetes: The Ma'anshan Birth Cohort (MABC) Study. J Diabetes Res 2019; 2019:8313901. [PMID: 31341914 PMCID: PMC6613005 DOI: 10.1155/2019/8313901] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/14/2019] [Accepted: 06/17/2019] [Indexed: 12/13/2022] Open
Abstract
AIM This study investigated the associations among early pregnancy vitamin D concentrations, seasonality, and vitamin D metabolic gene variants and how these variables related alone and in interaction with the risk of gestational diabetes mellitus (GDM). METHODS Research participants were women from the Ma'anshan birth cohort study in China. The overall study included 3110 women to explore the association between early pregnancy vitamin D concentrations and the risk of GDM. In the current analysis, a nested case-control study of 274 GDM cases and 380 controls was conducted to investigate seven vitamin D metabolic gene variants and the risk of GDM. Vitamin D concentrations were measured by radioimmunoassay. Genotypes were determined by improved multiple ligase detection reaction. Interactions between genetic variants and vitamin D as predictors of the risk of GDM were evaluated by a pair-wise analysis under a multiplicative interaction model. RESULTS Vitamin D concentrations were not significantly associated with the risk of GDM (OR = 0.79, 95% CI = 0.55-1.13) after adjusting for seasonality. Fall-winter conceptions had a 37% decreased risk of GDM compared with spring-summer conceptions (OR = 0.63, 95% CI = 0.49-0.81), independent of vitamin D concentrations. Two VDR gene variants rs1544410 (OR = 2.03, 95% CI = 1.17-3.51 for CT versus CC) and rs731236 (OR = 2.42, 95% CI = 1.29-4.55 for GA versus AA) were significantly associated with the risk of GDM. No interactions among genetic variants and vitamin D concentrations were detected. CONCLUSION Early pregnancy vitamin D insufficiency or deficiency was not significantly associated with the risk of GDM. The results of this study emphasize the importance of genetic variants in VDR and conception season as factors that affect the risk of GDM.
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Affiliation(s)
- Beibei Zhu
- Department of Maternal, Child & Adolescent Health, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, China
| | - Kun Huang
- Department of Maternal, Child & Adolescent Health, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, China
| | - Shuangqin Yan
- Ma'anshan Maternal and Child Health Care Center, Ma'anshan, China
| | - Jiahu Hao
- Department of Maternal, Child & Adolescent Health, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, China
| | - Peng Zhu
- Department of Maternal, Child & Adolescent Health, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, China
| | - Yao Chen
- Department of Maternal, Child & Adolescent Health, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, China
| | - Aoxing Ye
- Department of Maternal, Child & Adolescent Health, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, China
| | - Fangbiao Tao
- Department of Maternal, Child & Adolescent Health, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, China
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Keller A, Stougård M, Frederiksen P, Thorsteinsdottir F, Vaag A, Damm P, Jacobsen R, L Heitmann B. In utero exposure to extra vitamin D from food fortification and the risk of subsequent development of gestational diabetes: the D-tect study. Nutr J 2018; 17:100. [PMID: 30388966 PMCID: PMC6215342 DOI: 10.1186/s12937-018-0403-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 10/14/2018] [Indexed: 12/14/2022] Open
Abstract
Background The primary aim of this study was to assess whether exposure during fetal life to extra vitamin D from food fortification was associated with a reduction in the risk of subsequently developing gestational diabetes mellitus (GDM). Furthermore, we examined whether the effect of the vitamin D from fortification differed by women’s season of birth. Methods This semi-ecological study is based on the cancellation in 1985 of the mandatory policy to fortify margarine with vitamin D in Denmark, with inclusion of entire national adjacent birth cohorts either exposed or unexposed to extra vitamin D in utero. The identification of GDM cases later in life among both exposure groups was based on the Danish national health registers. Logistic regression analyses generating odds ratios (ORs) and 95% confidence intervals (95% CIs) were performed. Results Women who were prenatally exposed to the extra vitamin D from fortification tended to have a lower risk of subsequently developing GDM than unexposed women (OR 0.87, 95%CI 0.74,1.02, P = 0.08). When analyses were stratified by women’s season of birth, exposed women born in spring had a lower risk of developing GDM compared to unexposed subjects (OR 0.68, 95%CI 0.50,0.94, p = 0.02). Conclusion This study suggests that prenatal exposure to extra vitamin D from mandatory fortification may lower the risk of developing gestational diabetes among spring-born women. Trial registration This study is part of the D-tect project, which is registered on clinicaltrials.gov: NCT03330301. Electronic supplementary material The online version of this article (10.1186/s12937-018-0403-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Amélie Keller
- Research Unit for Dietary Studies at The Parker Institute Bispebjerg and Frederiksberg Hospital, part of the Copenhagen University Hospital - The capital Region, Nordre Fasanvej 57, vej 8, entrance 11, 2000, Frederiksberg, Denmark.
| | - Maria Stougård
- Research Unit for Dietary Studies at The Parker Institute Bispebjerg and Frederiksberg Hospital, part of the Copenhagen University Hospital - The capital Region, Nordre Fasanvej 57, vej 8, entrance 11, 2000, Frederiksberg, Denmark
| | - Peder Frederiksen
- Research Unit for Dietary Studies at The Parker Institute Bispebjerg and Frederiksberg Hospital, part of the Copenhagen University Hospital - The capital Region, Nordre Fasanvej 57, vej 8, entrance 11, 2000, Frederiksberg, Denmark
| | - Fanney Thorsteinsdottir
- Research Unit for Dietary Studies at The Parker Institute Bispebjerg and Frederiksberg Hospital, part of the Copenhagen University Hospital - The capital Region, Nordre Fasanvej 57, vej 8, entrance 11, 2000, Frederiksberg, Denmark
| | - Allan Vaag
- Cardiovascular, Renal and Metabolic Disease (CVRM) Translational Medicine Unit, Early Clinical Development, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ramune Jacobsen
- Research Unit for Dietary Studies at The Parker Institute Bispebjerg and Frederiksberg Hospital, part of the Copenhagen University Hospital - The capital Region, Nordre Fasanvej 57, vej 8, entrance 11, 2000, Frederiksberg, Denmark.,Research Unit for Chronic Conditions, Center of Clinical Research and Prevention, Bispebjerg og Frederiksberg Hospital, Capital Region, Frederiksberg, Denmark
| | - Berit L Heitmann
- Research Unit for Dietary Studies at The Parker Institute Bispebjerg and Frederiksberg Hospital, part of the Copenhagen University Hospital - The capital Region, Nordre Fasanvej 57, vej 8, entrance 11, 2000, Frederiksberg, Denmark.,The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, University of Sydney, Sydney, Australia.,The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.,The Department of Public Health, Section for General Medicine, University of Copenhagen, Copenhagen, Denmark
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Martínez-Domínguez SJ, Tajada M, Chedraui P, Pérez-López FR. Systematic review and meta-analysis of Spanish studies regarding the association between maternal 25-hydroxyvitamin D levels and perinatal outcomes. Gynecol Endocrinol 2018; 34:987-994. [PMID: 29842806 DOI: 10.1080/09513590.2018.1472761] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
Objective: This systematic review and meta-analysis of Spanish studies assessed the association of maternal 25-hydroxyvitamin D [25(OH)D] levels on perinatal outcomes. Methods: PubMed, Cochrane Library, Embase, Scielo, Scopus, and Web of Science research databases were searched from inception through December 30 2017 using the terms 'vitamin D', 'pregnancy', and 'Spain'. Studies that compared first or second half of pregnancy normal 25(OH)D (≥30.0 ng/mL) versus insufficient (20.0-29.9 ng/mL) or deficient (<20.0 ng/mL) circulating levels and perinatal outcomes were systematically extracted. Data are presented as pooled odds ratios and their 95% confidence intervals (CIs) for categorical variables or mean differences and CIs for continuous variables. Risk of bias was evaluated with the Newcastle-Ottawa Scale. Results: Five cohort studies met inclusion criteria. The risk of gestational diabetes mellitus, preeclampsia, preterm birth, and small-for-gestational-age infants, and birthweight was not influenced by first half of pregnancy maternal 25(OH)D levels. In addition, second half of pregnancy 25(OH) levels did not affect birthweight. Conclusion: Maternal 25(OH)D levels during pregnancy did not affect studied perinatal outcomes and birthweight.
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Affiliation(s)
| | - Mauricio Tajada
- a Facultad de Medicina , Universidad de Zaragoza , Zaragoza , Spain
- b Obstetrics Service , Miguel Servet University Hospital , Zaragoza , Spain
| | - Peter Chedraui
- c Institute of Biomedicine, Research Area for Women's Health, Facultad de Ciencias Médicas , Universidad Católica de Santiago de Guayaquil , Guayaquil , Ecuador
- d Facultad de Ciencias de la Salud , Universidad Católica "Nuestra Señora de la Asunción" , Asunción , Paraguay
| | - Faustino R Pérez-López
- a Facultad de Medicina , Universidad de Zaragoza , Zaragoza , Spain
- e Department of Obstetrics and Gynecology , Lozano-Blesa University Hospital , Zaragoza , Spain
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Carlson NS. Current Resources for Evidence-Based Practice, November 2018. J Obstet Gynecol Neonatal Nurs 2018; 47:820-829. [PMID: 30312573 DOI: 10.1016/j.jogn.2018.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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71
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The Role of Vitamin D in Fertility and during Pregnancy and Lactation: A Review of Clinical Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102241. [PMID: 30322097 PMCID: PMC6210343 DOI: 10.3390/ijerph15102241] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 09/29/2018] [Accepted: 09/29/2018] [Indexed: 12/19/2022]
Abstract
Vitamin D deficiency is common and there exists a huge gap between recommended dietary vitamin D intakes and the poor vitamin D supply in the general population. While vitamin D is important for musculoskeletal health, there are accumulating data suggesting that vitamin D may also be important for fertility, pregnancy outcomes and lactation. Significant changes in vitamin D metabolism during pregnancy such as increased production of the “active vitamin D hormone” calcitriol support the important role of vitamin D in this setting. Observational studies show that vitamin D deficiency is a risk marker for reduced fertility and various adverse pregnancy outcomes and is associated with a low vitamin D content of breast milk. Meta-analyses of randomized controlled trials (RCTs) document that physiological vitamin D supplementation during pregnancy is safe and improves vitamin D and calcium status, thereby protecting skeletal health. Although certain RCTs and/or meta-analyses reported some other beneficial effects, it is still not clear whether vitamin D supplementation improves fertility or decreases the risk of adverse pregnancy outcomes such as low birth weight, pre-eclampsia and neonatal mortality, or reduces wheeze/asthma in the infants. Nevertheless, vitamin D supplementation in pregnant women is frequently required to achieve a sufficient vitamin D status as recommended by nutritional vitamin D guidelines. In this review, we provide an overview of systematic reviews, meta-analyses and large trials reporting clinical data on the role of vitamin D for fertility, pregnancy and lactation.
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72
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Lin Z, Wang Y, Zhang B, Jin Z. Association of type 2 diabetes susceptible genes GCKR, SLC30A8, and FTO polymorphisms with gestational diabetes mellitus risk: a meta-analysis. Endocrine 2018; 62:34-45. [PMID: 30091126 DOI: 10.1007/s12020-018-1651-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 06/08/2018] [Indexed: 12/23/2022]
Abstract
PURPOSE Current studies have detected the correlation of polymorphisms in type 2 diabetes susceptible genes GCKR, SLC30A8 and FTO with gestational diabetes mellitus (GDM) risk. However, findings of these studies were incongruous. Hence, we performed an integrated review and meta-analysis for the researches regarding the association of single nucleotide polymorphisms (SNPs) in GCKR, SLC30A8 and FTO genes and GDM risk. METHODS Eligible publications were selected on the basis of several inclusion and exclusion criteria. Correlation between each SNP and GDM risk was estimated by computing odds ratios (ORs) with 95% confidence intervals (95%CIs). RESULTS Consequently, 19 case-control studies (from 16 citations) including 3636 GDM cases and 7229 GDM-free controls were participated in a meta-analysis of seven prevalent SNPs (GCKR rs1260326 and rs780094; SLC30A8 rs13266634 and rs11558471; FTO rs8050136, rs1421085 and rs9939609). Our results demonstrated that the rs780094, rs13266634 and rs9939609 SNPs were significantly associated with GDM risk. In stratified analysis, correlations of rs780094 and rs13266634 SNPs could be observed in Asian and Caucasian subgroups. Moreover, association between rs9939609 SNP and GDM risk was detected in Caucasian subgroup. CONCLUSIONS The GCKR rs780094, SLC30A8 rs13266634 and FTO rs9939609 SNPs were demonstrated to be the potential biomarkers for GDM risk prediction.
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Affiliation(s)
- Ziqi Lin
- Department of Obstetrics and Gynecology, Shengjing Hospital Affiliated to China Medical University, Shenyang, 110004, Liaoning, China
| | - Yue Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital Affiliated to China Medical University, Shenyang, 110004, Liaoning, China
| | - Bao Zhang
- Department of Obstetrics and Gynecology, Shengjing Hospital Affiliated to China Medical University, Shenyang, 110004, Liaoning, China
| | - Zhen Jin
- Department of Obstetrics and Gynecology, Shengjing Hospital Affiliated to China Medical University, Shenyang, 110004, Liaoning, China.
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Dovnik A, Mujezinović F. The Association of Vitamin D Levels with Common Pregnancy Complications. Nutrients 2018; 10:nu10070867. [PMID: 29976852 PMCID: PMC6073751 DOI: 10.3390/nu10070867] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 06/30/2018] [Accepted: 07/03/2018] [Indexed: 12/18/2022] Open
Abstract
The association between vitamin D deficiency and various adverse pregnancy outcomes has been extensively investigated in recent years. The pregnant woman is the only source of vitamin D for the foetus. The main sources of vitamin D for pregnant women are sunlight, fortified dairy products, oily fish and dietary supplements. Vitamin D deficiency during pregnancy has been associated with some adverse neonatal outcomes as well as an increased risk of late pregnancy complications. The outcomes of the published studies investigating preeclampsia and gestational diabetes mellitus vary with some large trials suggesting a potential positive effect of vitamin D supplementation during pregnancy on the decreased risk of these complications. Research also suggests a possible connection between lower vitamin D concentrations and increased risk of preterm labour. In our manuscript, we aim to review the existing literature regarding the prevalence of vitamin D deficiency during pregnancy, the factors associated with vitamin D deficiency, and possible pregnancy complications arising from it.
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Affiliation(s)
- Andraž Dovnik
- University Clinic for Gynaecology and Perinatology, Maribor University Medical Centre, Ljubljanska 5, SI-2000 Maribor, Slovenia.
| | - Faris Mujezinović
- University Clinic for Gynaecology and Perinatology, Maribor University Medical Centre, Ljubljanska 5, SI-2000 Maribor, Slovenia.
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Zhang Y, Gong Y, Xue H, Xiong J, Cheng G. Authors' reply re: Vitamin D and gestational diabetes mellitus: a systematic review based on data free of Hawthorne effect. BJOG 2018; 125:1339-1340. [PMID: 29873173 DOI: 10.1111/1471-0528.15279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Yanbo Zhang
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, Chengdu, China.,School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yunhui Gong
- Department of Obstetrics, West China Women's and Children's Hospital, Sichuan University, Chengdu, China
| | - Hongmei Xue
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, Chengdu, China
| | - Jingyuan Xiong
- Research Centre for Public Health and Preventive Medicine, West China School of Public Health, Sichuan University, Chengdu, China
| | - Guo Cheng
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, Chengdu, China
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Corcoy R, Mendoza LC, Simmons D, Desoye G, Mathiesen ER, Kautzky-Willer A, Damm P, Dunne FP, Wender-Ozegowska E, Lapolla A, van Assche A, Devlieger R, Hill D, Jensen DM, Adelantado JM, Zawiejska A, Bertolotto A, Dalfra MG, Harreiter J, Galjaard S, Andersen LLT, Tanvig M, Jelsma JG, Jans G, Snoek FJ, van Poppel MNM. Re: Vitamin D and gestational diabetes mellitus: a systematic review based on data free of Hawthorne effect. BJOG 2018; 125:1338-1339. [PMID: 29873172 DOI: 10.1111/1471-0528.15278] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Rosa Corcoy
- CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Zaragoza, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Lilian C Mendoza
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - David Simmons
- Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, UK
| | - Gernot Desoye
- Department of Obstetrics and Gynecology, Medizinische Universitaet Graz, Graz, Austria
| | - Elisabeth R Mathiesen
- Departments of Endocrinology and Obstetrics, Centre for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark
| | - Alexandra Kautzky-Willer
- Division of Endocrinology, Department of Medicine III, Gender Medicine Unit, Medical University of Vienna, Vienna, Austria
| | - Peter Damm
- Departments of Endocrinology and Obstetrics, Centre for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark
| | | | - Ewa Wender-Ozegowska
- Division of Reproduction, Medical Faculty I, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Andre van Assche
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Leuven, Belgium
| | - Roland Devlieger
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Leuven, Belgium
| | - David Hill
- Recherche en Santé Lawson SA, St Gallen, Switzerland
| | - Dorte M Jensen
- Department of Endocrinology and Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Juan M Adelantado
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Agnieszka Zawiejska
- Division of Reproduction, Medical Faculty I, Poznan University of Medical Sciences, Poznan, Poland
| | | | | | - Jürgen Harreiter
- Division of Endocrinology, Department of Medicine III, Gender Medicine Unit, Medical University of Vienna, Vienna, Austria
| | - Sander Galjaard
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Leuven, Belgium
| | - Lise Lotte T Andersen
- Department of Endocrinology and Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Mette Tanvig
- Department of Endocrinology and Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Judith G Jelsma
- Department of Public and Occupational Health, Amsterdam Public Health Research institute, VU University Medical Centre, Amsterdam, the Netherlands
| | - Goele Jans
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Leuven, Belgium
| | - Frank J Snoek
- Department of Medical Psychology, VU University Medical Centre and Academic Medical Centre, Amsterdam, the Netherlands
| | - Mireille N M van Poppel
- Department of Public and Occupational Health, Amsterdam Public Health Research institute, VU University Medical Centre, Amsterdam, the Netherlands.,Department of Medical Psychology, VU University Medical Centre and Academic Medical Centre, Amsterdam, the Netherlands
| | -
- CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Zaragoza, Spain
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