Yıl: 2021 Cilt: 21 Sayı: 3 Sayfa Aralığı: 339 - 349 Metin Dili: İngilizce DOI: 10.5505/amj.2021.60234 İndeks Tarihi: 18-02-2022

FIRST-TRIMESTER MATERNAL VITAMIN D LEVELS AND RISK FOR GESTATIONAL DIABETES MELLITUS

Öz:
Objectives: Vitamin D deficiency is linked to increased risk of adverse pregnancy outcomes, fetal and neonatal complications, as well as serious health consequences later in life for both mothers and offspring. However, studies on maternal vitamin D status and risk for gestational diabetes mellitus (GDM) are controversial. This study aimed to retrospectively evaluate the risk for GDM based on maternal serum vitamin D levels. Materials and Methods: After applying the exclusion criteria, a total of 197 pregnant women, including 33 GDM cases and 164 controls, were enrolled in the study. Vitamin D levels were measured at 11–14 weeks of gestation. GDM was diagnosed by performing a 75-g oral glucose tolerance test between 24 and 28 weeks of gestation. Results: BMI was higher in the GDM group than in the non-GDM group (24.68 [21.72–27.64] kg/m2 vs. 22.04 [20.51–24.73] kg/m2, p = 0.004). Vitamin D levels were significantly lower in the GDM group than in the nonGDM group (17.2 [15.6–19.2] nmol/L vs. 33.0 [31.2–35.0] nmol/L, p < 0.001). The prevalence of vitamin D deficiency was as high as 87.88% in the GDM group, with a 67.062-fold higher risk for GDM (odds ratio 67.062, 95% confidence interval 20.904–215.150, p < 0.001). Conclusion: Insufficient vitamin D level in early pregnancy is significantly associated with GDM development. Routine screening for vitamin D deficiency during pregnancy, particularly at the first prenatal visit, may contribute to the identification and better management of GDM and its related adverse outcomes in mothers and offspring.
Anahtar Kelime:

İLK TRİMESTER MATERNAL VİTAMİN D DÜZEYLERİ VE GESTASYONEL DİYABET RİSKİ

Öz:
Amaç: Vitamin D eksikliği; artmış advers gebelik sonuçları, fetal neonatal komplikasyonlar ve anne yenidoğanın ilerideki yaşamlarındaki ciddi sağlık sorunları ile ilişkilidir. Bununla birlikte maternal vitamin D statüsünün gestasyonel diyabet (GDM) riski ile ilişkisini araştıran çalışma sonuçları çelişkilidir. Bu çalışma retrospektif olarak maternal vitamin D düzeylerine göre GDM riskini değerlendirmeyi amaçlamaktadır. Materyal ve Metot: Dışlama kriterleri uygulandıktan sonra 33 GDM ve 164 kontrol toplam 197 gebe kadın çalışmaya alındı. Vitamin D düzeylerine gebeliğin 11-14 haftaları arasında bakıldı. GDM tanısı gebeliğin 24-28 haftaları arasında 75 gram glukozla yapılan oral glukoz tolerans testi ile kondu. Bulgular: GDM grubunda BMI non-GDM grubundan yüksekti (24,68 [21,72–27,64] kg/m2 vs. 22,04 [20,51– 24,73] kg/m2, p = 0,004). ). Vitamin D düzeyleri GDM grubunda non-GDM grubundan anlamlı olarak daha düşük bulundu (17,2 [15,6–19,2] nmol/L vs. 33,0 [31,2–35,0] nmol/L, p <0,001). Vitamin D eksikliği prevalansı GDM grubunda % 87,88 olup, D vitamini eksikliği GDM riskini 67,06 kat arttırmaktaydı (odds oranı 67,06, 95% güven aralığı 20,90–215,15, p <0,001). Sonuç: Gebeliğin erken döneminde D vitamini eksikliği ile GDM gelişme riski arasında anlamlı bir ilişki saptanmıştır. Gebelik sırasında özellikle de ilk prenatal vizitte D vitamini eksikliğinin rutin olarak taranması GDM’nin ve GDM’nin anne ve yenidoğandaki olumsuz sonuçlarının daha iyi yönetilmesi bakımından yararlı olacaktır.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Wang L, Zhang C, Song Y, Zhang Z. Serum vitamin D deficiency and risk of gestational diabetes mellitus: a meta-analysis. Archives of Medical Science: AMS. 2020;16(4):742.
  • 2. Zhu Y, Zhang C. Prevalence of gestational diabetes and risk of progression to type 2 diabetes: a global perspective. Current diabetes reports. 2016;16(1):7.
  • 3. Amraei M, Mohamadpour S, Sayehmiri K, Mousavi SF, Shirzadpour E, Moayeri A. Effects of vitamin D deficiency on incidence risk of gestational diabetes mellitus: a systematic review and meta-analysis. Frontiers in endocrinology. 2018;9:7.
  • 4. Milajerdi A, Abbasi F, Mousavi SM, Esmaillzadeh A. Maternal vitamin D status and risk of gestational diabetes mellitus: a systematic review and meta-analysis of prospective cohort studies. Clinical Nutrition. 2021.
  • 5. Ilie PC, Stefanescu S, Smith L. The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality. Aging clinical and experimental research. 2020;32(7):1195-8.
  • 6. Corica D, Zusi C, Olivieri F, Marigliano M, Piona C, Fornari E, et al. Vitamin D affects insulin sensitivity and β-cell function in obese non-diabetic youths. European journal of endocrinology. 2019;181(4):439-50.
  • 7. Grineva E, Karonova T, Micheeva E, Belyaeva O, Nikitina I. Vitamin D deficiency is a risk factor for obesity and diabetes type 2 in women at late reproductive age. Aging (Albany NY). 2013;5(7):575.
  • 8. Olmos-Ortiz A, Avila E, Durand-Carbajal M, Díaz L. Regulation of calcitriol biosynthesis and activity: focus on gestational vitamin D deficiency and adverse pregnancy outcomes. Nutrients. 2015;7(1):443-80.
  • 9. Joergensen JS, Lamont RF, Torloni MR. Vitamin D and gestational diabetes: an update. Current Opinion in Clinical Nutrition & Metabolic Care. 2014;17(4):360-7.
  • 10. Weinert LS. International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy: comment to the International Association of Diabetes and Pregnancy Study Groups Consensus Panel. Diabetes Care. 2010;33(7):e97; author reply e8 (doi:10.2337/dc10-0544).
  • 11. Sowell KD, Keen CL, Uriu-Adams JY. Vitamin D and Reproduction: From Gametes to Childhood. Healthcare (Basel). 2015;3(4):1097-120 (doi:10.3390/healthcare3041097).
  • 12. Yakar B, Kaya MO. Vitamin D deficiency during pregnancy in Turkey and the effect of the sunlight: a systematic review and meta-analysis. Turkish Journal of Biochemistry. 2021;46(2):129-35 (doi:10.1515/tjb-2020-0059).
  • 13. Weinert LS, Silveiro SP. Maternal–fetal impact of vitamin D deficiency: a critical review. Maternal and child health journal. 2015;19(1):94-101.
  • 14. Christoph P, Challande P, Raio L, Surbek D. High prevalence of severe vitamin D deficiency during the first trimester in pregnant women in Switzerland and its potential contributions to adverse outcomes in the pregnancy. Swiss medical weekly. 2020;150.
  • 15. Savvidou MD, Akolekar R, Samaha RB, Masconi AP, Nicolaides KH. Maternal serum 25- hydroxyvitamin D levels at 11(+0) -13(+6) weeks in pregnant women with diabetes mellitus and in those with macrosomic neonates. BJOG. 2011;118(8):951-5 (doi:10.1111/j.1471- 0528.2011.02982.x).
  • 16. Ateş S, Aydın S, Karasu AFG, Dane B. Association between maternal vitamin D status and risk of gestational diabetes mellitus in pregnant women. Haseki Tip Bulteni. 2017;55(1):15.
  • 17. Baker AM, Haeri S, Camargo Jr CA, Stuebe AM, Boggess KA. First‐trimester maternal vitamin D status and risk for gestational diabetes (GDM) a nested case‐control study. Diabetes/metabolism research and reviews. 2012;28(2):164-8.
  • 18. Lacroix M, Battista M-C, Doyon M, Houde G, Ménard J, Ardilouze J-L, et al. Lower vitamin D levels at first trimester are associated with higher risk of developing gestational diabetes mellitus. Acta diabetologica. 2014;51(4):609-16.
  • 19. Xu C, Ma H-h, Wang Y. Maternal early pregnancy plasma concentration of 25-Hydroxyvitamin D and risk of gestational diabetes mellitus. Calcified tissue international. 2018;102(3):280-6.
  • 20. Moyce BL, Dolinsky VW. Maternal β-cell adaptations in pregnancy and placental signalling: implications for gestational diabetes. International journal of molecular sciences. 2018;19(11):3467.
  • 21. El Lithy A, Abdella RM, El-Faissal YM, Sayed AM, Samie RMA. The relationship between low maternal serum vitamin D levels and glycemic control in gestational diabetes assessed by HbA1c levels: an observational cross-sectional study. BMC pregnancy and childbirth. 2014;14(1):1-6.
  • 22. Kramer CK, Swaminathan B, Hanley AJ, Connelly PW, Sermer M, Zinman B, et al. Vitamin D and parathyroid hormone status in pregnancy: effect on insulin sensitivity, β-cell function, and gestational diabetes mellitus. The Journal of Clinical Endocrinology & Metabolism. 2014;99(12):4506-13.
  • 23. Lee KW, Ching SM, Ramachandran V, Yee A, Hoo FK, Chia YC, et al. Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis. BMC pregnancy and childbirth. 2018;18(1):1-20. L, Zhang C, Song Y, Zhang Z. Serum vitamin D deficiency and risk of gestational diabetes mellitus: a meta-analysis. Archives of Medical Science: AMS. 2020;16(4):742.
APA GÜNGÖR K, dokuzeylul gungor n (2021). FIRST-TRIMESTER MATERNAL VITAMIN D LEVELS AND RISK FOR GESTATIONAL DIABETES MELLITUS. , 339 - 349. 10.5505/amj.2021.60234
Chicago GÜNGÖR KAĞAN,dokuzeylul gungor nur FIRST-TRIMESTER MATERNAL VITAMIN D LEVELS AND RISK FOR GESTATIONAL DIABETES MELLITUS. (2021): 339 - 349. 10.5505/amj.2021.60234
MLA GÜNGÖR KAĞAN,dokuzeylul gungor nur FIRST-TRIMESTER MATERNAL VITAMIN D LEVELS AND RISK FOR GESTATIONAL DIABETES MELLITUS. , 2021, ss.339 - 349. 10.5505/amj.2021.60234
AMA GÜNGÖR K,dokuzeylul gungor n FIRST-TRIMESTER MATERNAL VITAMIN D LEVELS AND RISK FOR GESTATIONAL DIABETES MELLITUS. . 2021; 339 - 349. 10.5505/amj.2021.60234
Vancouver GÜNGÖR K,dokuzeylul gungor n FIRST-TRIMESTER MATERNAL VITAMIN D LEVELS AND RISK FOR GESTATIONAL DIABETES MELLITUS. . 2021; 339 - 349. 10.5505/amj.2021.60234
IEEE GÜNGÖR K,dokuzeylul gungor n "FIRST-TRIMESTER MATERNAL VITAMIN D LEVELS AND RISK FOR GESTATIONAL DIABETES MELLITUS." , ss.339 - 349, 2021. 10.5505/amj.2021.60234
ISNAD GÜNGÖR, KAĞAN - dokuzeylul gungor, nur. "FIRST-TRIMESTER MATERNAL VITAMIN D LEVELS AND RISK FOR GESTATIONAL DIABETES MELLITUS". (2021), 339-349. https://doi.org/10.5505/amj.2021.60234
APA GÜNGÖR K, dokuzeylul gungor n (2021). FIRST-TRIMESTER MATERNAL VITAMIN D LEVELS AND RISK FOR GESTATIONAL DIABETES MELLITUS. Ankara Medical Journal, 21(3), 339 - 349. 10.5505/amj.2021.60234
Chicago GÜNGÖR KAĞAN,dokuzeylul gungor nur FIRST-TRIMESTER MATERNAL VITAMIN D LEVELS AND RISK FOR GESTATIONAL DIABETES MELLITUS. Ankara Medical Journal 21, no.3 (2021): 339 - 349. 10.5505/amj.2021.60234
MLA GÜNGÖR KAĞAN,dokuzeylul gungor nur FIRST-TRIMESTER MATERNAL VITAMIN D LEVELS AND RISK FOR GESTATIONAL DIABETES MELLITUS. Ankara Medical Journal, vol.21, no.3, 2021, ss.339 - 349. 10.5505/amj.2021.60234
AMA GÜNGÖR K,dokuzeylul gungor n FIRST-TRIMESTER MATERNAL VITAMIN D LEVELS AND RISK FOR GESTATIONAL DIABETES MELLITUS. Ankara Medical Journal. 2021; 21(3): 339 - 349. 10.5505/amj.2021.60234
Vancouver GÜNGÖR K,dokuzeylul gungor n FIRST-TRIMESTER MATERNAL VITAMIN D LEVELS AND RISK FOR GESTATIONAL DIABETES MELLITUS. Ankara Medical Journal. 2021; 21(3): 339 - 349. 10.5505/amj.2021.60234
IEEE GÜNGÖR K,dokuzeylul gungor n "FIRST-TRIMESTER MATERNAL VITAMIN D LEVELS AND RISK FOR GESTATIONAL DIABETES MELLITUS." Ankara Medical Journal, 21, ss.339 - 349, 2021. 10.5505/amj.2021.60234
ISNAD GÜNGÖR, KAĞAN - dokuzeylul gungor, nur. "FIRST-TRIMESTER MATERNAL VITAMIN D LEVELS AND RISK FOR GESTATIONAL DIABETES MELLITUS". Ankara Medical Journal 21/3 (2021), 339-349. https://doi.org/10.5505/amj.2021.60234