Vitamin D status during pregnancy and the risk of gestational diabetes mellitus: A longitudinal study in a multiracial cohort

Jin Xia, Yiqing Song, Shristi Rawal, Jing Wu, Stefanie N. Hinkle, Michael Y. Tsai, Cuilin Zhang

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1895-1905
Number of pages11
JournalDiabetes, Obesity and Metabolism
Volume21
Issue number8
DOIs
StatePublished - Aug 2019

Bibliographical note

Funding Information:
This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development intramural funding as well as the American Recovery and Reinvestment Act funding (grant numbers HHSN275200800013C, HHSN275200800002I, HHSN27500006, HHSN275200800003IC, HHSN275200800014C, HHSN275200800012C, HHSN275200800028C, HHSN275201000009C, and HHSN275201000001Z). Y.S. was supported by a grant (R01-HL113056) from the National Institutes of Health (NIH)/National Heart, Lung, and Blood Institute (NHLBI), Bethesda, Maryland; J.X. and Y.S. were supported by the Indiana University Health-Indiana University School of Medicine Strategic Research Initiative Grant, Indianapolis, Indiana.

Funding Information:
We would like to acknowledge the research teams at our participating clinical centres, including Christiana Care Health Systems, Wilmington, Delaware; University of California, Irvine, California; Long Beach Memorial Medical Center, California; Northwestern University, Evanston, Illinois; Medical University of South Carolina, Charleston, South Carolina; Columbia University, New York, New York; New York Hospital Queens, New York; St Peters' University Hospital, New Brunswick, New Jersey; University of Alabama at Birmingham, Alabama; Women and Infants Hospital of Rhode Island, Providence, Rhode Island; Fountain Valley Regional Hospital and Medical Center, California; and Tufts University, Medford, Massachusetts. We would also like to thank the C-TASC Corporation, Owings Mill, Maryland, for providing data coordination, as well as the Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, for providing the laboratory support and resources for the analysis of blood samples and biomarkers. This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development intramural funding as well as the American Recovery and Reinvestment Act funding (grant numbers HHSN275200800013C, HHSN275200800002I, HHSN27500006, HHSN275200800003IC, HHSN275200800014C, HHSN275200800012C, HHSN275200800028C, HHSN275201000009C, and HHSN275201000001Z). Y.S. was supported by a grant (R01-HL113056) from the National Institutes of Health (NIH)/National Heart, Lung, and Blood Institute (NHLBI), Bethesda, Maryland; J.X. and Y.S. were supported by the Indiana University Health-Indiana University School of Medicine Strategic Research Initiative Grant, Indianapolis, Indiana.

Funding Information:
This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development intramural funding as well as the American Recovery and Reinvestment Act funding (grant numbers HHSN275200800013C, HHSN275200800002I, HHSN 27500006, HHSN275200800003IC, HHSN275200800014C, HHSN 275200800012C, HHSN275200800028C, HHSN275201000009C, and HHSN275201000001Z). Y.S. was supported by a grant (R01-HL113056) from the National Institutes of Health (NIH)/National Heart, Lung, and Blood Institute (NHLBI), Bethesda, Maryland; J.X. and Y.S. were supported by the Indiana University Health-Indiana University School of Medicine Strategic Research Initiative Grant, Indianapolis, Indiana.

Publisher Copyright:
Published 2019. This article is a U.S. Government work and is in the public domain in the USA.

Keywords

  • observational study
  • population study

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