Effects of Vitamin D Deficiency on Incidence Risk of Gestational Diabetes Mellitus: A Systematic Review and Meta-analysis

Abstract

IntroductionProper nutrition is important for overall health, and it reduces healthcare costs associated with malnutrition. Many studies have investigated vitamin D deficiency and its role in gestational diabetes and controversial data have reported. A comprehensive consideration of articles in this field provides the possibility of a general study of this relationship. This meta-analysis is an evaluation of the relationship between vitamin D deficiency and gestational diabetes.Material and methodsDifferent databases (such as PubMed, Science Information Institute, EmBase, Scopus, and the Cochrane Library) were searched for studies and eligible English articles published before February 2017 that have reported the risk of gestational diabetes in relation to vitamin D deficiency. This relationship was measured using odds ratios (ORs) with a confidence interval (CI) of 95%. The influence of each study was measured through sensitivity analysis. Funnel plots, Egger regression tests, and the Begg–Mazumdar correlation test were used to determine bias or publication bias. STATA (version 11.2) was used for all analyses.ResultsTwenty-six studies were selected as eligible for this research and included in the final analysis. In general, vitamin D deficiency among mothers may be related to an increased risk of gestational diabetes (OR = 1.18; 95% CI, 1.01–1.35; p < 0.001). The serum level of 25(OH)D is less meaningful in people with gestational diabetes than in those who have normal glucose tolerance. Subgroup analysis showed that the results concerning this association may vary with study design but do not change with country of origin.ConclusionSome evidence has shown that vitamin D deficiency may increase the risk of gestational diabetes.

The role of vitamin D in perinatology. An up-to-date review

“…Similar observations were made by Al-Ajlan et al in Saudi Arabian women [119]. There are some well-performed systematic reviews and meta-analyses about the above-mentioned problem -in both of them lower vitamin D levels were found to be associated with the increased risk of developing GDM [65,[120][121][122][123]. According to the meta-analysis by Palacios et al, vitamin D deficiency in early pregnancy was associated with elevated risk of developing GDM [27].…”

The Role of Vitamin D in Fertility and during Pregnancy and Lactation: A Review of Clinical Data

“…Several investigations have shown that low serum 25(OH)D concentrations are associated with some adverse neonatal and pregnancy outcomes [ 65 , 66 , 67 , 68 ]. In this context, several reviews and meta-analyses support the notion that low serum 25(OH)D concentrations are a risk factor for hypertensive disorders in pregnancy such as pre-eclampsia, and for gestational diabetes mellitus [ 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 ]. Moreover, in the majority of the published meta-analyses low serum 25(OH)D concentration in pregnant women are associated with an increased risk of their children for childhood asthma, wheeze, respiratory tract infections, allergic rhinitis, and eczema [ 79 , 80 , 81 , 82 , 83 , 84 , 85 ].…”

Impact of sunshine on the risk of gestational diabetes mellitus in primiparous women

“…If the solar ultraviolet B radiation is low, production of vitamin D in the skin will remain low exposing the individual to lower blood vitamin D levels. Further, low blood vitamin D levels have been shown to be a risk factor for GDM [18,19]. It has been suggested that vitamin D mediates the onset of GDM by regulating the immune system and inflammatory responses, oxidative stress, blood calcium level, hepatic metabolism, as well as with the function and development of pancreatic islets [23][24][25][26].…”

“…According to recent systematic reviews, low vitamin D levels in pregnant women seem to be associated with GDM [18,19]. Main sources for vitamin D are sunshine and fish oil [20].…”