Longitudinal association of 25-hydroxyvitamin D with adipokines and markers of glucose metabolism among Brazilian pregnant women

Abstract

This study aimed to evaluate the longitudinal association of vitamin D status with glycaemia, insulin, homoeostatic model assessment of insulin resistance, adiponectin and leptin. A prospective cohort with 181 healthy, pregnant Brazilian women was followed at the 5th–13th, 20th–26th and 30th–36th gestational weeks. In this cohort, 25-hydroxyvitamin D (25(OH)D) plasma concentrations were analysed using liquid chromatography–tandem MS. Vitamin D status was categorised as sufficient or insufficient using the Endocrine Society Practice Guidelines (≥75/<75 nmol/l) and the Institute of Medicine (≥50/<50 nmol/l) thresholds. Linear mixed-effect regression models were employed to evaluate the association between vitamin D status and each outcome, considering interaction terms between vitamin D status and gestational age (P<0·1). At baseline, 70·7 % of pregnant women had 25(OH)D levels <75 nmol/l and 16 % had levels <50 nmol/l. Women with sufficient vitamin D status at baseline, using both thresholds, presented lower glycaemia than those with insufficient 25(OH)D. Pregnant women with 25(OH)D concentrations <75 nmol/l showed lower insulin (β=−0·12; 95 % CI −0·251, 0·009;P=0·069) and adiponectin (β=−0·070; 95 % CI −0·150, 0·010;P=0·085) concentrations throughout pregnancy than those with 25(OH)D levels ≥75 nmol/l. Pregnant women with 25(OH)D <50 nmol/l at baseline presented significantly higher leptin concentrations than those with 25(OH)D levels ≥50 nmol/l (β=−0·253; 95 % CI −0·044, 0·550;P=0·095). The baseline status of vitamin D influences the biomarkers involved in glucose metabolism. Vitamin D-sufficient women at baseline had higher increases in insulin and adiponectin changes throughout gestation than those who were insufficient.

Seasonality of gestational diabetes mellitus and maternal blood glucose levels

“…A few interventional studies indicated that supplementation optimizes maternal vitamin D status or improves maternal glucose metabolism. [ 18 , 19 ] Vitamin D is the product of sun rays, which might explain the relationship between high temperature and GDM. However, observational studies about the association between maternal vitamin D status and risk of GDM are conflicting.…”

Influence of vitamin D serum concentration, prenatal care and social determinants on birth weight: a northeastern Brazilian cohort study

“…The pregnant women in our study were not supplemented with vitamin D (24,25) . Furthermore, in Brazil, vitamin D intake through dietary sources is low and pregnant women who participate in public prenatal care programmes do not use vitamin D supplementation (26,27) . In Brazil, only supplementation with Fe (40 mg) and folic acid (400 μg) is mandatory for pregnant women (27) .…”

Effect of prenatal EPA and DHA on maternal and cord blood insulin sensitivity: a secondary analysis of the mothers, omega 3, and mental health study

“…For example, Vitamin D supplementation has been reported to be insulin-sensitizing in non-pregnant individuals [9, 10]. Similarly, in a longitudinal study evaluating associations between vitamin D concentrations and insulin sensitivity during pregnancy, pregnant women who had blood concentrations of vitamin D that were deemed “sufficient” in early gestation had higher blood adiponectin concentrations than pregnant women deemed vitamin D insufficient [11].…”