The relationship between low maternal serum 25-hydroxyvitamin D levels and gestational diabetes mellitus according to the severity of 25-hydroxyvitamin D deficiency

Abstract

OBJECTIVE:To assess the relationship between low maternal serum 25-hydroxyvitamin D levels and gestational diabetes mellitus in Turkish pregnant women according to the severity of 25-hydroxyvitamin D deficiency and assess intact parathyroid hormone levels in women with gestational diabetes mellitus and controls with low and sufficient 25-hydroxyvitamin D levels.METHODS:We analyzed serum 25-hydroxyvitamin D and intact parathyroid hormone levels in 234 women with gestational diabetes mellitus and 168 controls. To define the deficiency status, 25-hydroxyvitamin D levels were further classified into severely deficient, deficient, insufficient and sufficient groups.RESULTS:Women with gestational diabetes mellitus had significantly lower 25-hydroxyvitamin D levels compared to controls (30.8±16.3 vs. 36.0±16.2 nmol/L). However, when subgroups of 25-hydroxyvitamin D were analyzed, gestational diabetes mellitus was significantly more common only in women with severely deficient 25-hydroxyvitamin D levels. After adjusting for covariates, only severely deficient 25-hydroxyvitamin D levels were independently associated with an increased relative risk of gestational diabetes mellitus. The relative risk of gestational diabetes mellitus in women with insufficient and deficient 25-hydroxyvitamin D levels was not statistically significant. Intact parathyroid hormone concentrations were also significantly higher in women with gestational diabetes mellitus compared to the controls (45.3±26.2 vs. 38.7±27.6 pg/ml).CONCLUSIONS:The results obtained from this study provide novel data indicating that only severely deficient maternal serum 25-hydroxyvitamin D levels are significantly associated with an elevated relative risk of gestational diabetes mellitus, even after adjusting for established risk factors of gestational diabetes mellitus.

A Cross Sectional Study of Vitamin D Level in Patients With Gestational Diabetes Mellitus Attending Ante-Natal Care at King Abdul Aziz University Hospital, Jeddah.

“…Similar results were reported in a study conducted in Canada (2012) where GDM group had higher BMI than non-GDM group (71.3± 18.4 vs 65.2 ±12.0 p=0.0005) (Parlea et al, 2012). Also in Turkey, the authors reported significant older age and higher BMI among GDM group compared with non-GDM (p=0.002, p<0.001) respectively (Zuhur et al, 2013).…”

“…Parlea et al conducted a nested case-control study among 345 pregnant women (116 GDM & 219 non-GDM) and they reported significant lower vitamin D serum level in GDM group (56.3 vs. 62.0 nmol⁄ l, P = 0.018) (Parlea et al, 2012). Also, in Turkey, Zuhur et al recognized significant increase in GDM cases among women who suffered from severe vitamin D deficiency (Zuhur et al, 2013). All these studies and other studies provided clear evidence of vitamin D being a risk factor in the development of GDM (Parlea et al, 2012).…”

A Comparison of Vitamin D Level among the Patients of Gestational Diabetes Mellitus in a Tertiary Care Hospital in North India

“…There was no statistical significance between cases and controls according to parity (p>0.05). This is in contrast with study by Zuhur et al (11) in which the percentage of multipara was 85.9% in women with GDM and 60.7% in controls with significant difference. This difference might be due to difference in the methods used for the diagnosis of GDM.…”

“…It complicates two to five percent of pregnancies, of which 90% is contributed by gestational diabetes mellitus (GDM) (11) . The controversy and confusion still exists because of various guidelines for diagnosis of GDM.…”

Association Between Maternal Vitamin D Status and Risk of Gestational Diabetes Mellitus in Pregnant Women

“…Recently, Zuhur et al (19) studied 234 cases of GDM and 168 controls in Turkey and reported that only severely deficient maternal serum 25(OH)D levels (<5.2 ng/mL) were significantly associated with an elevated relative risk of GDM. Likewise, Maghbooli et al (11) studied maternal vitamin D deficiency and GDM in a cross-sectional study of 741 pregnant women at 24-28-weeks gestation and found significantly lower levels of 25(OH)D in women with GDM compared to normoglycaemic controls.…”