Vitamin D deficiency in gestational diabetes mellitus and the role of the placenta

Cho, Geum Joon; Hong, Soon Cheol; Oh, Min Jeong; Kim, Hai Joong

doi:10.1016/j.ajog.2013.08.015

Cited by 71 publications

(62 citation statements)

References 35 publications

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“…Similarly, Wang et al., studying 400 Chinese women, found higher rates of vitamin D deficiency in those women with gestational diabetes compared with normoglycaemic pregnant controls matched for season, with a 1·8‐fold higher risk of developing gestational diabetes in women with 25(OH)D concentrations <25 m m (<10 ng/ml) compared with women with higher concentrations. In a study by Cho et al., a strong association between vitamin D deficiency [defined as 25(OH)D <20 ng/ml] and gestational diabetes also was found. The investigators focused on placental production of mRNA and protein for vitamin D receptor (VDR), CYP24A – an enzyme involved in the conversion of 25(OH)D and 1,25(OH) 2 D to inactive metabolites, and CYP27B1 – an enzyme that hydroxylates 25(OH)D to 1,25(OH) 2 D. The production of CYP24A1 protein and mRNA expression was significantly higher in placental tissue of women with gestational diabetes compared with normal controls; yet, there were no differences in CYP27B1 protein and mRNA expression, suggesting that the inactivation of 25(OH)D and 1,25(OH) 2 D through increased activity of CYP24A during gestational diabetes may account in part for the higher rates of deficiency in those with gestational diabetes.…”

Section: Editorialmentioning

confidence: 97%

Commentary for McManus et al. paper, ‘Maternal, umbilical arterial and umbilical venous 25‐hydroxyvitamin D and adipocytokine concentrations in pregnancies with and without gestational diabetes'

Wagner

2014

Clinical Endocrinology

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Section: Editorialmentioning

confidence: 97%

Commentary for McManus et al. paper, ‘Maternal, umbilical arterial and umbilical venous 25‐hydroxyvitamin D and adipocytokine concentrations in pregnancies with and without gestational diabetes'

Wagner

2014

Clinical Endocrinology

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“…They attributed it to significantly higher production of CYP24A1 protein and messenger RNA expression in placental tissue from patients with GDM. Since CYP24A1 catabolizes both 25(OH) D and bioactive 1,25 (OH)2D forms to inactive metabolites, elevated levels of CYP24A1 in the placenta of GDM mothers may play a key role in producing Vitamin D deficiency in them [14].…”

Section: Discussionmentioning

confidence: 99%

Maternal Vitamin D Deficiency: A Risk Factor for Gestational Diabetes Mellitus in North India

Kapry¹

2015

Gynecol Obstet (Sunnyvale)

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Objective: The aim was to assess maternal vitamin D deficiency in early pregnancy and subsequent risk of developing gestational diabetes mellitus (GDM) in north India.Methods: Nested case control study was done taking 550 antenatal women. Two maternal blood samples, one at <20 wks and the other at term along with cord blood were taken. Vitamin D was estimated by 25-Hydroxyvitamin D 125 I RIA. Kit and categorised according to ACOG (2011) criteria. Patients were categorised into GDM and control groups as per ADA recommendations. Pearson χ 2 , ANOVA, linear correlation and logistic regression were used for statistical analysis.Results: High prevalence (72.8%) of vitamin D deficiency was found in early pregnancy. Serum 25(OH) D concentrations were significantly lower (46% less) in women who subsequently developed GDM compared with controls [mean: 11.93 ± 3.42 ng/ml, 95% CI: 10.7-13.17 ng /ml; vs. mean: 22.26 ± 15.28 ng/ml, 95% CI: 20.0-24.52 ng/ml; p<0.001]. Fasting blood sugar in early gestation negatively correlated with 25 (OH) D level (r=-0.489, p=0.004) and at term gestation (r=-0.435, p<0.013). Women with hypovitaminosis D in early pregnancy were eleven times more likely to have GDM compared to controls (p=0.001; r=11.55). Cord serum 25(OH) D concentrations were also significantly lower among neonates of GDM mothers than of controls (mean, 10.39 ± 2.26 ng/ml, vs. 21.33 ± 14.40; p<0.001). In GDM women, maternal 25 (OH) D concentration at <20 weeks positively correlated with vitamin D concentration at term gestation (r=0.781, p<0.001) and also with cord blood levels (r=0.478, p<0.0001). Conclusion:Maternal vitamin D deficiency is highly prevalent in early pregnancy and is an independent risk factor for GDM in North India. Further clinical trials are needed to find out whether vitamin D supplementation would prevent or improve glycemic control in women with GDM.

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“…5(12), 1940-1950 1941 Introduction:-Vitamin D is an important secosteroid hormone in skeletal and non-skeletal systems (Yoon, 2017). After absorption, vitamin D is bound to a binding protein which carries it in blood stream to the liver where vitamin D is hydroxylated into 25(OH) vitamin D (calcidiol), (Lapillonne, 2010) and then to the kidneys, where it is hydroxylated by CYP27B1 to 1,25 dihydroxy-vitamin D (calcitriol), which is the biologically active form of vitamin D (Cho et al, 2013).…”

Section: Issn: 2320-5407mentioning

confidence: 99%

Hypovitaminosis D Deleteriously Affect Pregnancy Outcome: A Proposed Role for Daily Vitamin D Supplementation to Improve Outcome.

Sherbeny¹,

Mohammed²

2017

IJAR

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Objectives: To estimate serum 25-hydroxy vitamin D (25OHD) levels in newly pregnant women and to evaluate its relation to development of gestational diabetes mellitus (GDM) and maternal and fetal outcome. Patients & Methods: The study included 328 pregnant women, and at 6 th week gestational age (GA), women's clinical and obstetric data were collected and blood samples were obtained for estimation of baseline blood glucose (BG) and serum 25OHD levels. Studied women were divided into two equal groups: Group A included pregnant women received supplemental vitamin D3 in a daily dose of 1000 IU oral capsule starting since 6 th week GA till delivery. Group B included pregnant women who completed their pregnancy without vitamin D supplementation. All women underwent the 75g Oral Glucose Tolerance Test (75-OGTT) at the 20 th , 28 th and 36 th week for detection of GDM. All women were followed up till delivery and maternal and neonatal outcome. Results: Serum 25OHD levels were sufficient, insufficient and deficient in 42, 142 and 144 women, respectively. Forty-three women (13.1%) developed GDM and 62 women (18.9%) had emergency and 23 women had elective CS. Moreover, 48 neonates (14.6%) required NICU admission; 15 for respiratory-aid, 22 for phototherapy and 11 neonates for management of sepsis, but 4 neonates died. Women of group A showed significantly lower frequency of GDM with significantly lower BG levels, significantly lower frequency of CS especially emergency CS and significantly lower frequency of NICU admission. Conclusion: Low serum 25OHD levels are a widespread problem among pregnant women and are associated with higher frequency of GDM, CS delivery especially emergency ones and NICU admission rate. Supplemental vitamin D therapy did well for reducing the frequencies of these events. Supplemental daily dose of 1000 IU appears appropriate and convenient as it was taken in the form of oral capsules.

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Vitamin D deficiency in gestational diabetes mellitus and the role of the placenta

Cited by 71 publications

References 35 publications

Commentary for McManus et al. paper, ‘Maternal, umbilical arterial and umbilical venous 25‐hydroxyvitamin D and adipocytokine concentrations in pregnancies with and without gestational diabetes'

Commentary for McManus et al. paper, ‘Maternal, umbilical arterial and umbilical venous 25‐hydroxyvitamin D and adipocytokine concentrations in pregnancies with and without gestational diabetes'

Maternal Vitamin D Deficiency: A Risk Factor for Gestational Diabetes Mellitus in North India

Hypovitaminosis D Deleteriously Affect Pregnancy Outcome: A Proposed Role for Daily Vitamin D Supplementation to Improve Outcome.

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