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Association between vitamin D status and the risk of gestational diabetes mellitus: a meta-analysis

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Abstract

Purpose

Vitamin D is widely used for bone growth and normal insulin secretion; however, the association between vitamin D status and gestational diabetes risk is controversial. This meta-analysis aimed to quantitatively evaluate the association between vitamin status and risk of gestational diabetes.

Methods

We performed a systematic search on the PubMed, EmBase, and Cochrane Library databases in January 2015 to obtain observational studies studying gestational diabetes risk in relation to vitamin D status. Odds ratios (ORs) with 95 % confidence intervals (CIs) were used to measure the association between vitamin D status and the risk of gestational diabetes.

Results

A total of 20 observational studies were included in the final analysis containing 16,515 individuals. Overall, maternal vitamin D insufficiency was found to be associated with a greater risk of gestational diabetes (RR 1.45; 95 % CI 1.15–1.83; P < 0.001). Subgroup analysis indicated that this association might differ based on countries, study design, assessment of vitamin D levels, sample size, age at baseline, adjusted models, and study quality.

Conclusions

This meta-analysis revealed that maternal vitamin D insufficiency is associated with increased risk of gestational diabetes.

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References

  1. Metzger BE, Coustan DR (1998) Summary and recommendations of the fourth international workshop-conference on gestational diabetes mellitus. The organizing committee. Diabetes Care 21(Suppl 2):B161–167

    PubMed  Google Scholar 

  2. Hunt KJ, Schuller KL (2007) The increasing prevalence of diabetes in pregnancy. Obstet Gynecol Clin North Am 34(2):173–199. doi:10.1016/j.ogc.2007.03.002 vii

    Article  PubMed  PubMed Central  Google Scholar 

  3. American Diabetes Association (2004) Gestational diabetes mellitus. Diabetes Care 27(Suppl 1):S88–90

    Google Scholar 

  4. Yap C, Cheung NW, Gunton JE, Athayde N, Munns CF, Duke A, McLean M (2014) Vitamin D supplementation and the effects on glucose metabolism during pregnancy: a randomized controlled trial. Diabetes Care 37(7):1837–1844. doi:10.2337/dc14-0155

    Article  CAS  PubMed  Google Scholar 

  5. Gernand AD, Simhan HN, Caritis S, Bodnar LM (2014) Maternal vitamin D status and small-for-gestational-age offspring in women at high risk for preeclampsia. Obstet Gynecol 123(1):40–48. doi:10.1097/AOG.0000000000000049

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Grant CC, Stewart AW, Scragg R, Milne T, Rowden J, Ekeroma A, Wall C, Mitchell EA, Crengle S, Trenholme A, Crane J, Camargo CA Jr (2014) Vitamin D during pregnancy and infancy and infant serum 25-hydroxyvitamin D concentration. Pediatrics 133(1):e143–153. doi:10.1542/peds.2013-2602

    Article  PubMed  Google Scholar 

  7. Maghbooli Z, Hossein-Nezhad A, Karimi F, Shafaei AR, Larijani B (2008) Correlation between vitamin D3 deficiency and insulin resistance in pregnancy. Diabetes Metab Res Rev 24(1):27–32. doi:10.1002/dmrr.737

    Article  CAS  PubMed  Google Scholar 

  8. Kramer CK, Swaminathan B, Hanley AJ, Connelly PW, Sermer M, Zinman B, Retnakaran R (2014) Vitamin D and parathyroid hormone status in pregnancy: effect on insulin sensitivity, beta-cell function, and gestational diabetes mellitus. J Clin Endocrinol Metab 99(12):4506–4513. doi:10.1210/jc.2014-2341

    Article  CAS  PubMed  Google Scholar 

  9. Poel YH, Hummel P, Lips P, Stam F, van der Ploeg T, Simsek S (2012) Vitamin D and gestational diabetes: a systematic review and meta-analysis. Eur J Intern Med 23(5):465–469. doi:10.1016/j.ejim.2012.01.007

    Article  CAS  PubMed  Google Scholar 

  10. Aghajafari F, Nagulesapillai T, Ronksley PE, Tough SC, O’Beirne M, Rabi DM (2013) Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies. BMJ 346:f1169. doi:10.1136/bmj.f1169

    Article  PubMed  Google Scholar 

  11. Baker AM, Haeri S, Camargo CA Jr, Stuebe AM, Boggess KA (2012) First-trimester maternal vitamin D status and risk for gestational diabetes (GDM) a nested case–control study. Diabetes Metab Res Rev 28(2):164–168. doi:10.1002/dmrr.1282

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Fernandez-Alonso AM, Dionis-Sanchez EC, Chedraui P, Gonzalez-Salmeron MD, Perez-Lopez FR, Spanish Vitamin D, Women’s Health Research G (2012) First-trimester maternal serum 25-hydroxyvitamin D(3) status and pregnancy outcome. Int J Gynaecol Obstet 116(1):6–9. doi:10.1016/j.ijgo.2011.07.029

    Article  CAS  PubMed  Google Scholar 

  13. Parlea L, Bromberg IL, Feig DS, Vieth R, Merman E, Lipscombe LL (2012) Association between serum 25-hydroxyvitamin D in early pregnancy and risk of gestational diabetes mellitus. Diabet Med 29(7):e25–32. doi:10.1111/j.1464-5491.2011.03550.x

    Article  CAS  PubMed  Google Scholar 

  14. Lacroix M, Battista MC, Doyon M, Houde G, Menard J, Ardilouze JL, Hivert MF, Perron P (2014) Lower vitamin D levels at first trimester are associated with higher risk of developing gestational diabetes mellitus. Acta Diabetol 51(4):609–616. doi:10.1007/s00592-014-0564-4

    Article  CAS  PubMed  Google Scholar 

  15. Zhou J, Su L, Liu M, Liu Y, Cao X, Wang Z, Xiao H (2014) Associations between 25-hydroxyvitamin D levels and pregnancy outcomes: a prospective observational study in southern China. Eur J Clin Nutr 68(8):925–930. doi:10.1038/ejcn.2014.99

    Article  CAS  PubMed  Google Scholar 

  16. Burris HH, Rifas-Shiman SL, Kleinman K, Litonjua AA, Huh SY, Rich-Edwards JW, Camargo CA Jr, Gillman MW (2012) Vitamin D deficiency in pregnancy and gestational diabetes mellitus. Am J Obstet Gynecol 207(3):182. doi:10.1016/j.ajog.2012.05.022 e181-188

    Article  PubMed  PubMed Central  Google Scholar 

  17. Zuhur SS, Erol RS, Kuzu I, Altuntas Y (2013) The relationship between low maternal serum 25-hydroxyvitamin D levels and gestational diabetes mellitus according to the severity of 25-hydroxyvitamin D deficiency. Clinics (Sao Paulo) 68(5):658–664. doi:10.6061/clinics/2013(05)13

    Article  Google Scholar 

  18. Park S, Yoon HK, Ryu HM, Han YJ, Lee SW, Park BK, Park SY, Yim CH, Kim SH (2014) Maternal vitamin D deficiency in early pregnancy is not associated with gestational diabetes mellitus development or pregnancy outcomes in Korean pregnant women in a prospective study. J Nutr Sci Vitaminol (Tokyo) 60(4):269–275

    Article  CAS  Google Scholar 

  19. Rodriguez A, Garcia-Esteban R, Basterretxea M, Lertxundi A, Rodriguez-Bernal C, Iniguez C, Rodriguez-Dehli C, Tardon A, Espada M, Sunyer J, Morales E (2014) Associations of maternal circulating 25-hydroxyvitamin D3 concentration with pregnancy and birth outcomes. BJOG. doi:10.1111/1471-0528.13074

    Google Scholar 

  20. Parildar H, Dogruk Unal A, Aksan Desteli G, Cigerli O, Guvener Demirag N (2013) Frequency of Vitamin D deficiency in pregnant diabetics at Baskent University Hospital, Istanbul. Pak J Med Sci 29(1):15–20. doi:10.12669/pjms.291.2896

    PubMed  PubMed Central  Google Scholar 

  21. Schneuer FJ, Roberts CL, Guilbert C, Simpson JM, Algert CS, Khambalia AZ, Tasevski V, Ashton AW, Morris JM, Nassar N (2014) Effects of maternal serum 25-hydroxyvitamin D concentrations in the first trimester on subsequent pregnancy outcomes in an Australian population. Am J Clin Nutr 99(2):287–295. doi:10.3945/ajcn.113.065672

    Article  CAS  PubMed  Google Scholar 

  22. Wang O, Nie M, Hu YY, Zhang K, Li W, Ping F, Liu JT, Chen LM, Xing XP (2012) Association between vitamin D insufficiency and the risk for gestational diabetes mellitus in pregnant Chinese women. Biomed Environ Sci 25(4):399–406. doi:10.3967/0895-3988.2012.04.004

    CAS  PubMed  Google Scholar 

  23. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6(7):e1000097. doi:10.1371/journal.pmed.1000097

    Article  PubMed  PubMed Central  Google Scholar 

  24. Wells G, Shea B, O’connell D, Peterson J, Welch V, Losos M, Tugwell P (2000) The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses

  25. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):177–188

    Article  CAS  PubMed  Google Scholar 

  26. Ades AE, Lu G, Higgins JP (2005) The interpretation of random-effects meta-analysis in decision models. Med Decis Making 25(6):646–654. doi:10.1177/0272989X05282643

    Article  CAS  PubMed  Google Scholar 

  27. Deeks JJ, Higgins J, Altman DG (2008) Analysing data and undertaking meta-analyses. Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series 243–296

  28. Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327(7414):557–560. doi:10.1136/bmj.327.7414.557

    Article  PubMed  PubMed Central  Google Scholar 

  29. Tobias A (1999) Assessing the influence of a single study in meta-analysis. Stata Tech Bull 47:15–17

    Google Scholar 

  30. Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50(4):1088–1101

    Article  CAS  PubMed  Google Scholar 

  32. Farrant HJ, Krishnaveni GV, Hill JC, Boucher BJ, Fisher DJ, Noonan K, Osmond C, Veena SR, Fall CH (2009) Vitamin D insufficiency is common in Indian mothers but is not associated with gestational diabetes or variation in newborn size. Eur J Clin Nutr 63(5):646–652. doi:10.1038/ejcn.2008.14

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Clifton-Bligh RJ, McElduff P, McElduff A (2008) Maternal vitamin D deficiency, ethnicity and gestational diabetes. Diabet Med 25(6):678–684. doi:10.1111/j.1464-5491.2008.02422.x

    Article  CAS  PubMed  Google Scholar 

  34. Zhang C, Qiu C, Hu FB, David RM, van Dam RM, Bralley A, Williams MA (2008) Maternal plasma 25-hydroxyvitamin D concentrations and the risk for gestational diabetes mellitus. PLoS One 3(11):e3753. doi:10.1371/journal.pone.0003753

    Article  PubMed  PubMed Central  Google Scholar 

  35. Makgoba M, Nelson SM, Savvidou M, Messow CM, Nicolaides K, Sattar N (2011) First-trimester circulating 25-hydroxyvitamin D levels and development of gestational diabetes mellitus. Diabetes Care 34(5):1091–1093. doi:10.2337/dc10-2264

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Soheilykhah S, Mojibian M, Rashidi M, Rahimi-Saghand S, Jafari F (2010) Maternal vitamin D status in gestational diabetes mellitus. Nutr Clin Pract 25(5):524–527. doi:10.1177/0884533610379851

    Article  PubMed  Google Scholar 

  37. Savvidou MD, Akolekar R, Samaha RB, Masconi AP, Nicolaides KH (2011) Maternal serum 25-hydroxyvitamin D levels at 11(+0)–13(+6) weeks in pregnant women with diabetes mellitus and in those with macrosomic neonates. BJOG 118(8):951–955. doi:10.1111/j.1471-0528.2011.02982.x

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, 230022, Hefei, China

    Min Lu, Yuanhong Xu, Liying Lv & Min Zhang

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Correspondence to Yuanhong Xu.

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Lu, M., Xu, Y., Lv, L. et al. Association between vitamin D status and the risk of gestational diabetes mellitus: a meta-analysis. Arch Gynecol Obstet 293, 959–966 (2016). https://doi.org/10.1007/s00404-016-4010-4

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