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Mediating Effect of Insulin-Like Growth Factor-I Underlying the Link Between Vitamin D and Gestational Diabetes Mellitus

  • Maternal Fetal Medicine/Biology: Original Article
  • Published:
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Abstract

Vitamin D was well-known to be associated with gestational diabetes mellitus (GDM). Insulin-like growth factor-I (IGF-I) has been linked to vitamin D and GDM, respectively. We hypothesize that changes in IGF-I metabolism induced by 25(OH)D3 might contribute to GDM. Therefore, we investigated the independent and combined relationships of serum 25(OH)D3 and IGF-I concentrations with GDM risk, and the mediation effect of IGF-I on 25(OH)D3. A total of 278 pregnant women (including 125 cases and 153 controls) were recruited in our current study. Maternal serum 25(OH)D3 and IGF-I were measured in the second trimester. Logistic regression models were used to estimate the associations of 25(OH)D3 and IGF-I concentrations with the risk of GDM. Mediation analyses were used to explore the mediation effect of IGF-I on the association between 25(OH)D3 and the risk of GDM. After adjusted for the confounded factors, both the third and fourth quartile of 25(OH)D3 decreased the risk of GDM (OR = 0.226; 95% CI, 0.103–0.494; OR = 0.109; 95% CI, 0.045–0.265, respectively) compared to the first quartile of 25(OH)D3. However, the third and fourth quartile of serum IGF-I (OR = 5.174; 95% CI, 2.287–11.705; OR = 12.784; 95% CI, 5.292–30.879, respectively) increased the risk of GDM compared to the first quartile of serum IGF-I. Mediation analyses suggested that 19.62% of the associations between 25(OH)D3 and GDM might be mediated by IGF-I. The lower concentration of serum 25(OH)D3 or higher IGF-I in the second trimester was associated with an increased risk of GDM. The serum IGF-I level might be a potential mediator between 25(OH)D3 and GDM.

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The derived data generated in this research will be shared with corresponding authors upon reasonable request.

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Acknowledgements

We would like to thank all participants who accepted to participate in this study and the doctors and research assistants who participated in the study.

Funding

This study was supported by the Henan Province Key Research Project Plan of Higher Education Institutions (22A320058), Henan Province Medical Science and Technology Research (SBGJ202103090 and LHGJ20210426), Henan Province Key Research and Development Project (221111310700), and Henan Environmental and Reproductive Health Engineering Research Center. The funders had no role in the study design, implementation, analysis, decision to publish, or reparation of the manuscript.

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Authors and Affiliations

  1. Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China

    Lingling Cui, Zhiqian Li, Xiaoli Yang, Huijun Zhou, Zhengya Zhang, Yuting Gao, Lina Ren, Yibo Wang, Ruijie Sun & Linpu Ji

  2. Department of Advanced Medical Research, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, 450001, Henan, China

    Linlin Hua

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  1. Lingling Cui
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Correspondence to Linlin Hua.

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The study was approved by the Clinical Trial Ethics Committee of the Third Affiliated Hospital of Zhengzhou University, and the study had been registered with the Chinese Clinical Trial Registry (ChiCTR2000028811).

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43032_2024_1468_MOESM1_ESM.tif

Supplementary file1 (TIF 61 KB) Figure S1: The restricted cubic spline for the association between serum concentration of IGF-I and HOMA-IR. IGF-I, Insulin-like growth factor-I; HOMA-IR, homeostasis model assessment of insulin resistance.

Supplementary file2 (DOCX 22 KB)

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Cui, L., Li, Z., Yang, X. et al. Mediating Effect of Insulin-Like Growth Factor-I Underlying the Link Between Vitamin D and Gestational Diabetes Mellitus. Reprod. Sci. 31, 1541–1550 (2024). https://doi.org/10.1007/s43032-024-01468-0

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