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Lower vitamin D levels at first trimester are associated with higher risk of developing gestational diabetes mellitus

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Abstract

The progressive increase of insulin resistance observed in pregnancy contributes to the pathophysiology of gestational diabetes mellitus (GDM). There is controversy whether vitamin D deficiency contributes to abnormal glycemic regulation in pregnancy. We tested the associations between first trimester 25-hydroxyvitamin D (25OHD) levels and: 1) the risk of developing GDM; 2) insulin resistance/sensitivity, beta cell function and compensation indices in a large population-based prospective cohort of pregnant women. Participants (n = 655) were seen at first (6–13 weeks) and second (24–28 weeks) trimesters for blood samples. At first trimester, 25OHD levels were measured. At second trimester, glucose and insulin were measured 3 times during the oral glucose tolerance test to estimate insulin resistance (HOMA-IR), beta cell function (HOMA-B), insulin sensitivity (Matsuda index), insulin secretion (AUCins/gluc) and beta cell compensation (ISSI-2). Based on IADPSG criteria, 54 participants (8.2 %) developed GDM. Lower first trimester 25OHD levels were associated with higher risk of developing GDM even after adjustment for vitamin D confounding factors and GDM risk factors (OR = 1.48 per decrease of one SD in 25OHD levels; P = 0.04). Lower first trimester 25OHD levels were associated with higher HOMA-IR (r = − 0.08; P = 0.03), lower Matsuda index (r = 0.13; P = 0.001) and lower ISSI-2 (r = 0.08; P = 0.04). After adjustment for confounders, we found no significant association with HOMA-B and AUCins/gluc. Our results suggest that low levels of 25OHD at first trimester are (1) an independent risk factor for developing GDM and (2) associated with insulin resistance at second trimester.

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Acknowledgments

The authors acknowledge the Blood Sampling in Pregnancy clinic at the Clinical Research Center Etienne-Le Bel (CRCEL) affiliated to the CHUS; the assistance of clinical research nurses (Maude Gérard, Georgette Proulx, Suzan Hayes, Marie-Josée Gosselin) and research assistants (Caroline Rousseau, Pascal Brassard) for recruiting women and obtaining their consent; the contribution of Denis Cyr and Guy Fink for performing 25OHD analyses; and the CHUS laboratory for performing 25OHD extractions and blood glucose, calcium, phosphorus and parathormone analyses. CRCEL is a Fonds de Recherche du Québec—Santé (FRQS) supported research center. The study was supported by a Fonds de Recherche du Québec—Santé (FRQ-S) Operating grant (MF Hivert) and by Diabète Québec (P Perron). MF Hivert was awarded a FRQ-S research scholar, a Canadian Diabetes Association’s Clinical Scientist Award, and the Maud Menten Award from the Institute of Genetics (IG)—Canadian Institute of Health Research (CIHR). M Lacroix was supported by Diabète Québec, Centre de recherche Mère-Enfant de l’Université de Sherbrooke and Foundation of Stars.

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Authors and Affiliations

  1. Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada

    Marilyn Lacroix, Marie-Claude Battista, Ghislaine Houde, Jean-Luc Ardilouze, Marie-France Hivert & Patrice Perron

  2. Centre de recherche clinique Étienne-Le Bel, Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada

    Myriam Doyon, Ghislaine Houde, Julie Ménard, Jean-Luc Ardilouze, Marie-France Hivert & Patrice Perron

  3. Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA, USA

    Marie-France Hivert

  4. Division of Endocrinology, Department of Medicine, Centre hospitalier universitaire de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, QC, J1H 5N4, Canada

    Patrice Perron

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  1. Marilyn Lacroix
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  2. Marie-Claude Battista
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Correspondence to Patrice Perron.

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Communicated by Massimo Porta.

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Lacroix, M., Battista, MC., Doyon, M. et al. Lower vitamin D levels at first trimester are associated with higher risk of developing gestational diabetes mellitus. Acta Diabetol 51, 609–616 (2014). https://doi.org/10.1007/s00592-014-0564-4

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  • DOI: https://doi.org/10.1007/s00592-014-0564-4

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