A systematic review and meta-analysis of the association between vitamin D deficiency and gestational diabetes mellitus
DOI:
https://doi.org/10.15419/bmrat.v5i3.422Keywords:
Gestational Diabetes, Meta-Analysis, Pregnancy, Vitamin DAbstract
Introduction: Vitamin D deficiency has become quite prevalent and is known to cause a great many diseases. Numerous studies have investigated the association between vitamin D deficiency and gestational diabetes, and the results are somewhat contradictory. The present study deals with the relationship between the vitamin D deficiency and gestational diabetes.
Methods: Two researchers made use of MeSH, Scopus, PubMed database, Science Direct, the Cochrane Library, the Web of Science, CINAHL, and Google Scholar search engines to identify qualified studies and articles carried out and published before August 2017 and reported the risk of gestational diabetes developing as a result of vitamin D deficiency. The association between the two conditions was measured using odds ratios (ORs) with 95% confidence intervals (CIs). Funnel plots, Egger’s, and Begg’s tests were also used to assess publication bias. All analysis was done by STATA (version 11.2).
Results: Twenty-nine eligible studies with a total of 14,497 participants were included in the final analysis. Overall, maternal vitamin D insufficiency was significantly associated with a greater risk of gestational diabetes (OR = 1.15; 95% CI, 1.00-1.30; p<0.001). Serum 25OHD was significantly lower in participants with gestational diabetes mellitus than in those with natural glucose tolerance (−29.7 nmol/L, 95% CI, −36.6 to −22.8; p=0.000).
Conclusion: According to the current meta-analysis results, vitamin D deficiency is correlated with the risk of gestational diabetes development.
References
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Brown, A. J., Dusso, A., & Slatopolsky, E. (1999). Vitamin D. The American Journal of Physiology, 277(2 Pt 2), F157–F175. PMID:10444570
Burris, H. H., Rifas-Shiman, S. L., Kleinman, K., Litonjua, A. A., Huh, S. Y., Rich-Edwards, J. W., . . . Gillman, M. W. (2012). Vitamin D deficiency in pregnancy and gestational diabetes mellitus. American Journal of Obstetrics and Gynecology, 207(3), 182.e1–182.e8. https://doi.org/10.1016/j.ajog.2012.05.022 PMID:22717271
Cho, G. J., Hong, S. C., Oh, M. J., & Kim, H. J. (2013). Vitamin D deficiency in gestational diabetes mellitus and the role of the placenta. American Journal of Obstetrics and Gynecology, 209(6), 560.e1–560.e8. https://doi.org/10.1016/j.ajog.2013.08.015 PMID:23954530
Clifton-Bligh, R. J., McElduff, P., & McElduff, A. (2008). Maternal vitamin D deficiency, ethnicity and gestational diabetes. Diabetic Medicine, 25(6), 678–684. https://doi.org/10.1111/j.1464-5491.2008.02422.x PMID:18544105
Farrant, H. J., Krishnaveni, G. V., Hill, J. C., Boucher, B. J., Fisher, D. J., Noonan, K., . . . Fall, C. H. (2009). Vitamin D insufficiency is common in Indian mothers but is not associated with gestational diabetes or variation in newborn size. European Journal of Clinical Nutrition, 63(5), 646–652. https://doi.org/10.1038/ejcn.2008.14 PMID:18285809
Fernández-Alonso, A. M., Dionis-Sánchez, E. C., Chedraui, P., González-Salmerón, M. D., & Pérez-López, F. R., & the Spanish Vitamin D and Women’s Health Research Group. (2012). First-trimester maternal serum 25-hydroxyvitamin D₃ status and pregnancy outcome. International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics, 116(1), 6–9. https://doi.org/10.1016/j.ijgo.2011.07.029 PMID:21959069
Gernand, A. D., Simhan, H. N., Caritis, S., & Bodnar, L. M. (2014). Maternal vitamin D status and small-for-gestational-age offspring in women at high risk for preeclampsia. Obstetrics and Gynecology, 123(1), 40–48. https://doi.org/10.1097/AOG.0000000000000049 PMID:24463662
Grant, C. C., Stewart, A. W., Scragg, R., Milne, T., Rowden, J., Ekeroma, A., . . . Camargo, C. A., Jr. (2014). Vitamin D during pregnancy and infancy and infant serum 25-hydroxyvitamin D concentration. Pediatrics, 133(1), e143–e153. https://doi.org/10.1542/peds.2013-2602 PMID:24344104
Hagenau, T., Vest, R., Gissel, T. N., Poulsen, C. S., Erlandsen, M., Mosekilde, L., & Vestergaard, P. (2009). Global vitamin D levels in relation to age, gender, skin pigmentation and latitude: An ecologic meta-regression analysis. Osteoporosis International, 20(1), 133–140. https://doi.org/10.1007/s00198-008-0626-y PMID:18458986
Holick, M. F. (2010). The vitamin D deficiency pandemic: A forgotten hormone important for health. Public Health Reviews, 32(1), 267–263. https://doi.org/10.1007/BF03391602
Hollis, B. W., & Wagner, C. L. (2004). Assessment of dietary vitamin D requirements during pregnancy and lactation. The American Journal of Clinical Nutrition, 79(5), 717–726. PMID:15113709
Jain, M., Kapry, S., Jain, S., Singh, S.K., and Singh, T.B. (2015). Maternal Vitamin D Deficiency: A Risk Factor for Gestational Diabetes Mellitus in North India. 5, 264.
Kramer, C. K., Swaminathan, B., Hanley, A. J., Connelly, P. W., Sermer, M., Zinman, B., & Retnakaran, R. (2014). Vitamin D and parathyroid hormone status in pregnancy: Effect on insulin sensitivity, β-cell function, and gestational diabetes mellitus. The Journal of Clinical Endocrinology and Metabolism, 99(12), 4506–4513. https://doi.org/10.1210/jc.2014-2341 PMID:25202819
Lacroix, M., Battista, M. C., Doyon, M., Houde, G., Ménard, J., Ardilouze, J. L., . . . Perron, P. (2014). Lower vitamin D levels at first trimester are associated with higher risk of developing gestational diabetes mellitus. Acta Diabetologica, 51(4), 609–616. https://doi.org/10.1007/s00592-014-0564-4 PMID:24526261
Lee, J. M., Smith, J. R., Philipp, B. L., Chen, T. C., Mathieu, J., & Holick, M. F. (2007). Vitamin D deficiency in a healthy group of mothers and newborn infants. Clinical Pediatrics, 46(1), 42–44. https://doi.org/10.1177/0009922806289311 PMID:17164508
Lu, M., Xu, Y., Lv, L., & Zhang, M. (2016). Association between vitamin D status and the risk of gestational diabetes mellitus: A meta-analysis. Archives of Gynecology and Obstetrics, 293(5), 959–966. https://doi.org/10.1007/s00404-016-4010-4 PMID:26825733
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A systematic review and meta-analysis of the association between vitamin D deficiency and gestational diabetes mellitus. (2018). Biomedical Research and Therapy, 5(3), 2078-2095. https://doi.org/10.15419/bmrat.v5i3.422
