Vitamin D Status and Gestational Diabetes in Russian Pregnant Women in the Period between 2012 and 2021: A Nested Case–Control Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
- The prospective observational study of early markers of GDM conducted from January 2012 to December 2014;
- GEM-GDM randomized controlled trial (Genetic and Epigenetic Mechanisms of Developing Gestational Diabetes Mellitus and Its Effects on the Fetus) performed from July 2015 to July 2021 [35].
2.2. Assessment of Biochemical Parameters
2.3. Statistical Analysis
3. Results
3.1. Characteristics and Vitamin D Status of Women with and without GDM
3.2. Vitamin D Status in the Third Trimester and Related Characteristics of Pregnant Women Participating in the Period 2012–2014 and 2018–2021
3.3. 25OH-Vitamin D Levels Change during Pregnancy
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Women with GDM N = 138 | Women without GDM N = 180 | p | |
---|---|---|---|
Age | 31 [28.0–34.0] | 29 [26.0–33.0] | 0.005 |
Pre-gestational BMI | 23.4 [21.4–27.2] | 22.4 [20.4–24.9] | 0.010 |
Family history of diabetes, N (%) | 56 (40.0) | 63 (34.2) | 0.287 |
History of arterial hypertension, N (%) | 19 (13.6) | 12 (6.5) | 0.033 |
History of GDM, N (%) | 6 (7.2) | 2 (2.0) | 0.144 |
History of IGT, N (%) | 3 (2.1) | 3 (1.6) | 1.000 |
PCOS, N (%) | 8 (5.7) | 11 (6.0) | 0.911 |
Parity: | |||
Nulliparae, N (%) | 91 (65.0) | 111 (60.3) | 0.390 |
Multiparae, N (%) | 49 (35.0) | 73 (39.7) | |
Fasting plasma glucose (mmol/L) | 5.2 [4.7–5.4] | 4.3 [4.0–4.5] | <0.001 |
1 h postload glucose (mmol/L) | 9.0 [7.6–10.1] | 6.7 [5.7–7.6] | <0.001 |
2 h postload glucose (mmol/L) | 7.6 [6.0–8.8] | 6.0 [5.1–6.5] | <0.001 |
Vitamin D supplements intake in the first trimester, N (%) | 37 (29.1) | 34 (21.2) | 0.124 |
Vitamin D supplements intake during pregnancy, N (%) | |||
No | 30 (23.6) | 53 (33.1) | 0.134 |
<1 month | 28 (22.0) | 42 (26.2) | |
1–3 months | 27 (21.3) | 25 (15.6) | |
>3 months | 42 (33.1) | 40 (25.0) | |
Doses of cholecalciferol, IU *** | 400 [400–2400] | 400 [400–400] | <0.001 |
Gestational age at the time of 25(OH)D analysis in the 1st trimester, weeks * | 11 [8–13] | 10 [8–12] | 0.028 |
First trimester 25(OH)D level, ng/mL * | 20.0 [15.1–25.7] | 20.5 [14.4–27.5] | 0.565 |
Severe vitamin D deficiency in the first trimester (<10 ng/mL), N (%) * | 5 (6.0) | 3 (2.3) | 0.266 |
Vitamin D deficiency in the first trimester (>10 and <20 ng/mL), N (%) * | 36 (43.4) | 57 (43.5) | 0.608 |
Vitamin D insufficiency in the first trimester (>20 and <30 ng/mL), N (%) * | 32 (38.6) | 46 (35.1) | 0.610 |
Adequate level of 25(OH)D in the first trimester, N (%) * | 10 (12.0) | 25 (19.1) | 0.175 |
Excessive level of 25(OH)D in the first trimester (>100 ng/mL) | 0 | 0 | |
Gestational age at the time of 25(OH)D analysis in the 3rd trimester, weeks ** | 26.5 [25.0–29.0] | 26.0 [25.0–28.2] | 0.438 |
Third trimester 25(OH)D level, ng/mL ** | 25.3 [19.7–32.9] | 26.7 [20.7–36.7] | 0.471 |
Severe vitamin D deficiency in the third trimester (<10 ng/mL), N (%) | 2 (1.9) | 6 (6.3) | 0.151 |
Vitamin D deficiency in the third trimester (>10 and <20 ng/mL), N (%) | 26 (24.3) | 15 (15.8) | 0.133 |
Vitamin D insufficiency in the third trimester (>20 and <30 ng/mL), N (%) | 42 (39.2) | 40 (42.1) | 0.680 |
Adequate level of 25(OH)D in the third trimester, N (%) | 37 (34.6) | 34 (35.8) | 0.857 |
Excessive level of 25(OH)D in the third trimester (>100 ng/mL) | 0 | 0 |
Vitamin D Levels | Crude Model | Adjusted Model * | ||||
---|---|---|---|---|---|---|
OR | 95% CI | p | OR | 95% CI | p | |
First trimester 25(OH)D concentration | 0.98 | 0.95–1.02 | 0.315 | 1.03 | 0.95–1.06 | 0.244 |
First-trimester vitamin D insufficiency | ||||||
≥30 ng/mL | 1.00 | 0.168 | 1.00 | 0.222 | ||
<30 ng/mL | 1.72 | 0.78–3.80 | 1.39 | 0.38–5.07 | ||
First-trimester vitamin D deficiency | ||||||
≥20 ng/mL | 1.00 | 0.608 | 1.00 | 0.218 | ||
<20 ng/mL | 1.16 | 0.67–2.00 | 1.32 | 0.48–3.61 | ||
Third trimester 25(OH)D concentration | 0.99 | 0.97–1.01 | 0.443 | 1.00 | 0.96–1.03 | 0.486 |
Third-trimester vitamin D insufficiency | ||||||
≥30 ng/mL | 1.00 | 0.857 | 1.00 | 0.489 | ||
<30 ng/mL | 1.05 | 0.59–1.88 | 1.17 | 0.50–2.41 | ||
Third-trimester vitamin D deficiency | ||||||
≥20 ng/mL | 1.00 | 0.501 | 1.00 | 0.494 | ||
<20 ng/mL | 1.25 | 0.65–2.39 | 1.08 | 0.44–2.66 |
Women Participating in 2012–2014 N = 98 * | Women Participating in 2018–2021 N = 104 * | p | |
---|---|---|---|
Age | 30 [27–33] | 31 [28–35] | 0.008 |
Pre-gestational BMI | 23.3 [20.9–26.9] | 22.2 [20.4–24.8] | 0.098 |
N (%) of women with GDM | 51 (52.0%) | 56 (53.8%) | 0.888 |
Family history of diabetes, N (%) | 40 (40.8) | 40 (38.5) | 0.732 |
History of arterial hypertension, N (%) | 10 (10.2) | 5 (4.8) | 0.183 |
History of GDM, N (%) | 1 (1.0) | 6 (5.8) | 1.000 |
History of IGT, N (%) | 4 (4.1) | 0 (0.0) | 0.054 |
PCOS, N (%) | 4 (4.1) | 7 (6.7) | 0.539 |
Parity: | |||
Nulliparae, N (%) | 70 (71.4) | 62 (59.6) | 0.078 |
Multiparae, N (%) | 28 (28.6) | 42 (40.4) | |
Fasting plasma glucose (mmol/L) | 4.7 [4.4–5.3] | 4.6 [4.2–5.1] | 0.072 |
1 h postload glucose (mmol/L) | 7.8 ± 1.9 | 7.7 ± 1.7 | 0.457 |
2 h postload glucose (mmol/L) | 6.4 [5.5–8.2] | 6.5 [5.5–7.7] | 0.777 |
Vitamin D supplements intake in the first trimester, N (%) | 21 (23.1) | 28 (29.8) | 0.301 |
Vitamin D supplements intake during pregnancy, N (%) | |||
No | 28 (30.8%) | 13 (13.8%) | <0.001 |
<1 month | 24 (26.4%) | 14 (14.9%) | |
1–3 months | 18 (19.8%) | 21 (22.3%) | |
>3 months | 21 (23.1%) | 46 (48.9%) | |
Doses of cholecalciferol, ME ** | - | 400 [400–2000] | - |
Third trimester 25(OH)D level, ng/mL | 25.6 [20.0–32.8] | 26.3 [20.3–35.0] | 0.827 |
Severe vitamin D deficiency in the third trimester (<10 ng/mL), N (%) | 3 (3.1) | 5 (4.8) | 0.722 |
Vitamin D deficiency in the third trimester (>10 and <20 ng/mL), N (%) | 22 (22.4) | 19 (18.3) | 0.460 |
Vitamin D insufficiency in the third trimester (>20 and <30 ng/mL), N (%) | 39 (39.8) | 43 (41.3) | 0.823 |
Adequate level of 25(OH)D, N (%) | 34 (34.7) | 37 (35.6) | 0.895 |
Excessive (>100 ng/mL) | 0 | 0 |
Serum 25(OH)D Levels, Me [Q1–Q3], ng/mL | p | ||
---|---|---|---|
1st Trimester | 3rd Trimester | ||
Women with GDM, N= 49 | 19.1 [14.0–26.5] | 25.2 [19.3–32.3] | <0.001 |
Women without GDM, N = 42 | 22.8 [13.5–30.2] | 26.8 [21.5–35.1] | <0.001 |
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Tkachuk, A.S.; Vasukova, E.A.; Anopova, A.D.; Karonova, T.L.; Pustozerov, E.A.; Teplova, Y.A.; Eriskovskaya, A.I.; Isakov, A.O.; Vasilieva, E.Y.; Kokina, M.A.; et al. Vitamin D Status and Gestational Diabetes in Russian Pregnant Women in the Period between 2012 and 2021: A Nested Case–Control Study. Nutrients 2022, 14, 2157. https://doi.org/10.3390/nu14102157
Tkachuk AS, Vasukova EA, Anopova AD, Karonova TL, Pustozerov EA, Teplova YA, Eriskovskaya AI, Isakov AO, Vasilieva EY, Kokina MA, et al. Vitamin D Status and Gestational Diabetes in Russian Pregnant Women in the Period between 2012 and 2021: A Nested Case–Control Study. Nutrients. 2022; 14(10):2157. https://doi.org/10.3390/nu14102157
Chicago/Turabian StyleTkachuk, Aleksandra S., Elena A. Vasukova, Anna D. Anopova, Tatiana L. Karonova, Evgenii A. Pustozerov, Yana A. Teplova, Angelina I. Eriskovskaya, Artem O. Isakov, Elena Y. Vasilieva, Maria A. Kokina, and et al. 2022. "Vitamin D Status and Gestational Diabetes in Russian Pregnant Women in the Period between 2012 and 2021: A Nested Case–Control Study" Nutrients 14, no. 10: 2157. https://doi.org/10.3390/nu14102157