Open AccessGlucose homeostasis, beta cell function, and insulin resistance in relation to vitamin D status after gestational diabetes mellitus
Author(s) -
Shaat Nael,
Ignell Claes,
Katsarou Anastasia,
Berntorp Kerstin
Publication year - 2017
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.13124
Subject(s) - gestational diabetes , insulin resistance , medicine , endocrinology , diabetes mellitus , body mass index , glucose homeostasis , vitamin d and neurology , insulin , homeostasis , type 2 diabetes , pregnancy , gestation , biology , genetics
We wanted to determine vitamin D status after gestational diabetes mellitus ( GDM ) and to evaluate whether levels of 25‐hydroxyvitamin D 3 (25 OHD 3 ) are associated with beta cell function, insulin resistance or a diagnosis of diabetes after GDM . Material and methods Glucose homeostasis was assessed during a 75‐g oral glucose tolerance test one to two years after delivery in 376 women with previous GDM (287 European and 78 non‐European, including 33 Arab and 35 Asian women). Insulin resistance was estimated using homeostasis model assessment of insulin resistance ( HOMA ‐ IR ). The insulinogenic index (I/G30) and the disposition index [(I/G30)/ HOMA ‐ IR ] were used to calculate insulin secretion. Concentrations of serum 25 OHD 3 were determined. Results Mean (± SD ) 25 OHD 3 concentration was 50.0 ± 22.3 nmol/L and differed significantly among subgroups of body mass index, ethnicity, and glucose tolerance status; 53% had 25 OHD 3 levels <50 nmol/L and 87% had 25 OHD 3 levels <75 nmol/L. There was a negative correlation between 25 OHD 3 concentration and HOMA ‐ IR ( p < 0.001) and a positive correlation between 25 OHD 3 and disposition index ( p = 0.002) in univariable regression analysis. Correlations attenuated after adjustment for body mass index. In univariable regression analysis, 25 OHD 3 concentrations were significantly associated with diabetes after GDM ( p = 0.004). However, in a multivariable model, non‐European origin, HOMA ‐ IR and insulinogenic index were significantly associated with postpartum diabetes, whereas 25 OHD 3 concentrations were not. Conclusion Vitamin D deficiency/insufficiency in previous GDM cases appears to be associated with beta cell dysfunction and insulin resistance, but not with postpartum diabetes when factors well known to influence type‐2 diabetes were adjusted for.