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The relationship between maternal vitamin D deficiency and glycolipid metabolism and adverse pregnancy outcome
Author(s) -
Chen HaiYing,
Zhang HongPing,
Yang Jie,
Huang ZhiQiong,
Xu HaiXia,
Jin Jiang,
Xu Kai,
Tong Yu,
Dong QianQian,
Zheng JianQiong
Publication year - 2020
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.14298
Subject(s) - medicine , endocrinology , pregnancy , offspring , vitamin d deficiency , gestation , vitamin d and neurology , gestational diabetes , biology , genetics
Objective Maternal vitamin D deficiency is associated with glucose and lipid metabolism in the mother and offspring. Meanwhile, it can also lead to adverse pregnancy outcomes. The aim of this case‐control study was to document maternal, umbilical arterial glucose and lipid metabolic levels and correlations in pregnancies with or without vitamin D deficiency, while also investigating adverse pregnancy outcomes. Design/Participants/Measurements A total of 425 pregnant women who received antenatal care and delivered at Wenzhou People's Hospital were enrolled. According to their serum 25‐hydroxyvitamin D [25(OH)D] level, the pregnant women were divided into the vitamin D deficiency group [25(OH)D < 20 ng/mL, 185 participants] and the control group [25(OH)D ≥ 20 ng/mL, 240 participants]. Maternal blood samples were collected at 24‐28 weeks of gestation and delivery for 75‐g oral glucose tolerance test (OGTT), and measurements of glucose and lipid metabolite levels and 25(OH)D levels. Umbilical arterial samples were collected during delivery (33.57‐41.43 gestational weeks). Results Compared with control participants, vitamin D deficiency women had significantly higher concentrations of fasting blood‐glucose ( P < .01), 1‐h OGTT plasma glucose ( P < .01), 2‐h OGTT plasma glucose ( P < .01), insulin ( P < .01), HOMA‐IR ( P < .01), LDL ( P < .01) and triglycerides ( P = .02) and lower concentrations of HOMA‐S ( P < .01). Compared with the control group, vitamin D deficiency women had higher concentrations of triglycerides ( P < .01) and lower concentrations of HDL‐C ( P < .01) and HOMA‐β ( P = .01) in infant umbilical arterial blood. Pearson's correlation analysis demonstrated that the maternal 25(OH)D level was negatively correlated with maternal plasma glucose, insulin, LDL‐C, cholesterol, triglyceride and HOMA‐IR ( r = −.38, −.27, −.2, −.11, −.11, −.33 and .11; P < .01, <.01, <.01, <.05, <.05 and <.01, respectively), while there was a positive correlation between maternal serum 25(OH)D and HOMA‐S ( r = .11, P < .05). The triglyceride level in the umbilical artery was negatively correlated with maternal serum 25(OH)D concentration ( r = −.286, P < .01), while the HDL‐C and HOMA‐β in umbilical artery were positively related ( r = .154, .103, P < .01). Compared with the control group, the incidences of pre‐eclampsia [4.8% (9/185) vs 1.25% (3/240), P = .03], gestational diabetes mellitus [19.45% (36/185) vs 12.08% (29/240), P = .04] and premature rupture of membranes [15.68% (29/185) vs 5.42% (13/240), P < .01] were higher in the vitamin D deficiency group. Conclusion Vitamin D deficiency during pregnancy is associated with maternal glucose and lipid metabolism and pregnancy outcomes. Therefore, it is worth recommending to maintain vitamin D status at an optimal level in pregnant women to prevent metabolic disorders and pregnancy complications.