A systematic review and meta-analysis of the association between vitamin D deficiency and gestational diabetes mellitus

Nargesi, Shahin; Ghorbani, Ayub; Shirzadpour, Ehsan; Mohamadpour, Mahmoud; Mousavi, Seyedeh Fatemeh; Amraei, Mansour

doi:10.15419/bmrat.v5i3.422

Cited by 4 publications

(6 citation statements)

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“…Specifically, hypovitaminosis-D may take its toll on placental hCTD, HBDs, and S100A9, which production depends on calcitriol transcriptional activity [ 189 , 198 , 202 ]. Moreover, maternal VD deficiency has been significantly associated with insulin resistance and a greater risk of GDM [ 203 , 204 , 205 ], which may be linked to the aberrant VD metabolism that takes place in the diabetic placenta [ 201 , 206 ]. Because of the latter, VD deficiency increases the susceptibility to maternal-fetal infections, most probably by the resultant limited immune response [ 207 , 208 ].…”

Section: Vitamin D Implications In Immune Regulation and Insulin Resistance In Gdmmentioning

confidence: 99%

Immunoendocrine Dysregulation during Gestational Diabetes Mellitus: The Central Role of the Placenta

Olmos-Ortíz

Flores-Espinosa

Díaz

et al. 2021

IJMS

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Gestational Diabetes Mellitus (GDM) is a transitory metabolic condition caused by dysregulation triggered by intolerance to carbohydrates, dysfunction of beta-pancreatic and endothelial cells, and insulin resistance during pregnancy. However, this disease includes not only changes related to metabolic distress but also placental immunoendocrine adaptations, resulting in harmful effects to the mother and fetus. In this review, we focus on the placenta as an immuno-endocrine organ that can recognize and respond to the hyperglycemic environment. It synthesizes diverse chemicals that play a role in inflammation, innate defense, endocrine response, oxidative stress, and angiogenesis, all associated with different perinatal outcomes.

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Section: Vitamin D Implications In Immune Regulation and Insulin Resistance In Gdmmentioning

confidence: 99%

Immunoendocrine Dysregulation during Gestational Diabetes Mellitus: The Central Role of the Placenta

Olmos-Ortíz

Flores-Espinosa

Díaz

et al. 2021

IJMS

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“…In a recent published meta-analysis considering 29 studies with a total of 14,497 participants, there was a significant association (OR = 1.15, 95% CI 1.00–1.30; P = <0.001) with random-effects model because the heterogeneity was low (I 2 = 31.6%; P heterogeneity = 0.055). [45] Another meta-analysis considering 26 studies also observed a significant association; however, the heterogeneity was much lower (I 2 = 8.1%; P heterogeneity = 0.346). [46] A meta-analysis conducted by Hu et al ., 2018, comprising 29 observational studies with 28,982 controls and 4,634 GDM cases, also found a significant association with random-effects model (OR = 1.39, 95% CI 1.20–1.60) having moderate heterogeneity (I 2 = 50.2%; P = 0.001).…”

Section: Discussionmentioning

confidence: 99%

“…The results of the present meta-analysis are consistence with those of previously published meta-analysis. [454647]…”

Section: Discussionmentioning

confidence: 99%

“…The optimal serum level of vitamin D during pregnancy is controversial, as we found in the subgroup meta-analysis based on geographical region which showed that only Asian[511121317232428303537384041] and European[1415181922253236] population have a significant relationship between vitamin D status and GDM risk considering random-effects model; however, the results of the present meta-analysis are contradictory than previously published meta-analyses. [4546] Even though vitamin D status is dependent on sunshine exposure but within Europe, the serum 25(OH) D levels are elevated in Northern European when compared with Southern European countries. [48] The results based on study design showed significant results with case–control study design (I 2 = 55.55%; P = 0.01) and nested case–control study design (I 2 = 50.63%; P = 0.11) with moderate heterogeneity, while cross-sectional study design (I 2 = 0.0%; P = 0.69) showed lack of heterogeneity.…”

Section: Discussionmentioning

confidence: 99%

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Significance of vitamin D on the susceptibility of gestational diabetes mellitus – A meta-analysis

Tripathi

Rao

Pandey

et al. 2019

Indian J Endocr Metab

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Vitamin D plays an important role in glucose tolerance by stimulating insulin secretion and evidences suggest a contradictory result on the association between vitamin D status and risk of developing gestational diabetes mellitus (GDM). The present updated meta-analysis has been undertaken to find out the joined effect of vitamin D status on the risk of effect GDM considering previously published articles. Data were collected through literature search using electronic databases to retrieve relevant published research articles using various combinations of the following keywords, “vitamin D,” “vitamin D deficiency,” “cholecalciferol,” “25-hydroxyvitamin D,” “25(OH) D,” “gestational diabetes mellitus,” and “GDM.” A total of 36 studies including 7,596 GDM cases and 23,377 non-GDM controls were involved in this study. Overall, pooled meta-analysis showed that pregnant women diagnosed with GDM have 18% higher risk of GDM risk when compared with controls [odds ratio (OR) = 1.18, 95% confidence interval (CI) 1.10–1.25; P = 0.00] with high heterogeneity (I2 = 73.29). The mean difference was also significantly different between cases and controls (OR = −0.18, 95% CI − 0.22 to − 0.14; P = 0.00). Subgroup analysis showed significant results with age more than 30 years, Asian and European regions, and case–control, cross-sectional, and nested case–control study design. Low concentration of vitamin D is associated with the development of GDM. Although in future more studies especially systematically designed clinical trials based on vitamin D supplementation with large sample size on different population are needed to elucidate the exact concentration of vitamin D during pregnancy as well as before and after pregnancy.

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“…According to studies, the prevalence of vitamin D de ciency is considerable among pregnant women (15,16), which might increase the risk of GDM. Although the systematic reviews of observational and randomized clinical trial studies showed a signi cant association between maternal vitamin D de ciency and the GDM occurrence (17)(18)(19), there are controversial results in this area. Therefore, the aim of the current study was to investigate the effect of supplementation with vitamin D on glycemic and metabolic status of pregnant women with GDM.…”

Section: Introductionmentioning

confidence: 99%

Effect of Vitamin D3 Supplementation on Fasting Plasma Glucose, Insulin Resistance and Lipid Profile in Women with Gestational Diabetes Mellitus: A Double-blind Randomized Controlled Clinical Trial

Sedighi

Shahbazi

Boushehri

et al. 2020

Preprint

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Background: There is inconsistent data on the effects of vitamin D supplementation on metabolic profiles in pregnant women with gestational diabetes mellitus (GDM). The aim of the current study was to assess the effect of vitamin D supplementation on the glycemic and metabolic status of pregnant women with GDM.Methods: In this randomized double-blind controlled trial pregnant women with GDM referred to the Diabetes Clinic of Hormozgan University of Medical science, Bandar Abbas, 2016-2017, were randomly assigned to the intervention (n=25) and placebo (n=25) groups. Subjects in the intervention group received two 50000 IU vitamin D3 pearls (at baseline and at day 21) plus 1000 mg calcium daily, and those in the placebo group received 2 placebos at the same times and 1000 mg calcium daily. Fasting blood samples were collected at baseline and after 6 weeks for the measurement of lipid profile, fasting plasma glucose (FPG), insulin, 25-hydroxy vitamin D, calcium, and phosphorus. Homeostatic model assessment for insulin resistance (HOMA-IR) was calculated.Results: Serum 25-hydroxy vitamin D significantly increased in the intervention group (P<0.001). Vitamin D supplementation significantly decreased FPG (P=0.049), serum insulin level (P=0.001), and HOMA-IR (P=0.001) in the intervention group compared to the placeb group. Furthermore, vitamin D significantly reduced serum triglyceride (P=0.0.002), whereas it had no significant effect on total cholesterol (P=0.099), low-density lipoprotein cholesterol (LDL-C) (P=0.279) , and high-density lipoprotein cholesterol (HDL-C) (P=0.472) compared to the placebo group.Conclusions: Vitamin D supplementation can be beneficial in the regulation of FPG, insulin level, and HOMA-IR in pregnant women with GDM.Trial registration: The research has retrospectively been registered at the Iranian Registry of Clinical Trials (IRCT) with the registration number: IRCT20150607022585N3 and is accessible at the following website: www.irct.ir.

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A systematic review and meta-analysis of the association between vitamin D deficiency and gestational diabetes mellitus

Cited by 4 publications

References 40 publications

Immunoendocrine Dysregulation during Gestational Diabetes Mellitus: The Central Role of the Placenta

Immunoendocrine Dysregulation during Gestational Diabetes Mellitus: The Central Role of the Placenta

Significance of vitamin D on the susceptibility of gestational diabetes mellitus – A meta-analysis

Effect of Vitamin D3 Supplementation on Fasting Plasma Glucose, Insulin Resistance and Lipid Profile in Women with Gestational Diabetes Mellitus: A Double-blind Randomized Controlled Clinical Trial

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