Low plasma vitamin B12 in pregnancy is associated with gestational ‘diabesity’ and later diabetes

Abstract

Aim-To test the hypothesis that low plasma vitamin B12 concentrations combined with high folate concentrations in pregnancy are associated with higher incidence of gestational diabetes (GDM) and later diabetes.Methods-Women (N=785) attending the antenatal clinics of the Holdsworth Memorial Hospital, Mysore, India had their anthropometry, insulin resistance (Homeostasis Model Assessment) and glucose tolerance assessed at 30 weeks gestation (100g Oral Glucose Tolerance Test/ OGTT; Carpenter-Coustan criteria), and five years after delivery (75g OGTT, WHO 1999). Vitamin B12 and folate concentrations in pregnancy were measured in stored frozen plasma samples.Results-Low vitamin B12 concentrations (<150 pmol/l, B12 deficiency) were observed in 43% of women and low folate concentrations (<7 nmol/l) in 4%. Women with vitamin B12 deficiency had higher body mass index (BMI; P<0.001), sum of skinfolds (P<0.001), insulin resistance (P=0.02) and a higher incidence of GDM (8.7% v 4.6%; OR=2.14, P=0.02; P=0.1 after adjusting for maternal BMI) than non-deficient women. Among vitamin B12-deficient women the incidence of GDM increased with folate concentration (5.6%, 8.8%, 12.8% respectively from lowest to highest third; P for interaction=0.2). B12 deficiency during pregnancy predicted larger skinfolds, increased insulin resistance (P<0.05) and incident diabetes at 5-year follow-up (P=0.02, after adjusting for current BMI).Conclusion-Maternal vitamin B12 deficiency is associated with increased adiposity and, in turn, with increased insulin resistance and GDM, especially in the presence of high folate concentrations. Vitamin B12 deficiency may be an important factor underlying the high risk of diabesity in south Asian Indians.

Can body fat distribution, adiponectin levels and inflammation explain differences in insulin resistance between ethnic Chinese, Malays and Asian Indians?

“…For example, it has been suggested that poor maternal vitamin B12 status during pregnancy, which is common in Indian populations, contributes to a higher risk of type 2 diabetes in the offspring. 38,39 Several studies in the United States have also demonstrated greater insulin resistance in East Asians as compared with whites for a given BMI. 25,40,41 For example, Chinese-American and Japanese-American women were more insulin resistant than white women after adjusting for waist circumference in a large cross-sectional study.…”

Transiciones en contexto: hallazgos vinculados a migración rural-urbana y enfermedades no transmisibles en Perú

“…Trabajos recientes ilustran la transmisión intergeneracional del riesgo para enfermedades crónicas no transmisibles. Varios estudios han mostrado que madres con una talla más corta tienen un riesgo elevado para diabetes gestacional (34)(35)(36) , el que podría incrementar el riesgo de diabetes de sus futuros descendientes (37) . Dado que la talla es un elemento insensible al cambio a través de nutrición luego de la infancia y adolescencia, los migrantes podrían mantener una talla más corta que los individuos urbanos.…”

Folic Acid Supplement Intake in Early Pregnancy Increases Risk of Gestational Diabetes Mellitus: Evidence From a Prospective Cohort Study

“…Previous studies have suggested that a high maternal folate concentration is associated with an increased risk of insulin resistance in children and gestational diabetes mellitus (GDM) (1). In addition, animal experiments have reported that maternal high-FA supplement promotes glucose intolerance and insulin resistance in male mouse offspring fed a high-fat diet (2).…”