Maternal, umbilical arterial and umbilical venous 25‐hydroxyvitamin D and adipocytokine concentrations in pregnancies with and without gestational diabetes

Abstract

SummaryObjective Gestational diabetes mellitus (GDM) has been associated with inflammation as well as Vitamin D insufficiency. While Vitamin D has anti-inflammatory properties, relationships between Vitamin D and inflammatory markers remain unexplored in GDM. Therefore, this case--control study investigated adipocytokine and Vitamin D [25(OH)D] concentrations and correlations in GDM and control women, as well as their neonates. Design/Participants/Measurements seventy-three women participated: 36 GDM and 37 controls. Maternal samples were drawn at 31 weeks. Umbilical arterial and venous samples were collected at birth. 25(OH)D and adipocytokine concentrations were compared for GDM vs control maternal, umbilical arterial and venous samples. Correlations were explored between biochemical results, maternal and neonatal demographics. Results Compared with age-and weight-matched control participants, GDM women had significantly lower concentrations of 25(OH)D (77Á3 AE 24Á3 vs 93Á2 AE 19Á2 nm/l; P = 0Á009); adiponectin (17Á5 AE 11Á8 vs 34Á1 AE 20Á3 μg/ml, P < 0Á001); resistin (25Á4 AE 9Á1 vs 31Á9 AE 12Á1 ng/ml, P = 0Á045); and plasminogen activator inhibitor-1 (PAI-1) 13Á9 AE 10Á0 vs 21Á0 AE 12Á6 ng/ml, P = 0Á038), while delivering 1 week earlier (38Á2 AE 1Á2 vs 39Á5 AE 0Á9 weeks, P < 0Á001). GDM maternal 25(OH)D concentrations positively correlated with PAI-1, IL-8 and TNF-a concentrations. Umbilical 25(OH)D concentrations were not significantly different in GDM vs control offspring, whereas adiponectin, resistin and PAI-1 concentrations were significantly lower in GDM offspring. Conclusions GDM women had lower 25(OH)D concentrations than controls, while neonatal umbilical concentrations of 25 (OH)D did not differ. GDM maternal and GDM offspring had lower adiponectin, resistin and PAI-1 concentrations compared with controls. Results suggest that both GDM women and their offspring demonstrate abnormal adipocytokine patterns.

Commentary for McManus et al. paper, ‘Maternal, umbilical arterial and umbilical venous 25‐hydroxyvitamin D and adipocytokine concentrations in pregnancies with and without gestational diabetes'

“…Based on what we know about vitamin D and pregnancy, it is not surprising then that in the McManus et al . study, maternal vitamin D supplementation did not impact on maternal 25(OH)D [and neonatal 25(OH)D] as the standard amount in prenatal vitamins – 400 IU – does not change vitamin D status in all but the most deficient women and does not allow most women to reach the 100 n m suggested by Hollis et al . for optimization of 25(OH)D conversion to 1,25(OH) 2 D. Only when you see a greater spread in the vitamin D status of the mothers and offspring might you see more dichotomy in some of the outcome measures.…”

“…Findings that challenge our traditional view of 25(OH)D as only anti‐inflammatory – may actually provide a path for continued research. Despite the small number of participants in the study by McManus et al ., the findings are intriguing, surprising and add to the existing literature and will prompt others – as, for example, the European DALI Study (Vitamin D and Lifestyle Intervention for Gestational Diabetes Mellitus) that is underway, to explore more deeply this dynamic system and to establish the pathways that are mediated by vitamin D during pregnancy.…”

“…While earlier studies have shown gestational diabetic women to have lower adipocytokine concentrations, McManus et al . are the first to demonstrate that such patterns are linked with vitamin D deficiency in both the mother and her neonate.…”

“…The article by McManus et al . that appears in this month's issue of Clinical Endocrinology entitled ‘Maternal, Umbilical Arterial And Umbilical Venous 25‐Hydroxyvitamin D And Adipocytokine Concentrations In Pregnancies With And Without Gestational Diabetes' extends the debate about the multifunctional role of vitamin D during pregnancy.…”

“…The article by McManus et al 1 that appears in this month's issue of Clinical Endocrinology entitled 'Maternal, Umbilical Arterial And Umbilical Venous 25-Hydroxyvitamin D And Adipocytokine Concentrations In Pregnancies With And Without Gestational Diabetes' extends the debate about the multifunctional role of vitamin D during pregnancy. Looking at the relationship between total circulating 25(OH)D and adipocytokine and its related cytokines during pregnancy as a function of glucose state of the mother is an important research focus.…”