The association of maternal fat-soluble antioxidants in early pregnancy with gestational diabetes mellitus: a prospective cohort study

Abstract

Introduction Oxidative stress is linked to the development of gestational diabetes mellitus (GDM). Maternal antioxidant vitamins in early pregnancy may play a role in GDM occurrence. We aimed to investigate the associations of vitamins A and E in early pregnancy with the risk of GDM and to explore whether these antioxidant vitamins can be biomarkers for the early prediction of GDM. Methods We carried out a prospective cohort study conducted in Beijing and enrolled pregnant women (n = 667) with vitamins A and E measurements at 9 weeks (IQR 8–10) of gestation and having one-step GDM screened with a 75-g oral glucose tolerance test between 24 and 28 weeks of gestation. Results The vitamin A levels in early pregnancy were significantly higher in women with GDM than in those without GDM (p < 0.0001) and positively correlated with fasting blood glucose. In multivariate models, vitamin A levels were significantly associated with GDM (OR, 1.46; 95% CI: 1.14–1.88; p = 0.0032) per SD. A significant trend of risk effect on GDM risk across quartiles of vitamin A was observed (ptrend = 0.016). No significant association of serum vitamin E with GDM was observed overall. However, a noted trend of protective effect on GDM risk across quartiles of vitamin E/cholesterol ratio was observed (ptrend = 0.043). In ROC analysis, the multivariate model consisting of vitamin A and other risk factors showed the best predictive performance (AUC: 0.760; 95% CI: 0.705–0.815; p < 0.001). Conclusions Higher levels of vitamin A in early pregnancy were significantly associated with an increased risk of GDM. Vitamin A has the potential to be a biomarker indicating pathogenesis of GDM.

Gestational Vitamin E Status and Gestational Diabetes Mellitus: A Retrospective Cohort Study

“…All available previous studies conducted the analyses based on the hypothesis that the association between VE concentration and GDM was linear [ 17 ]. The aforementioned systematic review by Sharifipour et al concluded that the VE level was significantly lower in women with GDM compared to healthy pregnant women [ 18 ].…”

“…Vitamin E (VE), a well documented antioxidant, can neutralize ROS, eliminate oxygen free radicals, and protect tissue from damage [ 9 , 10 ]. However, although a robust number of studies on the role of VE in the cause and prevention of diabetic complications [ 8 , 11 , 12 , 13 , 14 , 15 ], there are very few studies on its association with risk of diabetes mellitus, especially GDM [ 16 , 17 ]. The systematic review by Sharifipour et al aimed to evaluate the association between VE and GDM, and this only included eleven relevant studies with a total of 596 participants published before December 2019, of which seven were the case-control studies, and the rest were cross-sectional [ 18 ].…”

Oxidative Stress and Thrombophilia: Focus on Pregnancy-Related Pathophysiological Mechanisms

“…While some level of oxidative stress is necessary for normal fetal development and signaling processes, excessive oxidative stress can be detrimental to fetal health (54). A balanced diet rich in antioxidants (such as vitamins C and E, and other phytochemicals) can help mitigate oxidative stress during pregnancy (55,56). It's important to note that while oxidative stress can have negative effects, it also plays essential roles in normal physiological processes.…”

Dietary management of gestational diabetes: A review

“…[93] Other prospective studies have come to the opposite conclusion, suggesting that high vitamin A levels lead to GDM. [94]…”

“…[93] Other prospective studies have come to the opposite conclusion, suggesting that high vitamin A levels lead to GDM. [94] 7. Trace element A study suggests that micronutrient supplementation during pregnancy is beneficial for patients with GDM.…”