Vitamin D3 Supplementation in Overweight/Obese Pregnant Women: No Effects on the Maternal or Fetal Lipid Profile and Body Fat Distribution—A Secondary Analysis of the Multicentric, Randomized, Controlled Vitamin D and Lifestyle for Gestational Diabetes Prevention Trial (DALI)

Abstract

Vitamin D deficiency is a common finding in overweight/obese pregnant women and is associated with increased risk for adverse pregnancy outcome. Both maternal vitamin D deficiency and maternal obesity contribute to metabolic derangements in pregnancy. We aimed to assess the effects of vitamin D3 supplementation in pregnancy versus placebo on maternal and fetal lipids. Main inclusion criteria were: women <20 weeks’ gestation, BMI ≥ 29 kg/m2. Eligible women (n = 154) were randomized to receive vitamin D3 (1600 IU/day) or placebo. Assessments were performed <20, 24–28 and 35–37 weeks and at birth. Linear regression models were used to assess effects of vitamin D on maternal and cord blood lipids. In the vitamin D group significantly higher total 25-OHD and 25-OHD3 levels were found in maternal and cord blood compared with placebo. Adjusted regression models did not reveal any differences in triglycerides, LDL-C, HDL-C, free fatty acids, ketone bodies or leptin between groups. Neonatal sum of skinfolds was comparable between the two groups, but correlated positively with cord blood 25-OH-D3 (r = 0.34, p = 0.012). Vitamin D supplementation in pregnancy increases maternal and cord blood vitamin D significantly resulting in high rates of vitamin D sufficiency. Maternal and cord blood lipid parameters were unaffected by Vitamin D3 supplementation.

The Effect of Vitamin D Supplementation in Pregnant Women with Overweight and Obesity: A Randomised Controlled Trial

“…The baseline lipid profiles of our participants could partially explain the lack of significant results [ 45 ] as they presented relatively favourable profiles [ 46 ]. Previous studies showing lipid improvements through supplementation often involved participants with poorer baseline lipid levels [ 18 , 26 ], contrasting with studies reporting no improvements, which involved participants with initially favourable lipid levels, mirroring our findings [ 15 , 25 ]. Furthermore, the modest changes typically observed in lipid profiles following vitamin D3 supplementation [ 45 ], coupled with the increased sequestration of fat-soluble vitamin D in adipose tissues of women with OW/OB [ 40 ], present additional factors.…”

“…Despite the known role of vitamin D in reducing liver triglyceride synthesis and cholesterol conversion to bile acids [ 41 ], our study, employing a daily dosage of 800 IU, did not yield significant effects on lipid profile. This contrasts with some studies advocating for supplementation due to the association between vitamin D insufficiency and unfavourable lipid profiles [ 15 , 23 , 24 , 25 ]. However, the lack of impact is consistent with findings from studies administering doses of 1600–2000 IU/day [ 15 , 25 ].…”

“…Although vitamin D is considered an antiatherogenic agent due to its potential beneficial effects on lipid metabolism and its anti-inflammatory potency [ 21 , 22 ], its effects on the metabolic status of OW/OB pregnant women remain uncertain. Previous studies have indicated an association between vitamin D deficiency and an unfavourable lipid profile [ 15 , 23 , 24 , 25 ]. Moreover, there is evidence suggesting that vitamin D supplementation could improve metabolic profiles in women with gestational diabetes [ 26 ].…”

The Role of Maternal Vitamin D Deficiency in Offspring Obesity: A Narrative Review

“…However, no correlations were found between maternal VD status and leptin level in cord blood (10.1 ng/dL vs. 9.6 ng/dL, p ≥ 0.001). This may because although different intervention of VD supplements or placebo led to significant differences between two groups in maternal 25(OH)D, the levels of maternal 25(OH)D of two groups were still above 75 nmol/L, a standard for VD sufficiency, at 24~28 weeks of gestation (120 nmol/L vs. 82 nmol/L, p < 0.001) and 35~37 weeks of gestation (123 nmol/L vs. 85 nmol/L, p < 0.001) [ 145 ]. Therefore, clinical evidence on the relation between maternal VD status and offspring leptin level remains scarce.…”

Gestationsdiabetes (GDM) (Update 2023)

“…das Risiko für LGA-Geburten bei adipösen, schwangeren Frauen im Vergleich zu Placebo trotz suffizienter Vitamin D‑Werte nicht reduzieren [ 24 ]. Trotz der signifikanten Erhöhung von Vitamin D und einer hohen Suffizienzrate waren durch eine Vitamin D Supplementation in der Schwangerschaft im Vergleich zu Placebogruppe auch die Lipidparameter in den Behandlungsgruppen nicht signifikant unterschiedlich [ 25 ]. Eine Supplementation mit Probiotika und Myoinositol konnte das GDM Risiko verringern.…”