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Archives of Gynecology and Obstetrics

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01-05-2016 | Review

Association between vitamin D status and the risk of gestational diabetes mellitus: a meta-analysis

Authors: Min Lu, Yuanhong Xu, Liying Lv, Min Zhang

Published in: Archives of Gynecology and Obstetrics | Issue 5/2016

Abstract

Purpose

Vitamin D is widely used for bone growth and normal insulin secretion; however, the association between vitamin D status and gestational diabetes risk is controversial. This meta-analysis aimed to quantitatively evaluate the association between vitamin status and risk of gestational diabetes.

Methods

We performed a systematic search on the PubMed, EmBase, and Cochrane Library databases in January 2015 to obtain observational studies studying gestational diabetes risk in relation to vitamin D status. Odds ratios (ORs) with 95 % confidence intervals (CIs) were used to measure the association between vitamin D status and the risk of gestational diabetes.

Results

A total of 20 observational studies were included in the final analysis containing 16,515 individuals. Overall, maternal vitamin D insufficiency was found to be associated with a greater risk of gestational diabetes (RR 1.45; 95 % CI 1.15–1.83; P < 0.001). Subgroup analysis indicated that this association might differ based on countries, study design, assessment of vitamin D levels, sample size, age at baseline, adjusted models, and study quality.

Conclusions

This meta-analysis revealed that maternal vitamin D insufficiency is associated with increased risk of gestational diabetes.

Metzger BE, Coustan DR (1998) Summary and recommendations of the fourth international workshop-conference on gestational diabetes mellitus. The organizing committee. Diabetes Care 21(Suppl 2):B161–167PubMed

Hunt KJ, Schuller KL (2007) The increasing prevalence of diabetes in pregnancy. Obstet Gynecol Clin North Am 34(2):173–199. doi:10.1016/j.ogc.2007.03.002 vii CrossRefPubMedPubMedCentral

American Diabetes Association (2004) Gestational diabetes mellitus. Diabetes Care 27(Suppl 1):S88–90

Yap C, Cheung NW, Gunton JE, Athayde N, Munns CF, Duke A, McLean M (2014) Vitamin D supplementation and the effects on glucose metabolism during pregnancy: a randomized controlled trial. Diabetes Care 37(7):1837–1844. doi:10.2337/dc14-0155 CrossRefPubMed

Gernand AD, Simhan HN, Caritis S, Bodnar LM (2014) Maternal vitamin D status and small-for-gestational-age offspring in women at high risk for preeclampsia. Obstet Gynecol 123(1):40–48. doi:10.1097/AOG.0000000000000049 CrossRefPubMedPubMedCentral

Grant CC, Stewart AW, Scragg R, Milne T, Rowden J, Ekeroma A, Wall C, Mitchell EA, Crengle S, Trenholme A, Crane J, Camargo CA Jr (2014) Vitamin D during pregnancy and infancy and infant serum 25-hydroxyvitamin D concentration. Pediatrics 133(1):e143–153. doi:10.1542/peds.2013-2602 CrossRefPubMed

Maghbooli Z, Hossein-Nezhad A, Karimi F, Shafaei AR, Larijani B (2008) Correlation between vitamin D3 deficiency and insulin resistance in pregnancy. Diabetes Metab Res Rev 24(1):27–32. doi:10.1002/dmrr.737 CrossRefPubMed

Kramer CK, Swaminathan B, Hanley AJ, Connelly PW, Sermer M, Zinman B, Retnakaran R (2014) Vitamin D and parathyroid hormone status in pregnancy: effect on insulin sensitivity, beta-cell function, and gestational diabetes mellitus. J Clin Endocrinol Metab 99(12):4506–4513. doi:10.1210/jc.2014-2341 CrossRefPubMed

Poel YH, Hummel P, Lips P, Stam F, van der Ploeg T, Simsek S (2012) Vitamin D and gestational diabetes: a systematic review and meta-analysis. Eur J Intern Med 23(5):465–469. doi:10.1016/j.ejim.2012.01.007 CrossRefPubMed

10.

Aghajafari F, Nagulesapillai T, Ronksley PE, Tough SC, O’Beirne M, Rabi DM (2013) Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies. BMJ 346:f1169. doi:10.1136/bmj.f1169 CrossRefPubMed

11.

Baker AM, Haeri S, Camargo CA Jr, Stuebe AM, Boggess KA (2012) First-trimester maternal vitamin D status and risk for gestational diabetes (GDM) a nested case–control study. Diabetes Metab Res Rev 28(2):164–168. doi:10.1002/dmrr.1282 CrossRefPubMedPubMedCentral

12.

Fernandez-Alonso AM, Dionis-Sanchez EC, Chedraui P, Gonzalez-Salmeron MD, Perez-Lopez FR, Spanish Vitamin D, Women’s Health Research G (2012) First-trimester maternal serum 25-hydroxyvitamin D(3) status and pregnancy outcome. Int J Gynaecol Obstet 116(1):6–9. doi:10.1016/j.ijgo.2011.07.029 CrossRefPubMed

13.

Parlea L, Bromberg IL, Feig DS, Vieth R, Merman E, Lipscombe LL (2012) Association between serum 25-hydroxyvitamin D in early pregnancy and risk of gestational diabetes mellitus. Diabet Med 29(7):e25–32. doi:10.1111/j.1464-5491.2011.03550.x CrossRefPubMed

14.

Lacroix M, Battista MC, Doyon M, Houde G, Menard J, Ardilouze JL, Hivert MF, Perron P (2014) Lower vitamin D levels at first trimester are associated with higher risk of developing gestational diabetes mellitus. Acta Diabetol 51(4):609–616. doi:10.1007/s00592-014-0564-4 CrossRefPubMed

15.

Zhou J, Su L, Liu M, Liu Y, Cao X, Wang Z, Xiao H (2014) Associations between 25-hydroxyvitamin D levels and pregnancy outcomes: a prospective observational study in southern China. Eur J Clin Nutr 68(8):925–930. doi:10.1038/ejcn.2014.99 CrossRefPubMed

16.

Burris HH, Rifas-Shiman SL, Kleinman K, Litonjua AA, Huh SY, Rich-Edwards JW, Camargo CA Jr, Gillman MW (2012) Vitamin D deficiency in pregnancy and gestational diabetes mellitus. Am J Obstet Gynecol 207(3):182. doi:10.1016/j.ajog.2012.05.022 e181-188 CrossRefPubMedPubMedCentral

17.

Zuhur SS, Erol RS, Kuzu I, Altuntas Y (2013) The relationship between low maternal serum 25-hydroxyvitamin D levels and gestational diabetes mellitus according to the severity of 25-hydroxyvitamin D deficiency. Clinics (Sao Paulo) 68(5):658–664. doi:10.6061/clinics/2013(05)13 CrossRef

18.

Park S, Yoon HK, Ryu HM, Han YJ, Lee SW, Park BK, Park SY, Yim CH, Kim SH (2014) Maternal vitamin D deficiency in early pregnancy is not associated with gestational diabetes mellitus development or pregnancy outcomes in Korean pregnant women in a prospective study. J Nutr Sci Vitaminol (Tokyo) 60(4):269–275CrossRef

19.

Rodriguez A, Garcia-Esteban R, Basterretxea M, Lertxundi A, Rodriguez-Bernal C, Iniguez C, Rodriguez-Dehli C, Tardon A, Espada M, Sunyer J, Morales E (2014) Associations of maternal circulating 25-hydroxyvitamin D3 concentration with pregnancy and birth outcomes. BJOG. doi:10.1111/1471-0528.13074

20.

Parildar H, Dogruk Unal A, Aksan Desteli G, Cigerli O, Guvener Demirag N (2013) Frequency of Vitamin D deficiency in pregnant diabetics at Baskent University Hospital, Istanbul. Pak J Med Sci 29(1):15–20. doi:10.12669/pjms.291.2896 PubMedPubMedCentral

21.

Schneuer FJ, Roberts CL, Guilbert C, Simpson JM, Algert CS, Khambalia AZ, Tasevski V, Ashton AW, Morris JM, Nassar N (2014) Effects of maternal serum 25-hydroxyvitamin D concentrations in the first trimester on subsequent pregnancy outcomes in an Australian population. Am J Clin Nutr 99(2):287–295. doi:10.3945/ajcn.113.065672 CrossRefPubMed

22.

Wang O, Nie M, Hu YY, Zhang K, Li W, Ping F, Liu JT, Chen LM, Xing XP (2012) Association between vitamin D insufficiency and the risk for gestational diabetes mellitus in pregnant Chinese women. Biomed Environ Sci 25(4):399–406. doi:10.3967/0895-3988.2012.04.004 PubMed

23.

Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6(7):e1000097. doi:10.1371/journal.pmed.1000097 CrossRefPubMedPubMedCentral

24.

Wells G, Shea B, O’connell D, Peterson J, Welch V, Losos M, Tugwell P (2000) The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses

25.

DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):177–188CrossRefPubMed

26.

Ades AE, Lu G, Higgins JP (2005) The interpretation of random-effects meta-analysis in decision models. Med Decis Making 25(6):646–654. doi:10.1177/0272989X05282643 CrossRefPubMed

27.

Deeks JJ, Higgins J, Altman DG (2008) Analysing data and undertaking meta-analyses. Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series 243–296

28.

Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327(7414):557–560. doi:10.1136/bmj.327.7414.557 CrossRefPubMedPubMedCentral

29.

Tobias A (1999) Assessing the influence of a single study in meta-analysis. Stata Tech Bull 47:15–17

30.

Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634CrossRefPubMedPubMedCentral

31.

Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50(4):1088–1101CrossRefPubMed

32.

Farrant HJ, Krishnaveni GV, Hill JC, Boucher BJ, Fisher DJ, Noonan K, Osmond C, Veena SR, Fall CH (2009) Vitamin D insufficiency is common in Indian mothers but is not associated with gestational diabetes or variation in newborn size. Eur J Clin Nutr 63(5):646–652. doi:10.1038/ejcn.2008.14 CrossRefPubMedPubMedCentral

33.

Clifton-Bligh RJ, McElduff P, McElduff A (2008) Maternal vitamin D deficiency, ethnicity and gestational diabetes. Diabet Med 25(6):678–684. doi:10.1111/j.1464-5491.2008.02422.x CrossRefPubMed

34.

Zhang C, Qiu C, Hu FB, David RM, van Dam RM, Bralley A, Williams MA (2008) Maternal plasma 25-hydroxyvitamin D concentrations and the risk for gestational diabetes mellitus. PLoS One 3(11):e3753. doi:10.1371/journal.pone.0003753 CrossRefPubMedPubMedCentral

35.

Makgoba M, Nelson SM, Savvidou M, Messow CM, Nicolaides K, Sattar N (2011) First-trimester circulating 25-hydroxyvitamin D levels and development of gestational diabetes mellitus. Diabetes Care 34(5):1091–1093. doi:10.2337/dc10-2264 CrossRefPubMedPubMedCentral

36.

Soheilykhah S, Mojibian M, Rashidi M, Rahimi-Saghand S, Jafari F (2010) Maternal vitamin D status in gestational diabetes mellitus. Nutr Clin Pract 25(5):524–527. doi:10.1177/0884533610379851 CrossRefPubMed

37.

Savvidou MD, Akolekar R, Samaha RB, Masconi AP, Nicolaides KH (2011) Maternal serum 25-hydroxyvitamin D levels at 11(+0)–13(+6) weeks in pregnant women with diabetes mellitus and in those with macrosomic neonates. BJOG 118(8):951–955. doi:10.1111/j.1471-0528.2011.02982.x CrossRefPubMed

Title: Association between vitamin D status and the risk of gestational diabetes mellitus: a meta-analysis
Authors: Min Lu
Yuanhong Xu
Liying Lv
Min Zhang
Publication date: 01-05-2016
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 5/2016
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-016-4010-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Association between vitamin D status and the risk of gestational diabetes mellitus: a meta-analysis

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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