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Published in: BMC Pregnancy and Childbirth 1/2015

Open Access 01-12-2015 | Research article

Vitamin D deficiency and dyslipidemia in early pregnancy

Authors: Abdulrahman Al-Ajlan, Soundararajan Krishnaswamy, Majed S. Alokail, Naji J. Aljohani, Amal Al-Serehi, Eman Sheshah, Naemah M. Alshingetti, Mona Fouda, Iqbal Z. Turkistani, Nasser M. Al-Daghri

Published in: BMC Pregnancy and Childbirth | Issue 1/2015

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Abstract

Background

Vitamin D deficiency is a common nutritional issue and dietary supplementation in the general population, including pregnant women, is generally advised. Appropriately high levels of vitamin D are expected to play a role in containing the glycemic and atherogenic profiles observed in pregnancy. However, the relation between vitamin D status and the lipid metabolic profile in Saudi women, who are known to suffer from chronic vitamin D deficiency and high incidence of obesity and type II DM, during the course of pregnancy is not known.

Methods

In this study, we analyzed the relation between serum vitamin D level and various serum metabolic markers among Saudi women (n = 515) in their first trimester of pregnancy (11.2 ± 3.4 weeks). Coefficients of Pearson correlation and Spearman rank correlation were calculated for Gaussian and non-Gaussian variables, respectively. Serum vitamin D status was defined as (in nmol/L): deficient (<25), insufficient (25–50); sufficient (50–75) and desirable (>75).

Results

Results indicated that vitamin D status was sufficient in only 3.5 % of the study participants and insufficient and deficient in 26.2 % and 68.0 % of participants, respectively. Serum vitamin D values in the overall study population correlated positively with serum levels of total cholesterol (R = 0.172; p < 0.01), triglycerides (R = 0.184; p < 0.01) and corrected calcium (R = 0.141; p < 0.05). In the subgroup of vitamin D deficient subjects (n = 350), log serum vitamin D values correlated with serum triglycerides (R = 0.23; p = 0.002) and cholesterol (R = 0.26; p = 0.001).

Conclusions

The positive correlations between serum vitamin D and the atherogenic factors such as total cholesterol and triglycerides indicate a pro-atherogenic metabolic status in vitamin D deficient expectant mothers. This may represent an adaptation to the high metabolic demands of pregnancy.
Literature
1.
go back to reference Olmos-Ortiz A, Avila E, Durand-Carbajal M, Diaz L. Regulation of calcitriol biosynthesis and activity: focus on gestational vitamin D deficiency and adverse pregnancy outcomes. Nutrients. 2015;7(1):443–80.PubMedCentralPubMedCrossRef Olmos-Ortiz A, Avila E, Durand-Carbajal M, Diaz L. Regulation of calcitriol biosynthesis and activity: focus on gestational vitamin D deficiency and adverse pregnancy outcomes. Nutrients. 2015;7(1):443–80.PubMedCentralPubMedCrossRef
2.
go back to reference Wahl DA, Cooper C, Ebeling PR, Eggersdorfer M, Hilger J, Hoffmann K, et al. A global representation of vitamin D status in healthy populations. Arch Osteoporos. 2012;7(1–2):155–72.PubMedCrossRef Wahl DA, Cooper C, Ebeling PR, Eggersdorfer M, Hilger J, Hoffmann K, et al. A global representation of vitamin D status in healthy populations. Arch Osteoporos. 2012;7(1–2):155–72.PubMedCrossRef
3.
go back to reference Brannon PM. Vitamin D and adverse pregnancy outcomes: beyond bone health and growth. Proc Nutr Soc. 2012;71(2):205–12.PubMedCrossRef Brannon PM. Vitamin D and adverse pregnancy outcomes: beyond bone health and growth. Proc Nutr Soc. 2012;71(2):205–12.PubMedCrossRef
4.
go back to reference Hussain AN, Alkhenizan AH, El Shaker M, Raef H, Gabr A. Increasing trends and significance of hypovitaminosis D: a population-based study in the Kingdom of Saudi Arabia. Arch Osteoporos. 2014;9(1):190.PubMedCrossRef Hussain AN, Alkhenizan AH, El Shaker M, Raef H, Gabr A. Increasing trends and significance of hypovitaminosis D: a population-based study in the Kingdom of Saudi Arabia. Arch Osteoporos. 2014;9(1):190.PubMedCrossRef
5.
go back to reference Al-Mogbel ES. Vitamin D status among Adult Saudi Females visiting Primary Health Care Clinics. Int J Health Sci. 2012;6(2):116–26.CrossRef Al-Mogbel ES. Vitamin D status among Adult Saudi Females visiting Primary Health Care Clinics. Int J Health Sci. 2012;6(2):116–26.CrossRef
6.
go back to reference Soheilykhah S, Mojibian M, Rashidi M, Rahimi-Saghand S, Jafari F. Maternal vitamin D status in gestational diabetes mellitus. Nutr Clin Pract. 2010;25(5):524–7.PubMedCrossRef Soheilykhah S, Mojibian M, Rashidi M, Rahimi-Saghand S, Jafari F. Maternal vitamin D status in gestational diabetes mellitus. Nutr Clin Pract. 2010;25(5):524–7.PubMedCrossRef
7.
go back to reference Parlea L, Bromberg IL, Feig DS, Vieth R, Merman E, Lipscombe LL. Association between serum 25-hydroxyvitamin D in early pregnancy and risk of gestational diabetes mellitus. Diabet Med. 2012;29(7):e25–32.PubMedCrossRef Parlea L, Bromberg IL, Feig DS, Vieth R, Merman E, Lipscombe LL. Association between serum 25-hydroxyvitamin D in early pregnancy and risk of gestational diabetes mellitus. Diabet Med. 2012;29(7):e25–32.PubMedCrossRef
8.
go back to reference Lau SL, Gunton JE, Athayde NP, Byth K, Cheung NW. Serum 25-hydroxyvitamin D and glycated haemoglobin levels in women with gestational diabetes mellitus. Med J Aust. 2011;194(7):334–7.PubMed Lau SL, Gunton JE, Athayde NP, Byth K, Cheung NW. Serum 25-hydroxyvitamin D and glycated haemoglobin levels in women with gestational diabetes mellitus. Med J Aust. 2011;194(7):334–7.PubMed
9.
go back to reference Martin U, Davies C, Hayavi S, Hartland A, Dunne F. Is normal pregnancy atherogenic? Clin Sci (Lond). 1999;96(4):421–5.CrossRef Martin U, Davies C, Hayavi S, Hartland A, Dunne F. Is normal pregnancy atherogenic? Clin Sci (Lond). 1999;96(4):421–5.CrossRef
10.
go back to reference Carpenter MW. Gestational diabetes, pregnancy hypertension, and late vascular disease. Diabetes Care. 2007;30 Suppl 2:S246–250.PubMedCrossRef Carpenter MW. Gestational diabetes, pregnancy hypertension, and late vascular disease. Diabetes Care. 2007;30 Suppl 2:S246–250.PubMedCrossRef
11.
go back to reference Butte NF. Carbohydrate and lipid metabolism in pregnancy: normal compared with gestational diabetes mellitus. Am J Clin Nutr. 2000;71(5 Suppl):1256S–61S.PubMed Butte NF. Carbohydrate and lipid metabolism in pregnancy: normal compared with gestational diabetes mellitus. Am J Clin Nutr. 2000;71(5 Suppl):1256S–61S.PubMed
12.
go back to reference Di Cianni G, Miccoli R, Volpe L, Lencioni C, Ghio A, Giovannitti MG, et al. Maternal triglyceride levels and newborn weight in pregnant women with normal glucose tolerance. Diabet Med. 2005;22(1):21–5.PubMedCrossRef Di Cianni G, Miccoli R, Volpe L, Lencioni C, Ghio A, Giovannitti MG, et al. Maternal triglyceride levels and newborn weight in pregnant women with normal glucose tolerance. Diabet Med. 2005;22(1):21–5.PubMedCrossRef
13.
go back to reference Aghajafari F, Nagulesapillai T, Ronksley PE, Tough SC, O’Beirne M, Rabi DM. Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies. BMJ. 2013;346:f1169.PubMedCrossRef Aghajafari F, Nagulesapillai T, Ronksley PE, Tough SC, O’Beirne M, Rabi DM. Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies. BMJ. 2013;346:f1169.PubMedCrossRef
14.
go back to reference Thorne-Lyman A, Fawzi WW. Vitamin D during pregnancy and maternal, neonatal and infant health outcomes: a systematic review and meta-analysis. Paediatr Perinat Epidemiol. 2012;26 Suppl 1:75–90.PubMedCrossRef Thorne-Lyman A, Fawzi WW. Vitamin D during pregnancy and maternal, neonatal and infant health outcomes: a systematic review and meta-analysis. Paediatr Perinat Epidemiol. 2012;26 Suppl 1:75–90.PubMedCrossRef
15.
go back to reference Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr. 2006;84(1):18–28.PubMed Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr. 2006;84(1):18–28.PubMed
16.
go back to reference Ginde AA, Sullivan AF, Mansbach JM, Camargo Jr CA. Vitamin D insufficiency in pregnant and nonpregnant women of childbearing age in the United States. Am J Obstet Gynecol. 2010;202(5):436. e431-438.PubMedCentralPubMed Ginde AA, Sullivan AF, Mansbach JM, Camargo Jr CA. Vitamin D insufficiency in pregnant and nonpregnant women of childbearing age in the United States. Am J Obstet Gynecol. 2010;202(5):436. e431-438.PubMedCentralPubMed
17.
go back to reference Holmes VA, Barnes MS, Alexander HD, McFaul P, Wallace JM. Vitamin D deficiency and insufficiency in pregnant women: a longitudinal study. Br J Nutr. 2009;102(6):876–81.PubMedCrossRef Holmes VA, Barnes MS, Alexander HD, McFaul P, Wallace JM. Vitamin D deficiency and insufficiency in pregnant women: a longitudinal study. Br J Nutr. 2009;102(6):876–81.PubMedCrossRef
18.
go back to reference Vieth R. Why the minimum desirable serum 25-hydroxyvitamin D level should be 75 nmol/L (30 ng/ml). Best Pract Res Clin Endocrinol Metab. 2011;25(4):681–91.PubMedCrossRef Vieth R. Why the minimum desirable serum 25-hydroxyvitamin D level should be 75 nmol/L (30 ng/ml). Best Pract Res Clin Endocrinol Metab. 2011;25(4):681–91.PubMedCrossRef
19.
go back to reference Luxwolda MF, Kuipers RS, Kema IP, Dijck-Brouwer DA, Muskiet FA. Traditionally living populations in East Africa have a mean serum 25-hydroxyvitamin D concentration of 115 nmol/l. Br J Nutr. 2012;108(9):1557–61.PubMedCrossRef Luxwolda MF, Kuipers RS, Kema IP, Dijck-Brouwer DA, Muskiet FA. Traditionally living populations in East Africa have a mean serum 25-hydroxyvitamin D concentration of 115 nmol/l. Br J Nutr. 2012;108(9):1557–61.PubMedCrossRef
20.
go back to reference van Schoor NM, Lips P. Worldwide vitamin D status. Best Pract Res Clin Endocrinol Metab. 2011;25(4):671–80.PubMedCrossRef van Schoor NM, Lips P. Worldwide vitamin D status. Best Pract Res Clin Endocrinol Metab. 2011;25(4):671–80.PubMedCrossRef
21.
go back to reference Xiao JP, Zang J, Pei JJ, Xu F, Zhu Y, Liao XP. Low maternal vitamin D status during the second trimester of pregnancy: a cross-sectional study in Wuxi, China. PLoS One. 2015;10(2):e0117748.PubMedCentralPubMedCrossRef Xiao JP, Zang J, Pei JJ, Xu F, Zhu Y, Liao XP. Low maternal vitamin D status during the second trimester of pregnancy: a cross-sectional study in Wuxi, China. PLoS One. 2015;10(2):e0117748.PubMedCentralPubMedCrossRef
22.
go back to reference Sahu M, Bhatia V, Aggarwal A, Rawat V, Saxena P, Pandey A, et al. Vitamin D deficiency in rural girls and pregnant women despite abundant sunshine in northern India. Clin Endocrinol (Oxf). 2009;70(5):680–4.CrossRef Sahu M, Bhatia V, Aggarwal A, Rawat V, Saxena P, Pandey A, et al. Vitamin D deficiency in rural girls and pregnant women despite abundant sunshine in northern India. Clin Endocrinol (Oxf). 2009;70(5):680–4.CrossRef
23.
go back to reference Marwaha RK, Tandon N, Chopra S, Agarwal N, Garg MK, Sharma B, et al. Vitamin D status in pregnant Indian women across trimesters and different seasons and its correlation with neonatal serum 25-hydroxyvitamin D levels. Br J Nutr. 2011;106(9):1383–9.PubMedCrossRef Marwaha RK, Tandon N, Chopra S, Agarwal N, Garg MK, Sharma B, et al. Vitamin D status in pregnant Indian women across trimesters and different seasons and its correlation with neonatal serum 25-hydroxyvitamin D levels. Br J Nutr. 2011;106(9):1383–9.PubMedCrossRef
24.
go back to reference Ardawi MS, Qari MH, Rouzi AA, Maimani AA, Raddadi RM. Vitamin D status in relation to obesity, bone mineral density, bone turnover markers and vitamin D receptor genotypes in healthy Saudi pre- and postmenopausal women. Osteoporos Int. 2011;22(2):463–75.PubMedCrossRef Ardawi MS, Qari MH, Rouzi AA, Maimani AA, Raddadi RM. Vitamin D status in relation to obesity, bone mineral density, bone turnover markers and vitamin D receptor genotypes in healthy Saudi pre- and postmenopausal women. Osteoporos Int. 2011;22(2):463–75.PubMedCrossRef
25.
go back to reference Elsammak MY, Al-Wossaibi AA, Al-Howeish A, Alsaeed J. High prevalence of vitamin D deficiency in the sunny Eastern region of Saudi Arabia: a hospital-based study. East Mediterr Health J= La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit. 2011;17(4):317–22. Elsammak MY, Al-Wossaibi AA, Al-Howeish A, Alsaeed J. High prevalence of vitamin D deficiency in the sunny Eastern region of Saudi Arabia: a hospital-based study. East Mediterr Health J= La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit. 2011;17(4):317–22.
26.
go back to reference DeSisto CL, Kim SY, Sharma AJ. Prevalence estimates of gestational diabetes mellitus in the United States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2007–2010. Prev Chronic Dis. 2014;11:E104.PubMedCentralPubMedCrossRef DeSisto CL, Kim SY, Sharma AJ. Prevalence estimates of gestational diabetes mellitus in the United States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2007–2010. Prev Chronic Dis. 2014;11:E104.PubMedCentralPubMedCrossRef
27.
go back to reference Silver J, Russell J, Sherwood LM. Regulation by vitamin D metabolites of messenger ribonucleic acid for preproparathyroid hormone in isolated bovine parathyroid cells. Proc Natl Acad Sci U S A. 1985;82(12):4270–3.PubMedCentralPubMedCrossRef Silver J, Russell J, Sherwood LM. Regulation by vitamin D metabolites of messenger ribonucleic acid for preproparathyroid hormone in isolated bovine parathyroid cells. Proc Natl Acad Sci U S A. 1985;82(12):4270–3.PubMedCentralPubMedCrossRef
28.
go back to reference Silver J, Naveh-Many T, Mayer H, Schmelzer HJ, Popovtzer MM. Regulation by vitamin D metabolites of parathyroid hormone gene transcription in vivo in the rat. J Clin Invest. 1986;78(5):1296–301.PubMedCentralPubMedCrossRef Silver J, Naveh-Many T, Mayer H, Schmelzer HJ, Popovtzer MM. Regulation by vitamin D metabolites of parathyroid hormone gene transcription in vivo in the rat. J Clin Invest. 1986;78(5):1296–301.PubMedCentralPubMedCrossRef
29.
go back to reference Yonemura K, Fujimoto T, Fujigaki Y, Hishida A. Vitamin D deficiency is implicated in reduced serum albumin concentrations in patients with end-stage renal disease. Am J Kidney Dis. 2000;36(2):337–44.PubMedCrossRef Yonemura K, Fujimoto T, Fujigaki Y, Hishida A. Vitamin D deficiency is implicated in reduced serum albumin concentrations in patients with end-stage renal disease. Am J Kidney Dis. 2000;36(2):337–44.PubMedCrossRef
30.
go back to reference Kumar R, Cohen WR, Silva P, Epstein FH. Elevated 1,25-dihydroxyvitamin D plasma levels in normal human pregnancy and lactation. J Clin Invest. 1979;63(2):342–4.PubMedCentralPubMedCrossRef Kumar R, Cohen WR, Silva P, Epstein FH. Elevated 1,25-dihydroxyvitamin D plasma levels in normal human pregnancy and lactation. J Clin Invest. 1979;63(2):342–4.PubMedCentralPubMedCrossRef
31.
go back to reference Kawashima H, Torikai S, Kurokawa K. Calcitonin selectively stimulates 25-hydroxyvitamin D3-1 alpha-hydroxylase in proximal straight tubule of rat kidney. Nature. 1981;291(5813):327–9.PubMedCrossRef Kawashima H, Torikai S, Kurokawa K. Calcitonin selectively stimulates 25-hydroxyvitamin D3-1 alpha-hydroxylase in proximal straight tubule of rat kidney. Nature. 1981;291(5813):327–9.PubMedCrossRef
32.
go back to reference Stevenson JC, Hillyard CJ, MacIntyre I, Cooper H, Whitehead MI. A physiological role for calcitonin: protection of the maternal skeleton. Lancet. 1979;2(8146):769–70.PubMedCrossRef Stevenson JC, Hillyard CJ, MacIntyre I, Cooper H, Whitehead MI. A physiological role for calcitonin: protection of the maternal skeleton. Lancet. 1979;2(8146):769–70.PubMedCrossRef
33.
go back to reference Wiznitzer A, Mayer A, Novack V, Sheiner E, Gilutz H, Malhotra A, et al. Association of lipid levels during gestation with preeclampsia and gestational diabetes mellitus: a population-based study. Am J Obstet Gynecol. 2009;201(5):482. e481-488.PubMed Wiznitzer A, Mayer A, Novack V, Sheiner E, Gilutz H, Malhotra A, et al. Association of lipid levels during gestation with preeclampsia and gestational diabetes mellitus: a population-based study. Am J Obstet Gynecol. 2009;201(5):482. e481-488.PubMed
34.
go back to reference Couch SC, Philipson EH, Bendel RB, Pujda LM, Milvae RA, Lammi-Keefe CJ. Elevated lipoprotein lipids and gestational hormones in women with diet-treated gestational diabetes mellitus compared to healthy pregnant controls. J Diabetes Complications. 1998;12(1):1–9.PubMedCrossRef Couch SC, Philipson EH, Bendel RB, Pujda LM, Milvae RA, Lammi-Keefe CJ. Elevated lipoprotein lipids and gestational hormones in women with diet-treated gestational diabetes mellitus compared to healthy pregnant controls. J Diabetes Complications. 1998;12(1):1–9.PubMedCrossRef
35.
go back to reference Pittas AG, Chung M, Trikalinos T, Mitri J, Brendel M, Patel K, et al. Systematic review: Vitamin D and cardiometabolic outcomes. Ann Intern Med. 2010;152(5):307–14.PubMedCentralPubMedCrossRef Pittas AG, Chung M, Trikalinos T, Mitri J, Brendel M, Patel K, et al. Systematic review: Vitamin D and cardiometabolic outcomes. Ann Intern Med. 2010;152(5):307–14.PubMedCentralPubMedCrossRef
36.
go back to reference Wang L, Song Y, Manson JE, Pilz S, Marz W, Michaelsson K, et al. Circulating 25-hydroxy-vitamin D and risk of cardiovascular disease: a meta-analysis of prospective studies. Circ Cardiovasc Qual Outcomes. 2012;5(6):819–29.PubMedCentralPubMedCrossRef Wang L, Song Y, Manson JE, Pilz S, Marz W, Michaelsson K, et al. Circulating 25-hydroxy-vitamin D and risk of cardiovascular disease: a meta-analysis of prospective studies. Circ Cardiovasc Qual Outcomes. 2012;5(6):819–29.PubMedCentralPubMedCrossRef
37.
go back to reference Reid IR, Bolland MJ. Role of vitamin D deficiency in cardiovascular disease. Heart. 2012;98(8):609–14.PubMedCrossRef Reid IR, Bolland MJ. Role of vitamin D deficiency in cardiovascular disease. Heart. 2012;98(8):609–14.PubMedCrossRef
38.
go back to reference Riek AE, Oh J, Bernal-Mizrachi C. 1,25(OH)2 vitamin D suppresses macrophage migration and reverses atherogenic cholesterol metabolism in type 2 diabetic patients. J Steroid Biochem Mol Biol. 2013;136:309–12.PubMedCentralPubMedCrossRef Riek AE, Oh J, Bernal-Mizrachi C. 1,25(OH)2 vitamin D suppresses macrophage migration and reverses atherogenic cholesterol metabolism in type 2 diabetic patients. J Steroid Biochem Mol Biol. 2013;136:309–12.PubMedCentralPubMedCrossRef
39.
go back to reference Gupta AK, Sexton RC, Rudney H. Effect of vitamin D3 derivatives on cholesterol synthesis and HMG-CoA reductase activity in cultured cells. J Lipid Res. 1989;30(3):379–86.PubMed Gupta AK, Sexton RC, Rudney H. Effect of vitamin D3 derivatives on cholesterol synthesis and HMG-CoA reductase activity in cultured cells. J Lipid Res. 1989;30(3):379–86.PubMed
40.
go back to reference Xue B, Greenberg AG, Kraemer FB, Zemel MB. Mechanism of intracellular calcium ([Ca2+]i) inhibition of lipolysis in human adipocytes. FASEB J. 2001;15(13):2527–9.PubMed Xue B, Greenberg AG, Kraemer FB, Zemel MB. Mechanism of intracellular calcium ([Ca2+]i) inhibition of lipolysis in human adipocytes. FASEB J. 2001;15(13):2527–9.PubMed
41.
go back to reference Shi H, Dirienzo D, Zemel MB. Effects of dietary calcium on adipocyte lipid metabolism and body weight regulation in energy-restricted aP2-agouti transgenic mice. FASEB J. 2001;15(2):291–3.PubMed Shi H, Dirienzo D, Zemel MB. Effects of dietary calcium on adipocyte lipid metabolism and body weight regulation in energy-restricted aP2-agouti transgenic mice. FASEB J. 2001;15(2):291–3.PubMed
42.
go back to reference Rung E, Friberg PA, Shao R, Larsson DG, Nielsen E, Svensson PA, et al. Progesterone-receptor antagonists and statins decrease de novo cholesterol synthesis and increase apoptosis in rat and human periovulatory granulosa cells in vitro. Biol Reprod. 2005;72(3):538–45.PubMedCrossRef Rung E, Friberg PA, Shao R, Larsson DG, Nielsen E, Svensson PA, et al. Progesterone-receptor antagonists and statins decrease de novo cholesterol synthesis and increase apoptosis in rat and human periovulatory granulosa cells in vitro. Biol Reprod. 2005;72(3):538–45.PubMedCrossRef
43.
go back to reference Silbernagel G, Lutjohann D, Machann J, Meichsner S, Kantartzis K, Schick F, et al. Cholesterol synthesis is associated with hepatic lipid content and dependent on fructose/glucose intake in healthy humans. Exp Diabetes Res. 2012;2012:361863.PubMedCentralPubMedCrossRef Silbernagel G, Lutjohann D, Machann J, Meichsner S, Kantartzis K, Schick F, et al. Cholesterol synthesis is associated with hepatic lipid content and dependent on fructose/glucose intake in healthy humans. Exp Diabetes Res. 2012;2012:361863.PubMedCentralPubMedCrossRef
44.
go back to reference Phelps RL, Metzger BE, Freinkel N. Carbohydrate metabolism in pregnancy. XVII. Diurnal profiles of plasma glucose, insulin, free fatty acids, triglycerides, cholesterol, and individual amino acids in late normal pregnancy. Am J Obstet Gynecol. 1981;140(7):730–6.PubMed Phelps RL, Metzger BE, Freinkel N. Carbohydrate metabolism in pregnancy. XVII. Diurnal profiles of plasma glucose, insulin, free fatty acids, triglycerides, cholesterol, and individual amino acids in late normal pregnancy. Am J Obstet Gynecol. 1981;140(7):730–6.PubMed
45.
go back to reference Herrera E, Gomez-Coronado D, Lasuncion MA. Lipid metabolism in pregnancy. Biol Neonate. 1987;51(2):70–7.PubMedCrossRef Herrera E, Gomez-Coronado D, Lasuncion MA. Lipid metabolism in pregnancy. Biol Neonate. 1987;51(2):70–7.PubMedCrossRef
Metadata
Title
Vitamin D deficiency and dyslipidemia in early pregnancy
Authors
Abdulrahman Al-Ajlan
Soundararajan Krishnaswamy
Majed S. Alokail
Naji J. Aljohani
Amal Al-Serehi
Eman Sheshah
Naemah M. Alshingetti
Mona Fouda
Iqbal Z. Turkistani
Nasser M. Al-Daghri
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2015
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-015-0751-5

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