Senti Jeanine, Thiele Doria K, Anderson Cindy Miller
College of Nursing, University of North Dakota, Grand Forks, ND 58202-9025, USA.
J Obstet Gynecol Neonatal Nurs. 2012 May-Jun;41(3):328-38. doi: 10.1111/j.1552-6909.2012.01366.x.
To synthesize published research to determine the evidence for the association between maternal vitamin D status during pregnancy and the development of gestational diabetes mellitus (GDM).
Literature searches were conducted for data based articles that examined maternal vitamin D during pregnancy, GDM, glucose tolerance, and insulin resistance using the PubMed, CINAHL, and SCOPUS data bases and reference lists from reviewed papers.
Primary research studies published in the English language between 1999 and 2011 reporting findings regarding the association of vitamin D with glucose homeostasis during pregnancy and GDM.
Study characteristics and findings related to vitamin D status determinants, gestational timing, and measures of glucose homeostasis and insulin resistance.
Six data based articles met the criteria for study inclusion. Study findings comprised solely Level-2 evidence for the association of maternal vitamin D deficiency and risk of GDM. The majority of studies (66%) were conducted between 24 and 30 weeks gestation. Five (83%) studies reported an inverse relationship between circulating vitamin D levels and markers of glucose homeostasis associated with gestational diabetes or an increased risk for GDM associated with reduced maternal levels of vitamin D. In one study, researchers did not identify an association between vitamin D and GDM but did identify an association between higher vitamin D levels and lower fasting glucose and insulin levels.
Maternal vitamin D deficiency and insufficiency is prevalent among gravid women and is associated with markers of altered glucose homeostasis. These findings underscore the need for mechanistic and clinical studies to determine optimal vitamin D status in pregnancy for reduction in the risk for GDM with implications for vitamin D supplementation as a potential target for GDM prevention.
综合已发表的研究，以确定孕期母亲维生素D状态与妊娠期糖尿病（GDM）发生之间关联的证据。
利用PubMed、CINAHL和SCOPUS数据库以及综述论文的参考文献列表，检索有关孕期母亲维生素D、GDM、葡萄糖耐量和胰岛素抵抗的基于数据的文章。
1999年至2011年间以英文发表的关于维生素D与孕期葡萄糖稳态及GDM关联的主要研究。
与维生素D状态决定因素、妊娠时间以及葡萄糖稳态和胰岛素抵抗测量相关的研究特征和结果。
六篇基于数据的文章符合纳入研究标准。研究结果仅为母亲维生素D缺乏与GDM风险关联的2级证据。大多数研究（66%）在妊娠24至30周之间进行。五项研究（83%）报告循环维生素D水平与妊娠期糖尿病相关的葡萄糖稳态标志物之间呈负相关，或母亲维生素D水平降低与GDM风险增加相关。在一项研究中，研究人员未发现维生素D与GDM之间的关联，但发现较高的维生素D水平与较低的空腹血糖和胰岛素水平之间存在关联。
孕期母亲维生素D缺乏和不足在孕妇中普遍存在，且与葡萄糖稳态改变的标志物相关。这些发现强调需要进行机制和临床研究，以确定孕期最佳维生素D状态，以降低GDM风险，这对将维生素D补充作为GDM预防的潜在靶点具有重要意义。
