Park Sunmin, Yoon Hyun-Koo, Ryu Hyun-Mee, Han You Jung, Lee Si Won, Park Bo Kyung, Park So-Young, Yim Chang-Hoon, Kim Sung-Hoon
Department of Food & Nutrition, Hoseo University.
J Nutr Sci Vitaminol (Tokyo). 2014;60(4):269-75. doi: 10.3177/jnsv.60.269.
The association between vitamin D deficiency in the first trimester and GDM development remains controversial in various ethnicities. We prospectively assessed whether pregnant women with vitamin D deficiency during early pregnancy had an increased likelihood of GDM development or poor fetal growth or pregnancy outcomes compared to those with sufficient vitamin D levels. Serum 25-OH-D measurements and fetal ultrasonograms were carried out at 12-14, 20-22, and 32-34 wk in 523 pregnant women. Each woman was screened for GDM at 24-28 wk. There were no differences in serum 25-OH-D levels at 12-14 wk or 22-24 wk of pregnancy between GDM and non-GDM women after adjusting for maternal age, BMI at prepregnancy, BMI at first visit, BMI at GDM screening, gestational age at sampling, previous history of GDM, vitamin D intake, and seasonal variation in sampling. The risk of GDM, insulin resistance, and impaired β-cell function had no association with serum 25-OH-D levels in crude or adjusted logistic regression analysis. GDM was not associated with maternal serum 25-OH-D deficiency during the first trimester or fetal growth during the first and second trimesters. Pregnancy outcomes such as miscarriage, Apgar 1, Apgar 5 and birth weight were independent of maternal serum 25-OH-D levels during the first, second and third trimester of pregnancy. In conclusion, neither GDM prevalence nor fetal growth during pregnancy is associated with vitamin D deficiency at the first trimester in Korean women. Pregnancy outcomes are also independent of maternal vitamin D status.
孕早期维生素D缺乏与妊娠期糖尿病(GDM)发生之间的关联在不同种族中仍存在争议。我们前瞻性地评估了与维生素D水平充足的孕妇相比,孕早期维生素D缺乏的孕妇发生GDM、胎儿生长受限或妊娠结局不良的可能性是否增加。对523名孕妇在孕12 - 14周、20 - 22周和32 - 34周进行了血清25 - 羟维生素D(25 - OH - D)测定及胎儿超声检查。每位孕妇在孕24 - 28周时接受GDM筛查。在校正了孕妇年龄、孕前体重指数(BMI)、首次就诊时BMI、GDM筛查时BMI、采样时孕周、既往GDM病史、维生素D摄入量及采样季节变化后,GDM组和非GDM组孕妇在孕12 - 14周或22 - 24周时的血清25 - OH - D水平无差异。在粗逻辑回归分析和校正逻辑回归分析中,GDM风险、胰岛素抵抗及β细胞功能受损均与血清25 - OH - D水平无关。GDM与孕早期母体血清25 - OH - D缺乏或孕早期和孕中期胎儿生长均无关。妊娠结局如流产、1分钟阿氏评分、5分钟阿氏评分及出生体重与妊娠早、中、晚期母体血清25 - OH - D水平无关。总之,韩国女性中,GDM患病率及孕期胎儿生长均与孕早期维生素D缺乏无关。妊娠结局也与母体维生素D状态无关。