Hu Lingmin, Zhang Yue, Wang Xing, You Lianghui, Xu Pengfei, Cui Xianwei, Zhu Lijun, Ji Chenbo, Guo Xirong, Wen Juan
The Affiliated Changzhou Maternity and Child Health Care Hospital of Nanjing Medical University, Changzhou, China.
Nanjing Maternity and Child Health Care Institute, Nanjing Maternity and Child Health Care Hospital, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University, Nanjing, China.
Cell Physiol Biochem. 2018;45(1):291-300. doi: 10.1159/000486810. Epub 2018 Jan 19.
BACKGROUND/AIMS: Whether maternal vitamin D deficiency is associated with gestational diabetes remains controversial. This meta-analysis aimed to systematically evaluate published evidence on the association between maternal vitamin D status and the risk of gestational diabetes.
We retrieved relevant articles from the PubMed, Medline and Embase databases up to May 2017 for observational studies investigating the association between vitamin D status and the risk of gestational diabetes. Odds ratios (OR) or risk ratios (RR) from individual studies were pooled using the fixed and random effect models.
The meta-analysis of 29 observational studies included 28,982 participants, of which 4,634 were diagnosed with gestational diabetes, and showed that maternal vitamin D insufficiency was associated with a significantly increased risk of gestational diabetes by 39% (pooled OR = 1.39, 95%CI = 1.20-1.60) with moderate heterogeneity (I2 = 50.2%; P = 0.001). Moreover, the 25(OH)D level was significantly lower in gestational diabetes cases than in controls with a pooled effect of -4.79 nmol/L (95% CI = -6.43, -3.15). Significant heterogeneity was also detected (I2 = 65.0%, P < 0.001). Further subgroup analysis indicated that this association was also evident in most subpopulations.
This meta-analysis indicated a significant association between vitamin D insufficiency and increased risk of gestational diabetes. Further well-designed large-scale clinical trials are essential to verify this association.
背景/目的：母亲维生素D缺乏与妊娠期糖尿病之间是否存在关联仍存在争议。本荟萃分析旨在系统评价已发表的关于母亲维生素D状态与妊娠期糖尿病风险之间关联的证据。
我们检索了截至2017年5月的PubMed、Medline和Embase数据库中的相关文章，以寻找调查维生素D状态与妊娠期糖尿病风险之间关联的观察性研究。使用固定效应模型和随机效应模型汇总各个研究的比值比（OR）或风险比（RR）。
对29项观察性研究的荟萃分析纳入了28,982名参与者，其中4,634人被诊断为妊娠期糖尿病，结果显示母亲维生素D不足与妊娠期糖尿病风险显著增加39%相关（汇总OR = 1.39，95%CI = 1.20 - 1.60），具有中度异质性（I2 = 50.2%；P = 0.001）。此外，妊娠期糖尿病病例的25(OH)D水平显著低于对照组，汇总效应为-4.79 nmol/L（95%CI = -6.43，-3.15）。也检测到显著异质性（I2 = 65.0%，P < 0.001）。进一步的亚组分析表明，这种关联在大多数亚组中也很明显。
本荟萃分析表明维生素D不足与妊娠期糖尿病风险增加之间存在显著关联。进一步设计良好的大规模临床试验对于验证这种关联至关重要。
