1Nutritional Epidemiology Observatory,Department of Social and Applied Nutrition,Institute of Nutrition Josué de Castro,Rio de Janeiro Federal University,Rio de Janeiro 21941-590,RJ,Brazil.
5Department of Psychology, Social Work and Counselling,Faculty of Education and Health,University of Greenwich,London SE9 2UG,UK.
Br J Nutr. 2019 Jan;121(1):42-54. doi: 10.1017/S0007114518003057.
This study aimed to evaluate the longitudinal association of vitamin D status with glycaemia, insulin, homoeostatic model assessment of insulin resistance, adiponectin and leptin. A prospective cohort with 181 healthy, pregnant Brazilian women was followed at the 5th-13th, 20th-26th and 30th-36th gestational weeks. In this cohort, 25-hydroxyvitamin D (25(OH)D) plasma concentrations were analysed using liquid chromatography-tandem MS. Vitamin D status was categorised as sufficient or insufficient using the Endocrine Society Practice Guidelines (≥75/<75 nmol/l) and the Institute of Medicine (≥50/<50 nmol/l) thresholds. Linear mixed-effect regression models were employed to evaluate the association between vitamin D status and each outcome, considering interaction terms between vitamin D status and gestational age (P<0·1). At baseline, 70·7 % of pregnant women had 25(OH)D levels <75 nmol/l and 16 % had levels <50 nmol/l. Women with sufficient vitamin D status at baseline, using both thresholds, presented lower glycaemia than those with insufficient 25(OH)D. Pregnant women with 25(OH)D concentrations <75 nmol/l showed lower insulin (β=-0·12; 95 % CI -0·251, 0·009; P=0·069) and adiponectin (β=-0·070; 95 % CI -0·150, 0·010; P=0·085) concentrations throughout pregnancy than those with 25(OH)D levels ≥75 nmol/l. Pregnant women with 25(OH)D <50 nmol/l at baseline presented significantly higher leptin concentrations than those with 25(OH)D levels ≥50 nmol/l (β=-0·253; 95 % CI -0·044, 0·550; P=0·095). The baseline status of vitamin D influences the biomarkers involved in glucose metabolism. Vitamin D-sufficient women at baseline had higher increases in insulin and adiponectin changes throughout gestation than those who were insufficient.
本研究旨在评估维生素 D 状态与血糖、胰岛素、稳态模型评估的胰岛素抵抗、脂联素和瘦素之间的纵向关联。一项前瞻性队列研究纳入了 181 名健康的巴西孕妇,在妊娠第 5-13 周、第 20-26 周和第 30-36 周进行随访。在该队列中,使用液相色谱-串联质谱法分析 25-羟维生素 D(25(OH)D)血浆浓度。使用内分泌学会实践指南(≥75/<75 nmol/l)和医学研究所(≥50/<50 nmol/l)阈值,将维生素 D 状态分类为充足或不足。采用线性混合效应回归模型,考虑维生素 D 状态和孕龄(P<0·1)之间的交互项,评估维生素 D 状态与每种结局之间的关系。在基线时,70.7%的孕妇 25(OH)D 水平<75 nmol/l,16%的孕妇 25(OH)D 水平<50 nmol/l。使用两个阈值,基线时维生素 D 状态充足的孕妇血糖水平低于 25(OH)D 不足的孕妇。25(OH)D 浓度<75 nmol/l 的孕妇在整个孕期胰岛素(β=-0.12;95%CI-0.251,0.009;P=0.069)和脂联素(β=-0.070;95%CI-0.150,0.010;P=0.085)浓度均低于 25(OH)D 水平≥75 nmol/l 的孕妇。基线时 25(OH)D <50 nmol/l 的孕妇瘦素浓度明显高于 25(OH)D 水平≥50 nmol/l 的孕妇(β=-0.253;95%CI-0.044,0.550;P=0.095)。维生素 D 基线状态影响葡萄糖代谢相关的生物标志物。基线时维生素 D 充足的女性在整个孕期胰岛素和脂联素变化增加幅度大于维生素 D 不足的女性。