Tripathi Prashant, Rao Yashwant Kumar, Pandey Kiran, Gautam Kirti Amresh
Department of Biochemistry, GSVM Medical College, Kanpur, Uttar Pradesh, India.
Department of Pediatrics, GSVM Medical College, Kanpur, Uttar Pradesh, India.
Indian J Endocrinol Metab. 2019 Sep-Oct;23(5):514-524. doi: 10.4103/ijem.IJEM_184_19.
Vitamin D plays an important role in glucose tolerance by stimulating insulin secretion and evidences suggest a contradictory result on the association between vitamin D status and risk of developing gestational diabetes mellitus (GDM). The present updated meta-analysis has been undertaken to find out the joined effect of vitamin D status on the risk of effect GDM considering previously published articles. Data were collected through literature search using electronic databases to retrieve relevant published research articles using various combinations of the following keywords, "vitamin D," "vitamin D deficiency," "cholecalciferol," "25-hydroxyvitamin D," "25(OH) D," "gestational diabetes mellitus," and "GDM." A total of 36 studies including 7,596 GDM cases and 23,377 non-GDM controls were involved in this study. Overall, pooled meta-analysis showed that pregnant women diagnosed with GDM have 18% higher risk of GDM risk when compared with controls [odds ratio (OR) = 1.18, 95% confidence interval (CI) 1.10-1.25; = 0.00] with high heterogeneity (I = 73.29). The mean difference was also significantly different between cases and controls (OR = -0.18, 95% CI - 0.22 to - 0.14; = 0.00). Subgroup analysis showed significant results with age more than 30 years, Asian and European regions, and case-control, cross-sectional, and nested case-control study design. Low concentration of vitamin D is associated with the development of GDM. Although in future more studies especially systematically designed clinical trials based on vitamin D supplementation with large sample size on different population are needed to elucidate the exact concentration of vitamin D during pregnancy as well as before and after pregnancy.
维生素D通过刺激胰岛素分泌在葡萄糖耐量方面发挥重要作用,且有证据表明维生素D状态与妊娠期糖尿病(GDM)发生风险之间的关联存在矛盾结果。本更新的荟萃分析旨在结合先前发表的文章,探究维生素D状态对GDM发生风险的综合影响。通过使用电子数据库进行文献检索来收集数据,利用以下关键词的各种组合检索相关已发表的研究文章:“维生素D”、“维生素D缺乏”、“胆钙化醇”、“25-羟基维生素D”、“25(OH)D”、“妊娠期糖尿病”和“GDM”。本研究共纳入了包括7596例GDM病例和23377例非GDM对照的36项研究。总体而言,汇总的荟萃分析显示,与对照组相比,被诊断为GDM的孕妇患GDM的风险高18%[优势比(OR)=1.18,95%置信区间(CI)1.10 - 1.25;P = 0.00],异质性较高(I² = 73.29)。病例组和对照组之间的平均差异也具有显著性(OR = -0.18,95%CI -0.22至 -0.14;P = 0.00)。亚组分析显示,年龄大于30岁、亚洲和欧洲地区以及病例对照、横断面和巢式病例对照研究设计的结果具有显著性。低浓度的维生素D与GDM的发生有关。尽管未来需要更多的研究,尤其是基于不同人群大样本量维生素D补充的系统设计的临床试验,以阐明孕期以及孕前和产后维生素D的确切浓度。