Yu Jie, Liu Yanping, Xu Lingling
Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
Diabetes Metab Syndr Obes. 2024 Jul 31;17:2895-2901. doi: 10.2147/DMSO.S460796. eCollection 2024.
The relationship between vitamin A levels and gestational diabetes mellitus (GDM) is not well understood, and prospective studies are lacking.
This was a prospective, longitudinal study. A total of 391 women in early pregnancy were recruited between October and December 2018 at Shunyi District Maternal and Child Health Hospital (Beijing, China). Serum vitamin A concentration was measured at enrollment. GDM was diagnosed on the basis of a 75 g oral glucose-tolerance test at 24-28 weeks of follow-up. Logistic regression was used for the analysis.
None of the subjects in the cohort had vitamin A deficiency or excess. At the follow-up, 76 participants had developed GDM. Participants who developed GDM were older and had higher body mass index, fasting insulin, HbA, fasting glucose, homeostasis model assessment for insulin resistance, triglyceride, low-density lipoprotein , and high-sensitivity CRP levels, as well as higher serum vitamin A levels at baseline. On logistic multivariate analysis, higher vitamin A was positively associated with higher risk of GDM. The adjusted OR was 2.85 (95% CI 1.04-7.80, =0.042) for Q4 versus Q1 and 1.59 (95% CI 1.11-2.28, =0.011) for every 1 SD increase in serum vitamin A levels. In participants within the vitamin A reference range (0.33-0.78 mg/L), the positive association also maintained significance.
Higher serum vitamin A levels were associated with higher GDM risks, even within the reference range. The results and possible mechanisms need to be further verified and clarified.
维生素A水平与妊娠期糖尿病（GDM）之间的关系尚未完全明确，前瞻性研究也较为缺乏。
这是一项前瞻性纵向研究。2018年10月至12月期间，在中国北京顺义区妇幼保健院招募了391名孕早期女性。入组时测量血清维生素A浓度。在随访的24至28周时，基于75g口服葡萄糖耐量试验诊断GDM。采用逻辑回归进行分析。
队列中的受试者均无维生素A缺乏或过量情况。随访时，76名参与者发生了GDM。发生GDM的参与者年龄更大，且基线时体重指数、空腹胰岛素、糖化血红蛋白、空腹血糖、胰岛素抵抗稳态模型评估、甘油三酯、低密度脂蛋白和高敏C反应蛋白水平更高，血清维生素A水平也更高。在多因素逻辑分析中，较高的维生素A与GDM风险增加呈正相关。与第一四分位数相比，第四四分位数的校正比值比为2.85（95%置信区间1.04 - 7.80，P = 0.042），血清维生素A水平每增加1个标准差，校正比值比为1.59（95%置信区间1.11 - 2.28，P = 0.011）。在维生素A参考范围内（0.33 - 0.78mg/L）的参与者中，这种正相关也具有统计学意义。
即使在参考范围内，较高的血清维生素A水平也与较高的GDM风险相关。研究结果及可能的机制需要进一步验证和阐明。
