Vitamin D plays a role in the regulation of liver metabolism, function and development of pancreatic islets, blood calcium levels, oxidative stress, and the immune and inflammatory systems that mediate the start of gestational diabetes. These findings suggest that low levels of 25(OH)D may be a risk factor in pregnancy.
Recent evidence suggests that vitamin D receptors are expressed in a large number of tissues, including those involved in the regulation of glucose metabolism such as muscle and pancreatic beta cells. These receptors have a direct effect on pancreatic beta cells and are required for the normal production and secretion of insulin by the pancreas. Thus, vitamin D deficiency is related to alterations in blood glucose and insulin concentrations and in target tissue sensitivity to insulin. Vitamin D replenishment restores insulin secretion and sensitivity in patients with type 2 diabetes with established vitamin D deficiency.
Globally, vitamin D deficiency is found in 54% of pregnancies and in 75% of newborns. This affects pregnant women of all latitudes, not only those with lower exposure to sunlight. Poor vitamin D status in pregnant women has been proposed as one of the risk factors associated with the incidence of gestational diabetes.
Numerous studies have investigated the association between vitamin D deficiency and gestational diabetes. A systematic review and meta-analysis have also been conducted by analyzing data of studies from MeSH, Scopus, PubMed database, Science Direct, the Cochrane Library, the Web of Science, CINAHL, and Google Scholar and reported the risk of gestational diabetes as a result of vitamin D deficiency.
Twenty-nine eligible studies with a total of 14,497 participants were included in the final analysis. Overall, maternal vitamin D insufficiency was significantly
associated with a greater risk of gestational diabetes (OR=1.15; 95% CI 1.00-1.30; p<0.001). Serum 25OHD was significantly lower in participants with gestational diabetes mellitus than in those with natural glucose tolerance (-29.7 nmol/L, 95% CI -36.6 to -22.8; p=0.000).
In conclusion, these findings suggest that low levels of 25(OH)D may be a risk factor in pregnancy. The results of meta-analysis demonstrated a statistically significant association between maternal vitamin D insufficiency and the risk of gestational diabetes.
Image: Illustration (Source: Pexels)
References:
1. Agüero-Domenech N, Jover S, Sarrión A, Baranda J, Quesada-Rico JA, Pereira-Expósito A, et al. Vitamin D deficiency and gestational diabetes mellitus in relation to body mass index. Nutrients 2022;14(102).
2. Nargesi S, Ghorbani A, Shirzadpour E, Mohamadpour M, Mousavi SF, Amraei M. A systematic review and meta-analysis of the association between vitamin D deficiency and gestational diabetes mellitus. Biomed Res Ther. 2018;5(3):2078-95.
