Oral Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2017

Vitamin D deficiency in early pregnancy is associated with increased cardiometabolic risk and gestational diabetes (#60)

Aya Mousa 1 , Sally K Abell 1 , Soulmaz Shorakae 1 , Negar Naderpoor 1 , Cheryce L Harrison 1 , Danielle Hiam 2 , Alba Moreno-Asso 2 , Nigel K Stepto 2 , Robert Scragg 3 , Helena J Teede 1 , Barbora de Courten 1
  1. Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
  2. Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Victoria, Australia
  3. School of Population Health, The University of Auckland, Auckland, New Zealand

BACKGROUND: Maternal vitamin D deficiency has been associated with cardiometabolic risk factors during pregnancy and adverse pregnancy outcomes including gestational diabetes mellitus (GDM). Vitamin D has well-established anti-inflammatory properties, yet the association between vitamin D and inflammation, particularly adipokines, remains unexplored in pregnancy. We investigated whether maternal 25-hydroxyvitamin D (25(OH)D) concentrations were related to cardiometabolic risk factors during pregnancy and pregnancy outcomes, and whether these relationships may be mediated by circulating adipokines.

METHODS: Serum samples were collected from 102 overweight or obese pregnant women at 12-15 weeks gestation for measurement of 25(OH)D, fasting lipids, interleukin-6, monocyte chemoattractant protein-1, and novel adipokines omentin-1, visfatin, and high-molecular-weight (HMW)-adiponectin. Fasting, 1-, and 2-hour glucose levels were measured by oral glucose tolerance tests (OGTT) at 28-weeks gestation. Pregnancy outcomes were recorded at delivery. All analyses were adjusted for maternal factors: age, BMI, parity, smoking status, and ethnicity.

RESULTS: In 102 pregnant women (age=31.9±4.5 years; BMI=30.6±6.6 kg/m2 [mean±SD]), mean 25(OH)D concentration at 12-15 weeks was 47.9±16.0 nmol/l. After adjustment for maternal factors, 25(OH)D concentrations were negatively associated with total cholesterol (p=0.02), triglycerides (p=0.01), fasting glucose (p=0.006) and 1-hour post-OGTT glucose (p=0.045), and positively associated with HMW-adiponectin (p=0.008). Higher 25(OH)D concentrations were associated with increased length of gestation (p=0.006) and reduced risk of GDM (OR(95%CI)=0.97(0.94-0.99),p=0.04). After additional adjustment for C-sections, higher 25(OH)D concentrations were associated with reduced risk of preterm birth (OR(95%CI)=0.89(0.80-0.99),p=0.03). Adding HMW-adiponectin to the models attenuated all associations except fasting glucose (p=0.03) and length of gestation (p=0.03).

CONCLUSIONS: Low first-trimester 25(OH)D concentrations were associated with increased cardiometabolic risk factors and adverse pregnancy outcomes, and most associations appeared to be mediated by HMW-adiponectin. Intervention and mechanistic studies are needed to further explore the effects of vitamin D in pregnancy, and to elucidate whether these effects are independent or modulated by circulating adipokines.