Effect of Vitamin D Deficiency on Gestational Diabetes Mellitus: A Meta-Analysis
DOI:
https://doi.org/10.26911/jepublichealth.2023.08.03.03Abstract
Background: Gestational diabetes mellitus increases the risk of a number of short-term and long-term health problems in both mother and baby. Some evidence states that one of the causes of gestational diabetes mellitus is vitamin D deficiency. This study aimed to estimate the magnitude of the influence of vitamin D deficiency on the incidence of gestational diabetes mellitus, through a meta-analysis of previous primary studies.
Subjects and Method: This was a systematic review and meta-analysis with the following PICO, population: pregnant women, intervention: vitamin D deficiency, comparison: no vitamin D deficiency, outcome: gestational diabetes mellitus. The articles used in this study were obtained from four databases, namely PubMed, Google Scholar, Science Direct, and Springer Link, using the search keys "Vitamin D Deficiency"[Mesh] OR “Vitamin D Deficiency”[tw] AND "Diabetes, Gestational" [Mesh] OR “Gestational Diabetes Mellitus”[tw] OR “Gestational Diabetes”[tw]. The included article is a full-text cohort study design from 2018 to 2022 and reports the adjusted odds ratio (aOR) in a multivariate analysis. The selection of articles is done using PRISMA flow diagrams. Articles were analyzed using the Review Manager 5.3 application.
Results: A total of 9 cohort studies involving 42,972 pregnant women from the continents of Asia, Australia and Europe were used in the meta-analysis. Pregnant women with vitamin D deficiency had a risk of gestational diabetes mellitus 1.87 times compared to those without vitamin D deficiency (aOR= 1.87; 95% CI= 1.27 to 2.75; p= 0.002).
Conclusion: Vitamin D deficiency increases the risk of developing gestational diabetes mellitus.
Keywords: vitamin D deficiency, gestational diabetes mellitus, pregnancy
Correspondence:
Dian Handayani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A Surakarta 57126, Central Java, Indonesia. Email: dianhan1812@gmail.com. Mobile: +6285876686231.
References
ADA (2016). Position Statement: Standards of Medical Care in Diabetes. Diabetes Care. 39.
Al-Ajlan A, Al-Musharaf S, Fouda MA, Krishnaswamy S, Wani K, Aljohani NJ, Al-Serehi A, et al. (2018). Lower vitamin D levels in Saudi pregnant women are associated with higher risk of developing GDM. BMC Pregnancy Childbirth. 18(1). doi: 10.1186/s12884-018-1723-3.
Amraei M, Mohamadpour S, Sayehmiri K, Mousavi SF, Shirzadpour E, Moayeri A. (2018). Effects of Vitamin D Deficiency on Incidence Risk of Gestational Diabetes Mellitus: A Systematic Review and Meta analysis. Frontiers in endocrinology. 9 (7) doi: 10.3389/fendo.2018.00007.
Bellan M, Guzzaloni G, Rinaldi M, Mer-lotti E, Ferrari C, Tagliaferri A, Pirisi M, et al (2014). Altered glucose metabolism rather than naive type 2 diabetes mellitus (T2DM) is related to vitamin D status in obesity. Cardiovasc Diabetol. 13.
Berridge MJ (2017). Vitamin D deficiency and diabetes. Biochem J. 474: 1321–32. doi: 10.1042/BCJ20170042.
Cin-Aslan NN, Yalçin M, Yardimci H (2022). Vitamin D deficiency during the first trimester of pregnancy and the risk of developing gestational diabetes mellitus. J Obstet Gynecol Neonatal Nurs. 51(5): 526-535. doi: 10.1016/j.jogn.2022.06.038.
Dwarkanath P, Vinotha P, Thomas T, Joseph S, Thomas A, Shirley G, Sheela CN, et al. (2019). Relationship of Early Vitamin D Concentrations and Gestational Diabetes Mellitus in Indian Pregnant Women. Front Nutr. 6. doi: 10.3389/fnut.2019.00116.
Eggemoen ÅR, Waage CW, Sletner L, Gulseth HL, Birkeland KI, Jenum AK (2018). Vitamin D, Gestational Diabetes, and Measures of Glucose Metabolism in a Population-Based Multiethnic Cohort. J Diabetes Res. doi: 10.1155/2018/8939235.
El-Lithy A, Abdella RM, El-Faissal YM, Sayed AM, Samie RM (2014). The relationship between low maternal serum Vitamin D levels and glycemic control in gestational diabetes assessed by HbA1c levels: An observational cross-sectional study. BMC Pregnancy Childbirth. 14: 1-6.
Haidari F, Zakerkish M, Karandish M, Saki A, Pooraziz S (2016). Association between serum Vitamin D level and glycemic and inflamematory markers in non-obese patients with type 2 diabetes. Iran J Med Sci. 41.
Holick MF (2017). The vitamin D deficiency pandemic: approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord. 18: 153–165. doi: 10.1007/s11154-017-9424-1.
Iqbal S, Malik M, Bano G (2020). Serum Vitamin D levels and gestational diabetes mellitus: analysis of early pregnancy cohort from a teaching hospital of Kashmir Valley. J Family Med Prim Care. 9(8):4323-4328. doi: 10.4103/jfmpc.jfmpc_900_20
Li H, Ma J, Huang R, Wen Y, Liu G, Xuan M, Yang L, et al. (2020). Prevalence of vitamin D deficiency in the pregnant women: an observational study in Shanghai, China. Arch Public Health. 78. doi: 10.1186/s13690-020-00414-1.
Luo C, Li Z, Lu Y, Wei F, Suo D, Lan S, Ren Z, et al (2022). Association of serum vitamin D status with gestational diabetes mellitus and other laboratory parameters in early pregnant women. BMC Pregnancy Childbirth. doi: 10.1186/s12884-022-04725-9.
Milajerdi A, Abbasi F, Mousavi SM, Esmaillzadeh A (2021). Maternal vitamin D status and risk of gestational diabetes mellitus: A systematic review and meta-analysis of prospective cohort studies. Clin Nutr. 40(5): 2576-2586. doi: 10.1016/j.clnu.2021.03.037.
Mosavat M, Arabiat D, Smyth A, Newnham J, Whitehead L (2021). Second-trimester maternal serum vitamin D and pregnancy outcome: The Western Australian Raine cohort study. Diabetes Res Clin Pract. 175. doi: 10.1016/j.diabres.2021.108779.
Murti B (2018). Principles and Methods of Epidemiological Research (5th ed.). Master’s Program of Public Health, Universitas Sebelas Maret.
Nausheen S, Habib A, Bhura M, Rizvi A, Shaheen F, Begum K, Iqbal J, et al (2021). Impact evaluation of the efficacy of different doses of vitamin D supplementation during pregnancy on pregnancy and birth outcomes: a randomised, controlled, dose comparison trial in Pakistan. BMJ Nutrition, Prevention & Health. doi: 10.1136/bmjnph-2021-000304.
Plows JF, Stanley JL, Baker PN, Reynolds CM, Vickers MH (2018). The Pathophysiology of Gestational Diabetes Mellitus. Int J Mol Sci. 19(11): 3342. doi: 10.3390/ijms19113342.
Saeedi M, Cao Y, Fadl H, Gustafson H, Simmons D (2021). Increasing prevalence of gestational diabetes mellitus when implementing the IADPSG criteria: A systematic review and meta-analysis. Diabetes Res Clin Pract. 172. doi: 10.1016/j.diabres.2020.108642.
Seshadri KG, Tamilselvan B, Rajendran A (2011). Role of vitamin D in Diabetes. J Endocrinol Metab. 1.
Shao B, Mo M, Xin X, Jiang W, Wu J, Huang M, Wang S, et al. (2019). The interaction between prepregnancy BMI and gestational vitamin D deficiency on the risk of gestational diabetes mellitus subtypes with elevated fasting blood glucose. Clin Nutr. 39(7):2265-2273. doi: 10.1016/j.clnu.2019.10.015.
Silva-Zolezzi I, Samuel TM, Spieldenner J (2017). Maternal nutrition: opportunities in the prevention of gestational diabetes. Nutr Rev. 75. doi: 10.1093/nutrit/nuw033.
Vaidya A, Williams JS (2012). Vitamin D and insulin sensitivity: can gene association and pharmacogenetic studies of the vitamin d receptor provide clarity? Metab Clin Exp 61: 759–61. doi:10.1016/j.metabol.2011.12.009.
Wang W, Zhang J, Wang H, Wang X, Liu S (2019). Vitamin D deficiency enhances insulin resistance by promoting inflammation in type 2 diabetes. Int J Clin Exp Pathol. 12: 1859e67.
WHO (2022). Noncommunicable disease. World Health Organization.
Yue CY, Ying CM (2020). Sufficience serum vitamin D before 20 weeks of pregnancy reduces the risk of gestational diabetes mellitus. Nutr Metab (Lond). doi: 10.1186/s12986-020-00509-0.
Zhu B, Huang K, Yan S, Hao J, Zhu P, Chen Y, Ye A, Tao F (2019). VDR Variants rather than Early Pregnancy Vitamin D Concentrations Are Associated with the Risk of Gestational Diabetes: The Ma'an-shan Birth Cohort (MABC) Study. J Diabetes Res. doi: 10.1155/2019/8313901.
Downloads
Published
2023-07-16
Issue
Vol. 8 No. 3 (2023)
Section
Articles