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Cited by 132Folate and B Vitamins ResearchGestational Diabetes Research and ManagementBirth, Development, and Health

High folate and low vitamin B12 status during pregnancy is associated with gestational diabetes mellitus

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Lai, Jun S., Pang, Wei Wei, Cai, Shirong, Lee, Yung Seng, Chan, Jerry K.Y., Shek, Lynette P.C., Yap, Fabian K.P., Tan, Kok Hian +4 more·2018·Clinical Nutrition
DOI 10.1016/j.clnu.2017.03.022PMC PMC5534168
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Abstract

Background & aims B-vitamins and homocysteine may contribute to the development of gestational diabetes mellitus (GDM), but existing studies are inconsistent. We examined the cross-sectional associations of plasma folate, vitamins B6, B12, and homocysteine concentrations with GDM and glycemia in a sample of multi-ethnic Asian pregnant women. Methods Plasma concentrations of folate, vitamins B6, B12, homocysteine and glucose were measured at 26-weeks' gestation in 913 pregnant women. GDM was diagnosed using the 1999 World Health Organization criteria. Associations were examined with linear or logistic regression, adjusted for confounders and stratified by ethnicity. Results Higher plasma folate was associated with higher 2-h glucose and higher odds of GDM [0.15 (0.02, 0.23) per 1-SD increment in folate, OR 1.29 (1.00, 1.60)], mainly among Indian mothers. Higher plasma vitamin B12 and homocysteine were associated with lower fasting and 2-h glucose, and lower odds of GDM [-0.04 (-0.07, -0.01) per 1-SD increment in B12 and -0.09 (-0.18, -0.003) respectively, OR: 0.81 (0.68, 0.97); -0.05 (-0.08, -0.02) per 1-SD increment in homocysteine and -0.12 (-0.21, -0.02) respectively, OR: 0.76 (0.62, 0.92)]. The highest odds of GDM were observed among women with combined vitamin B12 insufficiency and high folate concentration [OR: 1.97 (1.05, 3.68)]. An association between higher vitamin B6 and higher 2-h glucose shifted towards null adjusting for other B-vitamins. Conclusions Higher maternal folate coupled with vitamin B12 insufficiency was associated with higher GDM risk. This finding has potential implications for antenatal supplement recommendations but will require confirmation in future studies.

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  • Women with combined vitamin B12 insufficiency and high folate levels have higher odds of developing GDM compared to those with normal vitamin B12 and high folate concentrations.

    “Similarly, Lai et al. found that women with combined vitamin B12 insufficiency and high folate levels had higher odds of developing GDM compared to those with normal vitamin B12 and high folate concentrations [144].”

    From Medical Nutrition Therapy for Women with Gestational Diabetes: Current Practice and Future Perspectives (2025) · cites this paper as [144]

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Authors
Lai, J. S., Pang, W. W., Cai, S., Lee, Y. S., Chan, J. K. Y., Shek, L. P. C., Yap, F. K. P., Tan, K. H., Godfrey, K. M., van Dam, R. M., Chong, Y. S., & Chong, M. F. F.
Affiliations
  • Agency for Science, Technology and Research (SG)
  • National University of Singapore (SG)
  • KK Women's and Children's Hospital (SG)
  • SingHealth Duke-NUS Academic Medical Centre (SG)
  • University Hospital Southampton NHS Foundation Trust (GB)
Corresponding author
Chong, Mary F.F.
ORCID
Venue
Clinical Nutrition
Publisher
Elsevier BV
Published
2018-06
Volume
37
Issue
3
Pages
940-947
ISSN
0261-5614 (ISSN-L)
DOI
10.1016/j.clnu.2017.03.022
PMC
PMC5534168
OpenAlex
W2598482036
Cited by
132
References
0
Citations by year
2026: 8 · 2025: 19 · 2024: 12 · 2023: 25 · 2022: 25 · 2021: 19 · 2020: 8 · 2019: 11 · 2018: 4
FWCI
5.50
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Clinical Nutrition (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • ePrints Soton (University of Southampton) (acceptedVersion)
  • National University of Singapore (submittedVersion)
Funders
  • National Institute for Health and Care Research (NF-SI-0515-10042)
  • British Heart Foundation (RG/15/17/31749)
  • Medical Research Council (MC_UU_12011/4)
Topics
  • Health Sciences › Medicine › Rheumatology › Folate and B Vitamins Research
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
Keywords
gestational diabetes mellitus, folic acid, vitamin B12, vitamin B6, homocysteine, glycemia, ethnic differences, Indian mothers, prenatal supplementation
MeSH terms
Adult, China, Cross-Sectional Studies, Female, Folic Acid, Homocysteine, Humans, India, Malaysia, Male, Nutritional Status, Pregnancy, Vitamin B 12, Vitamin B 12 Deficiency, Cohort Studies, Comorbidity, Diabetes, Gestational, Vitamin B 6

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