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Cited by 380Gestational Diabetes Research and ManagementVitamin D Research StudiesBirth, Development, and Health

Maternal Plasma 25-Hydroxyvitamin D Concentrations and the Risk for Gestational Diabetes Mellitus

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Zhang, Cuilin, Qiu, Chunfang, Hu, Frank B., David, Robert M., van Dam, Rob M., Bralley, Alexander, Williams, Michelle A.·2008·PLoS ONE
DOI 10.1371/journal.pone.0003753PMC PMC2582131
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Abstract

BACKGROUND: Evidence is accumulating for a role of vitamin D in maintaining normal glucose homeostasis. However, studies that prospectively examined circulating concentrations of 25-hydroxyvitamin D (25-[OH] D) in relation to diabetes risk are limited. Our objective is to determine the association between maternal plasma 25-[OH] D concentrations in early pregnancy and the risk for gestational diabetes mellitus (GDM). METHODS: A nested case-control study was conducted among a prospective cohort of 953 pregnant women. Among them, 57 incident GDM cases were ascertained and 114 women who were not diagnosed with GDM were selected as controls. Controls were frequency matched to cases for the estimated season of conception of the index pregnancy. RESULTS: Among women who developed GDM, maternal plasma 25-[OH] D concentrations at an average of 16 weeks of gestation were significantly lower than controls (24.2 vs. 30.1 ng/ml, P<0.001). This difference remained significant (3.62 ng/ml lower on average in GDM cases than controls (P value = 0.018)) after the adjustment for maternal age, race, family history of diabetes, and pre-pregnancy BMI. Approximately 33% of GDM cases, compared with 14% of controls (P<0.001), had maternal plasma 25-[OH] D concentrations consistent with a pre-specified diagnosis of vitamin D deficiency (<20 ng/ml). After adjustment for the aforementioned covariates including BMI, vitamin D deficiency was associated with a 2.66-fold (OR (95% CI): 2.66 (1.01-7.02)) increased GDM risk. Moreover, each 5 ng/ml decrease in 25-[OH] D concentrations was related to a 1.29-fold increase in GDM risk (OR (95% CI): 1.29 (1.05-1.60)). Additional adjustment for season and physical activity did not change findings substantially. CONCLUSIONS: Findings from the present study suggest that maternal vitamin D deficiency in early pregnancy is significantly associated with an elevated risk for GDM.

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  • Because vitamin D deficiency is more prevalent among obese women-who already have a higher incidence of gestational diabetes-it is difficult to clearly determine a direct causal relationship between vitamin D status and GDM.

    “However, because vitamin D deficiency is more prevalent among obese women—who already have a higher incidence of gestational diabetes—it is difficult to clearly determine a direct causal relationship between vitamin D status and GDM [135,137,138,139].”

    From Maternal Overnutrition and Fetal Programming: Long-Term Metabolic, Cognitive, and Epigenetic Consequences (2026) · cites this paper as [138]

    The Results (page unavailable) report that vitamin D concentrations were inversely associated with pre-pregnancy BMI and that women who developed GDM were heavier; Table 3 also shows higher GDM odds in the overweight groups. The paper reports an association between vitamin D deficiency and GDM even after BMI adjustment, but does not specifically say that obesity makes a direct causal relationship difficult to determine. Its Discussion (page unavailable) treats prevention through vitamin D treatment as a possibility requiring confirmation. (LLM, conf=0.84)

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  • Current evidence suggests that vitamin D deficiency may act as a contributing factor that increases the risk of developing gestational diabetes.

    “Current evidence suggests that vitamin D deficiency may act as a contributing factor that increases the risk of developing gestational diabetes.”

    From Maternal Overnutrition and Fetal Programming: Long-Term Metabolic, Cognitive, and Epigenetic Consequences (2026) · cites this paper as [138]

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Authors
Zhang, C., Qiu, C., Hu, F. B., David, R. M., van Dam, R. M., Bralley, A., & Williams, M. A.
Affiliations
  • National Institutes of Health (US)
  • Swedish Medical Center (US)
  • Brigham and Women's Hospital (US)
  • University of Washington (US)
Corresponding author
Zhang, Cuilin
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2008-11-18
Volume
3
Issue
11
Pages
e3753
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0003753
PMC
PMC2582131
OpenAlex
W2128292128
Cited by
380
References
2
Citations by year
2026: 2 · 2025: 5 · 2024: 10 · 2023: 9 · 2022: 20 · 2021: 15 · 2020: 30 · 2019: 21 · 2018: 33 · 2017: 29 · 2016: 29 · 2015: 30 · 2014: 20 · 2013: 33 · 2012: 35
FWCI
22.63
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, public-domain)
  • PubMed Central (publishedVersion, public-domain)
  • PubMed (publishedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
  • National University of Singapore (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • National Institutes of Health (5r01hl032562-03)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD/HL32562, R01HD032562)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Vitamin D Research Studies
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
Keywords
gestational diabetes mellitus, 25-hydroxyvitamin D, vitamin D deficiency, early pregnancy, glucose homeostasis, diabetes risk, pregnant women
MeSH terms
Adult, Female, Glucose Tolerance Test, Humans, Pregnancy, Pregnancy Complications, Prospective Studies, Risk, Risk Factors, Vitamin D, Cohort Studies, Odds Ratio, Case-Control Studies, Diabetes, Gestational, Overweight

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