Associations Between Serum Vitamin A Levels in Early Pregnancy and the Risk of Gestational Diabetes Mellitus
Open accessAbstract
Background: The relationship between vitamin A levels and gestational diabetes mellitus (GDM) is not well understood, and prospective studies are lacking. Methods: This was a prospective, longitudinal study. A total of 391 women in early pregnancy were recruited between October and December 2018 at Shunyi District Maternal and Child Health Hospital (Beijing, China). Serum vitamin A concentration was measured at enrollment. GDM was diagnosed on the basis of a 75 g oral glucose-tolerance test at 24– 28 weeks of follow-up. Logistic regression was used for the analysis. Results: None of the subjects in the cohort had vitamin A deficiency or excess. At the follow-up, 76 participants had developed GDM. Participants who developed GDM were older and had higher body mass index, fasting insulin, HbA 1c , fasting glucose, homeostasis model assessment for insulin resistance, triglyceride, low-density lipoprotein cholesterol , and high-sensitivity CRP levels, as well as higher serum vitamin A levels at baseline. On logistic multivariate analysis, higher vitamin A was positively associated with higher risk of GDM. The adjusted OR was 2.85 (95% CI 1.04– 7.80, P =0.042) for Q4 versus Q1 and 1.59 (95% CI 1.11– 2.28, P =0.011) for every 1 SD increase in serum vitamin A levels. In participants within the vitamin A reference range (0.33– 0.78 mg/L), the positive association also maintained significance. Conclusion: Higher serum vitamin A levels were associated with higher GDM risks, even within the reference range. The results and possible mechanisms need to be further verified and clarified. Keywords: gestational diabetes mellitus, vitamin A, insulin resistance, inflammation
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Even if non-lethal or non-teratogenic, excessive vitamin A levels may impair the offspring's future metabolism and are associated with higher GDM risks.
“However, the evidence highlights the necessity of cautious vitamin A intake during pregnancy; even if non-lethal or non-teratogenic, excessive levels may impair the offspring’s future metabolism [132] and are associated with higher GDM risks [133].”
From Maternal Overnutrition and Fetal Programming: Long-Term Metabolic, Cognitive, and Epigenetic Consequences (2026) · cites this paper as [133]
The Results (page not provided) associate higher serum vitamin A in early pregnancy with greater GDM risk, including among women within the reference range. But the paper says none of the participants had vitamin A excess, so it does not establish the GDM association for excessive levels. The offspring-metabolism claim is attached to a different citation [132] and is not assessed here. (LLM, conf=0.88)
Experimental — accuracy not yet measuredHigher vitamin A levels are positively associated with GDM.
“Some investigators observed that low retinol levels in early pregnancy are associated with an increased risk of insulin-treated GDM [125], while other researchers suggest higher vitamin A levels are positively associated with GDM [126].”
From Medical Nutrition Therapy for Women with Gestational Diabetes: Current Practice and Future Perspectives (2025) · cites this paper as [126]
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Cites
Vitamin A and Pregnancy: A Narrative Review
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Cheong, L., Law, L. S.-C., Tan, L. Y. L., Amal, A. A.-A., Khoo, C. M., & Eng, P. C. (2025) · Nutrients · doi:10.3390/nu17071210 · Cited by 14 · see citing works
Schiera, G., Macajone, G., Volpes, S., Greco, L., Di Liegro, C. M., Serio, G., Caradonna, F., & Naselli, F. (2026) · Cells · doi:10.3390/cells15040366 · Cited by 8 · see citing works
- Authors
- Yu, J., Liu, Y., & Xu, L.
- Affiliations
- Chinese Academy of Medical Sciences & Peking Union Medical College (CN)
- ORCID
- Venue
- Diabetes, Metabolic Syndrome and Obesity
- Publisher
- Informa UK Limited
- Published
- 2024-07
- Volume
- Volume 17
- Pages
- 2895-2901
- ISSN
- 1178-7007 (ISSN-L)
- PMC
- PMC11298187
- OpenAlex
- W4401194763
- Cited by
- 3
- References
- 1
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1
- FWCI
- 1.66
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Diabetes Metabolic Syndrome and Obesity (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Funders
- National Natural Science Foundation of China (82100947)
- Chinese Academy of Medical Sciences (I2M-C, 2021-I2M-C)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Health Sciences › Medicine › Rheumatology › Folate and B Vitamins Research
- Keywords
- gestational diabetes mellitus, serum vitamin A, early pregnancy, insulin resistance, inflammation, HbA1c, fasting insulin, HOMA, triglycerides, high-sensitivity CRP, risk factors
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