Associations of Circulating Calcium and 25-Hydroxyvitamin D With Glucose Metabolism in Pregnancy: A Cross-Sectional Study in European and South Asian Women
Whitelaw, D.C. Scally, Andy J. Tuffnell, D.J. Davies, T.J. Fraser, W.D. Bhopal, R.S. Wright, J. Lawlor, D.A.
Whitelaw, D.C.
Scally, Andy J.
Tuffnell, D.J.
Davies, T.J.
Fraser, W.D.
Bhopal, R.S.
Wright, J.
Lawlor, D.A.
Publication Date
2014-03
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13/12/2013
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Abstract
Vitamin D deficiency is thought to impair insulin action and glucose metabolism; however, previous studies have not examined ethnic differences or the influence of calcium and parathyroid hormone. We investigated this in a cohort of predominantly white European and south Asian women during pregnancy.
Methods:
In this cross-sectional study from an urban population in northern England (53.8°N), 1467 women were recruited when undergoing glucose tolerance testing (75 g oral glucose tolerance test) at 26 weeks' gestation.
Results:
Gestational diabetes mellitus (GDM) was diagnosed in 137 women (9.3%). Median 25-hydroxyvitamin D concentration for the study population was 9.3 ng/mL (interquartile range 5.2, 16.9) and was higher in European [15.2 ng/mL (10.7, 23.5)] than in south Asian women [5.9 ng/mL (3.9, 9.4), P < .001]. After appropriate adjustment for confounders, 25-hydroxyvitamin D showed a weak inverse association with fasting plasma glucose (FPG; mean difference 1.0% per 1 SD; the ratio of geometric means (RGM) 0.99, 95% confidence interval (CI) 0.98, 1.00), and PTH was weakly associated with FPG (RGM 1.01, 95% CI 1.00, 1.02), but neither was associated with fasting insulin, postchallenge glucose, or GDM. Serum calcium (albumin adjusted) was strongly associated with fasting insulin (RGM 1.06; 95% CI 1.03, 1.08), postchallenge glucose (RGM 1.03, 95% CI 1.01, 1.04), and GDM (odds ratio 1.33, 95% CI 1.06, 1.66) but not with FPG. Associations were similar in European and south Asian women.
Conclusions:
These findings do not indicate any important association between vitamin D status and glucose tolerance in pregnancy. Relationships between circulating calcium and glucose metabolism warrant further investigation.
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Whitelaw DC, Scally AJ, Tuffnell DJ et al (2014) Associations of Circulating Calcium and 25-Hydroxyvitamin D With Glucose Metabolism in Pregnancy: A Cross-Sectional Study in European and South Asian Women. Journal of Clinical Endocrinology and Metabolism. 99(3): 938-946.
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