Prepregnancy Habitual Intake of Vitamin D From Diet and Supplements in Relation to Risk of Gestational Diabetes Mellitus: A Prospective Cohort Study

J Diabetes. 2018 May;10(5):373-379. doi: 10.1111/1753-0407.12611. Epub 2017 Dec 18.

Abstract

Background: Vitamin D may play a pivotal role in regulating insulin secretion and insulin sensitivity. However, the effect of vitamin D intake, either from the diet or from supplements, on the development of gestational diabetes mellitus (GDM) remains unclear. We prospectively examined the association of prepregnancy habitual intake of vitamin D from diet and supplements with the risk of incident GDM in a well-established cohort.

Methods: The present study was performed on 21 356 singleton pregnancies from 15 225 women in the Nurses' Health Study II cohort. Diet information, including vitamin D intake from food sources and supplements, was assessed in 1991 and every 4 years thereafter by validated food frequency questionnaires. Log-binomial models with generalized estimating equations were used to estimate relative risks (RRs) and 95% confidence intervals (CIs).

Results: During 10 years of follow-up, 865 incident GDM cases were documented. After adjustment for age, parity, race/ethnicity, family history of diabetes, dietary and lifestyle factors, and body mass index, the RRs (95% CIs) of GDM risk associated with supplemental vitamin D intake of 0, 1-399, and ≥400 IU/day were 1.00 (reference), 0.80 (0.67-0.96), and 0.71 (0.56-0.90), respectively (Ptrend = 0.002). Dietary and total vitamin D intakes were also inversely associated with GDM risk, but the associations were not statistically significant.

Conclusions: Prepregnancy supplemental vitamin D intake was significantly and inversely associated with risk of GDM. This study indicates potential benefits of increasing vitamin D intake from supplements in the prevention of GDM in women of reproductive age.

Keywords: diet; gestational diabetes mellitus; nutrition; preconception; vitamin D; 妊娠糖尿病; 孕前; 维生素D; 营养; 饮食.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Age Factors
  • Diabetes, Gestational / diagnosis
  • Diabetes, Gestational / epidemiology
  • Diabetes, Gestational / prevention & control*
  • Diet*
  • Dietary Supplements*
  • Female
  • Humans
  • Incidence
  • Life Style
  • Maternal Nutritional Physiological Phenomena*
  • Multivariate Analysis
  • Nurses
  • Nutritional Status*
  • Odds Ratio
  • Pregnancy
  • Prenatal Care*
  • Prospective Studies
  • Recommended Dietary Allowances
  • Risk Factors
  • Time Factors
  • United States / epidemiology
  • Vitamin D / administration & dosage*
  • Vitamin D Deficiency / diagnosis
  • Vitamin D Deficiency / epidemiology
  • Vitamin D Deficiency / prevention & control*
  • Young Adult

Substances

  • Vitamin D