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Glucose homeostasis, beta cell function, and insulin resistance in relation to vitamin D status after gestational diabetes mellitus

Shaat, Nael LU ; Ignell, Claes LU ; Katsarou, Anastasia LU and Berntorp, Kerstin LU (2017) In Acta Obstetricia et Gynecologica Scandinavica p.1-7
Abstract

Introduction: We wanted to determine vitamin D status after gestational diabetes mellitus (GDM) and to evaluate whether levels of 25-hydroxyvitamin D3 (25OHD3) are associated with beta cell function, insulin resistance or a diagnosis of diabetes after GDM. Material and methods: Glucose homeostasis was assessed during a 75-g oral glucose tolerance test one to two years after delivery in 376 women with previous GDM (287 European and 78 non-European, including 33 Arab and 35 Asian women). Insulin resistance was estimated using homeostasis model assessment of insulin resistance (HOMA-IR). The insulinogenic index (I/G30) and the disposition index [(I/G30)/HOMA-IR] were used to calculate insulin secretion. Concentrations... (More)

Introduction: We wanted to determine vitamin D status after gestational diabetes mellitus (GDM) and to evaluate whether levels of 25-hydroxyvitamin D3 (25OHD3) are associated with beta cell function, insulin resistance or a diagnosis of diabetes after GDM. Material and methods: Glucose homeostasis was assessed during a 75-g oral glucose tolerance test one to two years after delivery in 376 women with previous GDM (287 European and 78 non-European, including 33 Arab and 35 Asian women). Insulin resistance was estimated using homeostasis model assessment of insulin resistance (HOMA-IR). The insulinogenic index (I/G30) and the disposition index [(I/G30)/HOMA-IR] were used to calculate insulin secretion. Concentrations of serum 25OHD3 were determined. Results: Mean (±SD) 25OHD3 concentration was 50.0 ± 22.3 nmol/L and differed significantly among subgroups of body mass index, ethnicity, and glucose tolerance status; 53% had 25OHD3 levels <50 nmol/L and 87% had 25OHD3 levels <75 nmol/L. There was a negative correlation between 25OHD3 concentration and HOMA-IR (p < 0.001) and a positive correlation between 25OHD3 and disposition index (p = 0.002) in univariable regression analysis. Correlations attenuated after adjustment for body mass index. In univariable regression analysis, 25OHD3 concentrations were significantly associated with diabetes after GDM (p = 0.004). However, in a multivariable model, non-European origin, HOMA-IR and insulinogenic index were significantly associated with postpartum diabetes, whereas 25OHD3 concentrations were not. Conclusion: Vitamin D deficiency/insufficiency in previous GDM cases appears to be associated with beta cell dysfunction and insulin resistance, but not with postpartum diabetes when factors well known to influence type-2 diabetes were adjusted for.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Disposition index, Ethnicity, Gestational diabetes, HOMA-IR, Insulinogenic index, OGTT, Postpartum diabetes, Vitamin D
in
Acta Obstetricia et Gynecologica Scandinavica
pages
1 - 7
publisher
Wiley-Blackwell
external identifiers
  • scopus:85017527797
  • wos:000403899400005
ISSN
0001-6349
DOI
10.1111/aogs.13124
language
English
LU publication?
yes
id
99695ce1-bf64-4c71-a515-5fc395b8a370
date added to LUP
2017-05-04 17:00:38
date last changed
2017-09-18 13:34:09
@article{99695ce1-bf64-4c71-a515-5fc395b8a370,
  abstract     = {<p>Introduction: We wanted to determine vitamin D status after gestational diabetes mellitus (GDM) and to evaluate whether levels of 25-hydroxyvitamin D<sub>3</sub> (25OHD<sub>3</sub>) are associated with beta cell function, insulin resistance or a diagnosis of diabetes after GDM. Material and methods: Glucose homeostasis was assessed during a 75-g oral glucose tolerance test one to two years after delivery in 376 women with previous GDM (287 European and 78 non-European, including 33 Arab and 35 Asian women). Insulin resistance was estimated using homeostasis model assessment of insulin resistance (HOMA-IR). The insulinogenic index (I/G30) and the disposition index [(I/G30)/HOMA-IR] were used to calculate insulin secretion. Concentrations of serum 25OHD<sub>3</sub> were determined. Results: Mean (±SD) 25OHD<sub>3</sub> concentration was 50.0 ± 22.3 nmol/L and differed significantly among subgroups of body mass index, ethnicity, and glucose tolerance status; 53% had 25OHD<sub>3</sub> levels &lt;50 nmol/L and 87% had 25OHD<sub>3</sub> levels &lt;75 nmol/L. There was a negative correlation between 25OHD<sub>3</sub> concentration and HOMA-IR (p &lt; 0.001) and a positive correlation between 25OHD<sub>3</sub> and disposition index (p = 0.002) in univariable regression analysis. Correlations attenuated after adjustment for body mass index. In univariable regression analysis, 25OHD<sub>3</sub> concentrations were significantly associated with diabetes after GDM (p = 0.004). However, in a multivariable model, non-European origin, HOMA-IR and insulinogenic index were significantly associated with postpartum diabetes, whereas 25OHD<sub>3</sub> concentrations were not. Conclusion: Vitamin D deficiency/insufficiency in previous GDM cases appears to be associated with beta cell dysfunction and insulin resistance, but not with postpartum diabetes when factors well known to influence type-2 diabetes were adjusted for.</p>},
  author       = {Shaat, Nael and Ignell, Claes and Katsarou, Anastasia and Berntorp, Kerstin},
  issn         = {0001-6349},
  keyword      = {Disposition index,Ethnicity,Gestational diabetes,HOMA-IR,Insulinogenic index,OGTT,Postpartum diabetes,Vitamin D},
  language     = {eng},
  pages        = {1--7},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Obstetricia et Gynecologica Scandinavica},
  title        = {Glucose homeostasis, beta cell function, and insulin resistance in relation to vitamin D status after gestational diabetes mellitus},
  url          = {http://dx.doi.org/10.1111/aogs.13124},
  year         = {2017},
}