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A STUDY OF VITAMIN D STATUS OF WOMEN WITH GESTATIONAL DIABETES MELLITUS IN ABUJA, NIGERIA
Abstract
Background: Gestational diabetes mellitus (GDM) is associated with both maternal and
perinatal morbidity and mortality. Studies have suggested that Vitamin D plays a major
role in pancreatic beta-cell function and insulin sensitivity and this has been associated
with type 2 Diabetes Mellitus (T2DM). Despite conflicting reports on the association
between GDM and Vitamin D insufficiency, Vitamin D supplementation in pregnancy is
being practised in some developed countries to avert possible sequelae of inadequacy
of Vitamin D. This study was aimed at investigating the relationship between Vitamin D
insufficiency and GDM in this environment to provide evidence of an association or
otherwise.
Methods: This was a case-control study. Two hundred (200) pregnant women that were
referred for Oral Glucose Tolerance Test (OGTT) were recruited from the Department of
Chemical Pathology of the National Hospital Abuja. They were made up of 100 cases
and 100 controls. Cases were defined as pregnant women with a fasting, 1 hour or 2
hour-plasma glucose value of ≥ 5.1 mmol/L, ≥ 10.0 mmol/L or ≥ 8.5 mmol/L respectively
(i.e. diagnosed with GDM) that met the eligibility criteria. Controls were those whose
corresponding plasma glucose levels fell below the above stated values. Socio
demographic and clinical data were obtained using a semi-structured interviewer
administered questionnaire. Plasma total calcium, phosphate, albumin, 25
hydroxycholecalciferol and intact parathyroid hormone (PTH) were determined. The
main statistical measures were the odds ratio for GDM among women with Vitamin D
insufficiency and the adjusted odds ratio after logistic regression using variables that
serve as possible effect modifiers or confounders in the association between Vitamin D
insufficiency and GDM.
Results: The overall mean age (± standard deviation) was 31.73 (4.32) years and pre
pregnancy BMI (± standard deviation) was 28.02 (5.12) Kg/m2. Plasma levels of 25
hydroxycholecalciferol, PTH, albumin-corrected total calcium and phosphate had overall
mean values (± standard deviations) of 28.77 (12.42 ng/mL), 7.69 (8.36) pg/mL, 2.12
(0.15) mmol/L, and 1.00 (0.25) mmol/L respectively. Fifty eight percent (58%) of the
subjects had Vitamin D insufficiency (plasma 25-hydroxycholecalciferol levels below 30
ng/mL). The proportion of cases and controls with Vitamin D insufficiency were 62% and
54% respectively. Odds ratio for GDM was 1.39 (95% Confidence Interval: 0.79 – 2.44)
and P-value = 0.3159. Adjusted odds ratio for GDM, after logistic regression was 0.984
(95% CI: 0.944 – 1.025) and P-value = 0.438.
Conclusion: The results showed that there was no association between Vitamin D
insufficiency and gestational diabetes mellitus. However, the high proportion of Vitamin
D insufficiency among the study population requires appropriate attention.
