Associations of circulating calcium and 25-hydroxyvitamin D with glucose metabolism in pregnancy: a cross-sectional study in European and South Asian women

Donald C. Whitelaw, Andrew J. Scally, Derek J. Tuffnell, T. Jeffrey Davies, William D. Fraser, Raj Bhopal, John Wright, Debbie A. Lawlor

Research output: Contribution to journalArticlepeer-review

Abstract

Background:
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 (75g OGTT) at 26 weeks gestation.
Results:
Gestational diabetes (GDM) was diagnosed in 137 women (9.3%). Median 25(OH)D concentration for the study population was 9.3ng/mL (interquartile range (IQR) 5.2, 16.9) and was higher in European (15.2ng/mL (10.7, 23.5)) than in South Asian women (5.9 ng/mL (3.9, 9.4), p<0.001). After appropriate adjustment for confounders, 25(OH)D showed a weak inverse association with fasting plasma glucose (FPG; mean difference 1.0% per 1SD; 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, post-challenge glucose or GDM. Serum calcium (albumin-adjusted) was strongly associated with fasting insulin (RGM 1.06; 95% CI 1.03, 1.08), post-challenge 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.
Original languageEnglish
Pages (from-to)938-946
JournalJournal of Clinical Endocrinology & Metabolism
Volume99
Issue number3
Early online date1 Jan 2014
DOIs
Publication statusPublished - 2014

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