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

Nael Shaat^1,2, Claes Ignell^1,3, Anastasia Katsarou^1,2

¹Department of Clinical Sciences, Lund University, Malmö, Sweden.

Acta Obstetricia Et Gynecologica Scandinavica

|March 10, 2017

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 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.

Keywords:

Disposition index HOMA-IR OGTT ethnicity gestational diabetes insulinogenic index postpartum diabetes vitamin D

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