Association of Maternal Folate and Vitamin B12 in Early Pregnancy With Gestational Diabetes Mellitus: A Prospective Cohort Study - PubMed (original) (raw)

. 2021 Jan;44(1):217-223.

doi: 10.2337/dc20-1607. Epub 2020 Nov 6.

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Association of Maternal Folate and Vitamin B12 in Early Pregnancy With Gestational Diabetes Mellitus: A Prospective Cohort Study

Xiaotian Chen et al. Diabetes Care. 2021 Jan.

Abstract

Objective: To investigate the association of folate and vitamin B12 in early pregnancy with gestational diabetes mellitus (GDM) risk.

Research design and methods: The data of this study were from a subcohort within the Shanghai Preconception Cohort Study. We included pregnancies with red blood cell (RBC) folate and vitamin B12 measurements at recruitment (between 9 and 13 gestational weeks) and those with three samples available for glucose measurements under an oral glucose tolerance test. GDM was diagnosed between 24 and 28 weeks' gestation. Odds ratio (OR) and 95% CI of having GDM was used to quantify the association.

Results: A total of 1,058 pregnant women were included, and GDM occurred in 180 (17.01%). RBC folate and vitamin B12 were significantly higher in pregnancies with GDM than those without GDM (P values were 0.045 and 0.002, respectively) and positively correlated with 1-h and 2-h serum glucose. Daily folic acid supplementation in early pregnancy increases the risk of GDM; OR (95% CI) was 1.73 (1.19-2.53) (P = 0.004). Compared with RBC folate <400 ng/mL, pregnancies with RBC folate ≥600 ng/mL were associated with ∼1.60-fold higher odds of GDM; the adjusted OR (95% CI) was 1.58 (1.03-2.41) (P = 0.033). A significant trend of risk effect on GDM risk across categories of RBC folate was observed (P trend = 0.021). Vitamin B12 was significantly associated with GDM risk (OR 1.14 per 100 pg/mL; P = 0.002). No significant association of serum folate and percentile ratio of RBC folate/vitamin B12 with GDM was observed.

Conclusions: Higher maternal RBC folate and vitamin B12 levels in early pregnancy are significantly associated with GDM risk, while the balance of folate/vitamin B12 is not significantly associated with GDM.

© 2020 by the American Diabetes Association.

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Figures

Figure 1

Figure 1

RCS regression analysis of RBC folate and vitamin B12 with GDM risk. A: RBC folate 400 ng/mL was selected as the reference level. B: The median of vitamin B12 298 pg/mL was selected as the reference level. The lines indicate estimated ORs, and the light blue areas represent 95% CI.

References

    1. Guariguata L, Linnenkamp U, Beagley J, Whiting DR, Cho NH. Global estimates of the prevalence of hyperglycaemia in pregnancy. Diabetes Res Clin Pract 2014;103:176–185 - PubMed
    1. Xu T, Dainelli L, Yu K, et al. The short-term health and economic burden of gestational diabetes mellitus in China: a modelling study. BMJ Open 2017;7:e018893 - PMC - PubMed
    1. Reece EA, Leguizamón G, Wiznitzer A. Gestational diabetes: the need for a common ground. Lancet 2009;373:1789–1797 - PubMed
    1. Metzger BE, Gabbe SG, Persson B, et al.; International Association of Diabetes and Pregnancy Study Groups Consensus Panel . International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 2010;33:676–682 - PMC - PubMed
    1. Obeid R, Heil SG, Verhoeven MMA, van den Heuvel EGHM, de Groot LCPGM, Eussen SJPM. Vitamin B12 intake from animal foods, biomarkers, and health aspects. Front Nutr 2019;6:93. - PMC - PubMed

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