The Relationship Between Folate, Vitamin B12 and Gestational Diabetes Mellitus with Proposed Mechanisms and Foetal Implications

Vitamin B12 ◽

Vitamin B12 Deficiency ◽

Folic Acid Supplementation ◽

Homocysteine Concentration ◽

Vitamin B9 ◽

The incidence of gestational diabetes mellitus (GDM) is rising, which warrants attention due to the associated complications during pregnancy and in the long term for both mother and offspring. Studies have suggested a relationship between maternal folate (vitamin B9) and vitamin B12 status and GDM risk. Seemingly the most problematic scenario occurs when there is B-vitamin imbalance, with high folate and low vitamin B12. This nutritional state can occur in vitamin B12 deficient women who exceed the recommended folic acid supplementation. However, the pathological mechanisms behind this relationship are currently unclear and are explored in this review article. A high folate/low B12 can lead to a functional folate deficiency through the methyl-trap phenomenon, impairing re-methylation of homocysteine and regeneration of folates for DNA synthesis and repair. Consequently elevated homocysteine concentration leads to endothelial dysfunction and oxidative stress. Vitamin B12 deficiency also leads to an impairment of the conversion of methylmalonyl-CoA to succinyl-CoA, which has been associated with insulin resistance. Insulin resistance is thought to contribute to the etiology of GDM. More studies are needed to confirm the impact of these and other mechanisms on disease development. However, it highlights a potential avenue for GDM risk modification through a vitamin B12 supplement and improvement of maternal metabolic health.

Frequency of Vitamin B12 Deficiency in Pregnant Women with Gestational Diabetes Mellitus

10.53350/pjmhs2115102753 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2753-2755

Author(s):

Shazia Jamil ◽

Naveed Mahmood ◽

Israr-ul- Haque ◽

Rabiah Haque ◽

Muhammad Imran-ul-Hasan ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Vitamin B12 ◽

Pregnant Women ◽

Vitamin B12 Deficiency ◽

Group I ◽

B12 Deficiency ◽

Vitamin B 12 ◽

Group Ii

Objective: To determine the prevalence of vitamin B-12 deficiency in pregnant women with gestational diabetes mellitus. Study Design: Retrospective study Place and Duration of Study: Department of Medicine, OMC Hospital, Jail Road Lahore from January, 2020 to December, 2020. Methods: Two hundred and thirty pregnant females were enrolled age between 18-45 years. Detailed demographics of enrolled cases age, gestational age, gravidity and body mass index were recorded after taking informed written consent. Among 230 cases, 100 women were non GDM (group I) and 130 had gestational diabetes mellitus (group II). Blood samples were taken from all the patients for measuring vitamin B12 status. Vitamin B12 was defined as <300 pg/ml. Results: Mean age of the patients in group I was 31.64±7.45 years with mean BMI 25.88±8.65 kg/m2 while mean age among GDM group was 34.55±5.71 years with mean BMI 27.36±9.44 kg/m2. Mean gestational age in group I was 33.72±4.21 weeks and in group II 35.08±9.27 weeks. In group I 20 (20%) had vitamin B12 deficiency and in group II rate ofvitamin B12 deficiency was high among 90 (69.2%) cases. We found a significantly relation between vitamin B12 and GDM with p value <0.0007. Conclusion: The prevalence of vitamin B-12 deficiency among pregnant women of gestational diabetes mellitus was significantly high as compared to normal pregnant women. Keywords: Pregnant Women, Gestational Diabetes Mellitus, Vitamin B12 deficiency

Hypovitaminosis D in Gestational Diabetes Mellitus: The Impact of Vitamin D Status on Insulin Resistance, Parathyroid Hormone, and Perinatal Outcome

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v6i1.112 ◽

2018 ◽

Vol 6 (1) ◽

Author(s):

Mohamed A Youssry MD ◽

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Vitamin D ◽

Parathyroid Hormone ◽

Gestational Diabetes ◽

Perinatal Outcome ◽

Hypovitaminosis D ◽

Vitamin D Status ◽

Vitamin B12 deficiency is linked with dyslipidemia in gestational diabetes mellitus.

The Professional Medical Journal ◽

10.29309/tpmj/2022.29.01.6484 ◽

2021 ◽

Vol 29 (01) ◽

pp. 46-52

Author(s):

Shehmeen Khan Khanzada ◽

Sabreena Abbas Khokhar ◽

Fouzia Shaikh

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Vitamin B12 ◽

Pregnant Women ◽

Venous Blood ◽

Vitamin B12 Deficiency ◽

Inverse Correlation ◽

Assay Method ◽

B12 Deficiency

Objective: To determine the vitamin B12 deficiency and dyslipidemia in Gestational Diabetes mellitus (GDM) diagnosed pregnant women. Study Design: Observational study. Setting: Department of Biochemistry and Gynecology/Obstetrics LUMHS Hospital Jamshoro. Period: January 2018 to December 2018. Material & Methods: A sample of 216 diagnosed GDM pregnant women was selected according to study criteria. Venous blood samples were centrifuged to separate sera; that were used for the estimation of (hexokinase method), blood lipids and Vitamin B12 (ECLIA assay method) by Cobas chemistry analyzer. Statistical SPSS software 21.0 (IBM, Inc USA) was used for study research variables at 95% CI (P ≤ 0.05). Results: Age of GDM cases was 36.12±9.5 years. Mean+/-SD vitamin B12 level was noted 154.7±81.7 ng/mL (P=0.0001). Serum cholesterol, triglycerides and LDLc were elevated and HDLc was low in GDM cases (P=0.0001). Of 216 GDM cases, vitamin B12 deficiency was present in 152 (70.3%) (P=0.0001) and dyslipidemia in 50 (23.1%) (X2=452.0) (P=0.0001). Vitamin B12 shows inverse correlation with RBG (r= -0.41, P=0.005), CHOL (r= -0.25, P=0.024), TAG (r= -0.81, P=0.0001), LDLc (r= -0.797, P=0.0001) and positive correlation with HDLc (r= 0.76, P=0.0001). Conclusion: The present study finds vitamin B12 deficiency in 152 (70.3%) and dyslipidemia in 50 (23.1%). Vitamin B12 deficient GDM women show high cholesterol, triglycerides, LDLc and low HDLc. Hence, it is concluded, the vitamin B12 deficiency is linked with dyslipidemia in Gestational Diabetes mellitus.

Frequency of Hypovitaminosis B12 in Pregnant Women with Gestational Diabetes Mellitus

10.53350/pjmhs211572296 ◽

2021 ◽

Vol 15 (7) ◽

pp. 2296-2298

Author(s):

Aesha Sadaf Rizwan ◽

Kousar Robeen ◽

Afshan Ahmad ◽

Irum Batool Hashmi ◽

Muhammad Tahir ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Vitamin B12 ◽

Pregnant Women ◽

Gestational Age ◽

Vitamin B12 Deficiency ◽

High Rate ◽

P Value ◽

B12 Deficiency

Objective: To determine the frequency of hypovitaminosis B12 in pregnant females presented with gestational diabetes mellitus. Study Design: Retrospective study Place and Duration: The department of Gynaecology and Obstetrics, Category A Hospital, Batkhela Malakand and Muhammad Teaching Hospital, Peshawarfor the duration of six months from October 2020 to March 2021. Methodology: Total 190 pregnant women (95 GDM, 95 non-GDM) were enrolled in this study. Patient’s ages were ranging between 18 to 40 years. Detailed demographics including age, gestational age, body mass index (BMI), and gravidty were recorded after taking informed written consent. Blood samples were taken from all the patients for measuring vitamin B12 status. Hypovitaminosis B12 was defined as <300 pg/ml. Data was analyzed by SPSS 24.0. Results: Mean age of patients was 32.46±6.82 years. Mean BMI was 26.24±2.34 kg/m2. Mean gestational age was 34.56±2.18 weeks. 105 (55.26%) women were multigravida. 80 (42.11%) patients had vitamin B12 level <300 pg/ml. Patients with GDM had high rate of vitaminosis B12 deficiency as compared to non-GDM patients (65.26% Vs 18.95%). A significant association was observed between GDM and hypovitaminosis B12 with p-value <0.0001. Conclusion: Vitamin B12 deficiency was significantly associated with gestational diabetes mellitus with frequency of 65.26%. Keywords: Vitaminosis B12, Gestational Diabetes Mellitus, Pregnancy

Gestational Diabetes Mellitus and Developmental Programming

Annals of Nutrition and Metabolism ◽

10.1159/000509902 ◽

2021 ◽

pp. 1-12

Author(s):

Anne H.Y. Chu ◽

Keith M. Godfrey

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Gestational Diabetes ◽

Maternal Obesity ◽

Association Studies ◽

In Utero ◽

Future Research ◽

Cardiometabolic Health ◽

During normal pregnancy, increased insulin resistance acts as an adaptation to enhance materno-foetal nutrient transfer and meet the nutritional needs of the developing foetus, particularly in relation to glucose requirements. However, about 1 in 6 pregnancies worldwide is affected by the inability of the mother’s metabolism to maintain normoglycaemia, with the combination of insulin resistance and insufficient insulin secretion resulting in gestational diabetes mellitus (GDM). A growing body of epidemiologic work demonstrates long-term implications for adverse offspring health resulting from exposure to GDM in utero. The effect of GDM on offspring obesity and cardiometabolic health may be partly influenced by maternal obesity; this suggests that improving glucose and weight control during early pregnancy, or better still before conception, has the potential to lessen the risk to the offspring. The consequences of GDM for microbiome modification in the offspring and the impact upon offspring immune dysregulation are actively developing research areas. Some studies have suggested that GDM impacts offspring neurodevelopmental and cognitive outcomes; confirmatory studies will need to separate the effect of GDM exposure from the complex interplay of social and environmental factors. Animal and human studies have demonstrated the role of epigenetic modifications in underpinning the predisposition to adverse health in offspring exposed to suboptimal hyperglycaemic in utero environment. To date, several epigenome-wide association studies in human have extended our knowledge on linking maternal diabetes-related DNA methylation marks with childhood adiposity-related outcomes. Identification of such epigenetic marks can help guide future research to develop candidate diagnostic biomarkers and preventive or therapeutic strategies. Longer-term interventions and longitudinal studies will be needed to better understand the causality, underlying mechanisms, or impact of GDM treatments to optimize the health of future generations.

Plasma retinol-binding protein 4 in the first and second trimester and risk of gestational diabetes mellitus in Chinese women: a nested case-control study

Nutrition & Metabolism ◽

10.1186/s12986-019-0425-9 ◽

2020 ◽

Vol 17 (1) ◽

Cited By ~ 1

Author(s):

Chuyao Jin ◽

Lizi Lin ◽

Na Han ◽

Zhiling Zhao ◽

Zheng Liu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Gestational Diabetes ◽

Binding Protein ◽

First Trimester ◽

Retinol Binding Protein ◽

Second Trimester ◽

Retinol Binding Protein 4 ◽

Plasma Retinol

Abstract Background To assess the association between plasma retinol-binding protein 4 (RBP4) levels both in the first trimester and second trimester and risk of gestational diabetes mellitus (GDM). Methods Plasma RBP4 levels and insulin were measured among 135 GDM cases and 135 controls nested within the Peking University Birth Cohort in Tongzhou. Multivariable linear regression analysis was conducted to assess the influence of RBP4 levels on insulin resistance. Conditional logistic regression models were used to compute the odds ratio (OR) and 95% confidence interval (CI) between RBP4 levels and risk of GDM. Results The GDM cases had significantly higher levels of RBP4 in the first trimester than controls (medians: 18.0 μg/L vs 14.4 μg/L; P < 0.05). Plasma RBP4 concentrations in the first and second trimester were associated with fasting insulin, homeostasis model assessment for insulin resistance (HOMA-IR), and the quantitative insulin sensitivity check index (QUICKI) in the second trimester (all P < 0.001). With adjustment for diet, physical activity, and other risk factors for GDM, the risk of GDM increased with every 1-log μg/L increment of RBP4 levels, and the OR (95% CI) was 3.12 (1.08–9.04) for RBP4 in the first trimester and 3.38 (1.03–11.08) for RBP4 in the second trimester. Conclusions Plasma RBP4 levels both in the first trimester and second trimester were dose-dependently associated with increased risk of GDM.

Gestational Diabetes Mellitus and Infant Adiposity at Birth: A Systematic Review and Meta-Analysis of Therapeutic Interventions

Journal of Clinical Medicine ◽

10.3390/jcm10040835 ◽

2021 ◽

Vol 10 (4) ◽

pp. 835

Author(s):

Manoja P. Herath ◽

Jeffrey M. Beckett ◽

Andrew P. Hills ◽

Nuala M. Byrne ◽

Kiran D. K. Ahuja

Keyword(s):

Diabetes Mellitus ◽

Adipose Tissue ◽

Gestational Diabetes ◽

Fat Mass ◽

Metabolic Disorders ◽

Later Life ◽

Therapeutic Interventions ◽

Increased Risk ◽

Exposure to untreated gestational diabetes mellitus (GDM) in utero increases the risk of obesity and type 2 diabetes in adulthood, and increased adiposity in GDM-exposed infants is suggested as a plausible mediator of this increased risk of later-life metabolic disorders. Evidence is equivocal regarding the impact of good glycaemic control in GDM mothers on infant adiposity at birth. We systematically reviewed studies reporting fat mass (FM), percent fat mass (%FM) and skinfold thicknesses (SFT) at birth in infants of mothers with GDM controlled with therapeutic interventions (IGDMtr). While treating GDM lowered FM in newborns compared to no treatment, there was no difference in FM and SFT according to the type of treatment (insulin, metformin, glyburide). IGDMtr had higher overall adiposity (mean difference, 95% confidence interval) measured with FM (68.46 g, 29.91 to 107.01) and %FM (1.98%, 0.54 to 3.42) but similar subcutaneous adiposity measured with SFT, compared to infants exposed to normal glucose tolerance (INGT). This suggests that IGDMtr may be characterised by excess fat accrual in internal adipose tissue. Given that intra-abdominal adiposity is a major risk factor for metabolic disorders, future studies should distinguish adipose tissue distribution of IGDMtr and INGT.

Gestational Diabetes Mellitus Treatment Schemes Modify Maternal Plasma Cholesterol Levels Dependent to Women´s Weight: Possible Impact on Feto-Placental Vascular Function

Nutrients ◽

10.3390/nu12020506 ◽

2020 ◽

Vol 12 (2) ◽

pp. 506 ◽

Cited By ~ 1

Author(s):

Susana Contreras-Duarte ◽

Lorena Carvajal ◽

María Jesús Garchitorena ◽

Mario Subiabre ◽

Bárbara Fuenzalida ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Vascular Function ◽

Plasma Cholesterol ◽

Umbilical Vein ◽

Maternal Plasma ◽

Maternal Weight ◽

Cholesterol Levels ◽

Gestational diabetes mellitus (GDM) associates with fetal endothelial dysfunction (ED), which occurs independently of adequate glycemic control. Scarce information exists about the impact of different GDM therapeutic schemes on maternal dyslipidemia and obesity and their contribution to the development of fetal-ED. The aim of this study was to evaluate the effect of GDM-treatments on lipid levels in nonobese (N) and obese (O) pregnant women and the effect of maternal cholesterol levels in GDM-associated ED in the umbilical vein (UV). O-GDM women treated with diet showed decreased total cholesterol (TC) and low-density lipoproteins (LDL) levels with respect to N-GDM ones. Moreover, O-GDM women treated with diet in addition to insulin showed higher TC and LDL levels than N-GDM women. The maximum relaxation to calcitonin gene-related peptide of the UV rings was lower in the N-GDM group compared to the N one, and increased maternal levels of TC were associated with even lower dilation in the N-GDM group. We conclude that GDM-treatments modulate the TC and LDL levels depending on maternal weight. Additionally, increased TC levels worsen the GDM-associated ED of UV rings. This study suggests that it could be relevant to consider a specific GDM-treatment according to weight in order to prevent fetal-ED, as well as to consider the possible effects of maternal lipids during pregnancy.