Improving of Metabolic Profile With Vitamin D Supplements in Pregnant Women

Abstract

Background. Serum 25-hydroxy-vitamin D deficiency is related to metabolic diseases as polycystic ovary syndrome, obesity, insulin resistance, cardiovascular diseases, cancer, gestational diabetes mellitus (GDM). Objective: To evaluate the effect of vitamin D therapy on metabolic parameters in pregnant women. Methods: There was a 16-week study of 62 participants with gestational diabetes mellitus. All pregnant women followed an appropriate diet and physical activity. Management of 37 women included 2,000 IU/day of cholecalciferol per os. Body mass index (BMI), hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), plasma 25- (OH) vitamin D, low‐density lipoprotein cholesterol (LDL‐C), homeostatic model assessment of insulin resistance (HOMA-ir) were estimated in pregnant women with GDM before and after the 16-week period. Quantitative data are expressed as the mean ± SD. The correlation between variables was assessed using the Pearson correlation coefficient. P-value <0.05 was considered statistically significant. All information was processed with SPSS 21.0. Results: The mean BMI was (30,2±2,34) kg/m2, baseline serum 25-(OH) vitamin D levels in all women were in a deficient limit (less than 30 nmol/L). HOMA in both groups was more than 3. The mean LDL‐C was (3,3±0,63) mmol/l and didn`t differ in the two groups. 25-(OH) vitamin D levels were inversely associated with BMI (r=–0.4; P=0.05), HOMA (r=–0.6; P=0.005), LDL‐C (r=–0.3; P=0.04). Vitamin D therapy has had significant improvement in plasma LDL‐C concentration, HbA1c, FPG in women with GDM (P<0.05). Compared with the Ist group cholecalciferol therapy had lead to a reduction of HOMA in the IInd group by (2,3±0,94) in 4 months (P < 0.05). Conclusions. The daily intake of vitamin D was accompanied by the significant glycemic improvement and the majority of women achieved diabetes control without insulin injections. Strong inverse correlation between 25 (OH) vitamin D levels and HOMA, reduction of HOMA can indicate improved sensitivity to insulin and benefits of vitamin D supplementation for the management of insulin resistance in GDM with vitamin D insufficiency.