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Association of maternal vitamin B12 and folate levels in early pregnancy with gestational diabetes : a prospective UK cohort study (PRiDE study)

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Saravanan, Ponnusamy, Sukumar, Nithya, Adaikalakoteswari, Antonysunil, Goljan, Ilona, Venkataraman, Hema, Gopinath, Amitha, Bagias, Christos, Yajnik, Chittaranjan S., Stallard, Nigel, Ghebremichael-Weldeselassie, Yonas and Fall, Caroline (2021) Association of maternal vitamin B12 and folate levels in early pregnancy with gestational diabetes : a prospective UK cohort study (PRiDE study). Diabetologia, 64 . pp. 2170-2182. doi:10.1007/s00125-021-05510-7

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Official URL: https://doi.org/10.1007/s00125-021-05510-7

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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 (Ptrend = 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.

Item Type: Journal Article
Subjects: Q Science > QP Physiology
R Medicine > RG Gynecology and obstetrics
Divisions: Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Diabetes in pregnancy, Vitamin B12, Folic acid
Journal or Publication Title: Diabetologia
Publisher: Springer
ISSN: 0012-186X
Official Date: October 2021
Dates:
DateEvent
October 2021Published
22 July 2021Available
28 April 2021Accepted
Volume: 64
Page Range: pp. 2170-2182
DOI: 10.1007/s00125-021-05510-7
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
Copyright Holders: © 2020 by the American Diabetes Association
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
MR/J000094/1Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
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