The association of maternal fat-soluble antioxidants in early pregnancy with gestational diabetes mellitus: a prospective cohort study
Yanyu Lyu, Guiyun Wang, Zhenfeng Sun, Xiaodai Cui, Qingyong Xiu, Lijun Wu
Abstract
Abstract Introduction Oxidative stress is linked to the development of gestational diabetes mellitus (GDM). Maternal antioxidant vitamins in early pregnancy may play a role in GDM occurrence. We aimed to investigate the associations of vitamins A and E in early pregnancy with the risk of GDM and to explore whether these antioxidant vitamins can be biomarkers for the early prediction of GDM. Methods We carried out a prospective cohort study conducted in Beijing and enrolled pregnant women ( n = 667) with vitamins A and E measurements at 9 weeks (IQR 8–10) of gestation and having one-step GDM screened with a 75-g oral glucose tolerance test between 24 and 28 weeks of gestation. Results The vitamin A levels in early pregnancy were significantly higher in women with GDM than in those without GDM ( p < 0.0001) and positively correlated with fasting blood glucose. In multivariate models, vitamin A levels were significantly associated with GDM (OR, 1.46; 95% CI: 1.14–1.88; p = 0.0032) per SD. A significant trend of risk effect on GDM risk across quartiles of vitamin A was observed ( p trend = 0.016). No significant association of serum vitamin E with GDM was observed overall. However, a noted trend of protective effect on GDM risk across quartiles of vitamin E/cholesterol ratio was observed ( p trend = 0.043). In ROC analysis, the multivariate model consisting of vitamin A and other risk factors showed the best predictive performance (AUC: 0.760; 95% CI: 0.705–0.815; p < 0.001). Conclusions Higher levels of vitamin A in early pregnancy were significantly associated with an increased risk of GDM. Vitamin A has the potential to be a biomarker indicating pathogenesis of GDM.