ASSOCIATION BETWEEN VITAMIN D DEFICIENCY AND INSULIN RESISTANCE IN EARLY PREGNANCY: A CROSS-SECTIONAL STUDY

Abstract

Introduction: Vitamin D is crucial in the metabolism of calcium and phosphorus, as well as in bone health, while also contributing to numerous other bodily functions. Vitamin D deficiency in pregnant women is very common worldwide. It is associated with an increased risk of preeclampsia, gestational diabetes mellitus and cesarean section. Consequences in the newborn are most often associated with low birth weight, risk of neonatal hypocalcemia, asthma, and/ or type 1 diabetes mellitus. A lack of vitamin D during pregnancy is linked to various metabolic issues, including insulin resistance. It is considered that increased body weight has a negative effect on the concentration of vitamin D. Deficiency of 25-hydroxyvitamin D has long been considered a risk factor for glucose intolerance and most likely 1,25-dihydroxyvitamin D has a role in the regulation of insulin secretion. 

Objective: To investigate how a deficiency in vitamin D impacts the onset of insulin resistance in pregnant women.

Material and Methods: A cross-sectional clinical study was conducted in the University Clinic for Endocrinology, Diabetes and Metabolic Diseases, Skopje, from March 2022 to March 2023 with 55 pregnant women in the first trimester of pregnancy. According to vitamin D values, the sample subjects were divided into three groups: a) Group 1: <20ng/ml; b) Group 2: 20-44ng/ml; and c) Group 3: >44ng/ml. We analyzed the level of insulinemia, glycemia and homeostatic model assessment for insulin resistance (HOMA IR) in the three groups.

Results: Among 55 pregnant women assessed in their first trimester, 30 (54.54%) showed a vitamin D deficiency (below 20ng/ml). Nineteen patients (34.54%) had normal vitamin D levels (ranging from 20 to 44ng/ml), while 6 (19.91%) had elevated levels (above 44ng/ml). In the group with vitamin D deficiency, the average HOMA IR value was higher at 3.14±1.59, compared to an average of 2.57±1 in the group with normal vitamin D levels.

Conclusion: A shortage of vitamin D during the first trimester of pregnancy is linked to increased insulin resistance, which can complicate metabolic health. Therefore, adequate supstituion of vitamin D during pregnancy is necessary for mother’s and offspring’s wellbeing.