High folate and low vitamin B12 status during pregnancy is associated with gestational diabetes mellitus

Lai, Jun Shi; Pang, Wei Wei; Cai, Shirong; Lee, Yung Seng; Chan, Jerry; Shek, Lynette Pei‐Chi; Yap, Fabian; Tan, Kok Hian; Godfrey, Keith M.; Dam, Rob M. van; Chong, Yap Seng; Chong, Mary Foong-Fong

doi:10.1016/j.clnu.2017.03.022

Cited by 86 publications

(102 citation statements)

References 30 publications

(56 reference statements)

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“…In addition to these risk factors, accumulating data from epidemiological studies indicate that macronutrient intake and blood micronutrient status are associated with GDM risk. [6][7][8][9] Recently, the role of folate and vitamin B 12 on the development of GDM has emerged as a field of interest. [10][11][12] Folate and vitamin B 12 are metabolically entwined during 1-carbon metabolism.…”

Section: Introductionmentioning

confidence: 99%

“…13 Growing evidence indicates that Hcy concentrations are significantly elevated among women with GDM. [14][15][16] In Italy, lower vitamin B 12 concentrations were observed in pregnant women with GDM. 14 However, other epidemiologic studies performed in Europe indicated that the concentrations of blood folate and vitamin B 12 were similar between women with and without GDM.…”

Section: Introductionmentioning

confidence: 99%

“…[14][15][16] In Italy, lower vitamin B 12 concentrations were observed in pregnant women with GDM. 14 However, other epidemiologic studies performed in Europe indicated that the concentrations of blood folate and vitamin B 12 were similar between women with and without GDM. 15,17 Recent studies from India and the UK suggest that maternal vitamin B 12 deficiency is associated with GDM in pregnant women.…”

Section: Introductionmentioning

confidence: 99%

“…10 Meanwhile, a cohort study in China indicated that folic acid consumption in early pregnancy may increase the risk of GDM. 18 It has been reported that higher maternal folate coupled with lower vitamin B 12 was associated with a higher GDM risk in Singapore. 12 However, the most recent study in Canada showed that maternal blood 1-carbon nutrients may not affect the risk of GDM.…”

Section: Introductionmentioning

confidence: 99%

“…18 It has been reported that higher maternal folate coupled with lower vitamin B 12 was associated with a higher GDM risk in Singapore. 12 However, the most recent study in Canada showed that maternal blood 1-carbon nutrients may not affect the risk of GDM. 19 The above findings have been inconclusive, not consistently supporting a single view of the association between high folate and low vitamin B 12 concentrations and GDM risk.…”

Section: Introductionmentioning

confidence: 99%

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Joint effects of folate and vitamin B₁₂ imbalance with maternal characteristics on gestational diabetes mellitus

Hou

Yan

et al. 2019

Journal of Diabetes

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Highlights• Higher folate and lower vitamin B 12 levels were associated with higher glucose and a higher risk of gestational diabetes mellitus (GDM). • The association between folate and vitamin B 12 imbalance and GDM risk can be further modified by maternal risk factors. Abstract Background: This study examined whether folate and vitamin B 12 imbalance is associated with gestational diabetes mellitus (GDM) and explored interactions between B vitamin imbalance and maternal risk factors for GDM. Methods: A cross-sectional study was performed in 406 Chinese pregnant women. Serum folate, vitamin B 12 , and blood glucose concentrations were measured at 24 to 28 weeks gestation during GDM screening. A diagnosis of GDM was made based on International Association of Diabetes and Pregnancy Study Groups criteria (fasting plasma glucose [FPG] ≥5.1 mM, 1-hour plasma glucose ≥10.0 mM, or 2-hour plasma glucose ≥8.5 mM). Binary logistic regression was used to obtain odds ratios (ORs) after controlling for different confounders. Results: Higher folate levels were associated with higher glucose concentrations and a higher risk of GDM (OR 1.98; 95% confidence interval [CI] 1.00-3.90), whereas higher vitamin B 12 levels were associated with lower FPG and a lower risk of GDM (OR 0.30; 95% CI 0.15-0.60). A higher folate: vitamin B 12 ratio was associated with higher glucose and a higher risk of GDM (OR 3.08; 95% CI 1.63-5.83). The presence of both a higher folate: vitamin B 12 ratio and advanced age further increased the OR to 2.13 (95% CI 1.09-4.15) with a significant additive interaction. Furthermore, a higher folate: vitamin B 12 ratio and a higher prepregnancy body mass index (pp-BMI) were synergistically associated with an increased risk of GDM (OR 3.03; 95% CI 1.40-6.57). Conclusions: An imbalance between folate and vitamin B 12 , represented by a higher folate: vitamin B 12 ratio, was highly associated with GDM risk, and this association could be further modified by maternal age and pp-BMI. K E Y W O R D S folate, gestational diabetes mellitus, pregnancy, synergistic effect, vitamin B 12

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Joint effects of folate and vitamin B₁₂ imbalance with maternal characteristics on gestational diabetes mellitus

Hou

Yan

et al. 2019

Journal of Diabetes

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Association of maternal folate status in the second trimester of pregnancy with the risk of gestational diabetes mellitus

Xie

et al. 2019

Food Science & Nutrition

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Interest in the high folate status of pregnant women has increased due to its role in the prevention of neural tube defects (NTDs). The effect of increased red blood cell (RBC) folate status during the second trimester of pregnancy on gestational diabetes mellitus (GDM) remains unclear. We measured RBC folate concentrations by competitive protein‐binding assay and obtained clinical information from electronic medical records. Logistic regression analysis was used to explore the associations of RBC folate concentrations with risks of gestational diabetes mellitus (GDM). We further assessed the potential nonlinear relations between continuous log‐transformed RBC folate concentrations and GDM risk by using the restricted cubic splines. We observed high RBC folate concentrations in GDM patients compared to control group [median (interquartile range, IQR), GDM vs. controls: 1,554.03 (1,240.54–1,949.99) vs. 1,478.83 (1,124.60–1,865.71) nmol/L, p = .001]. Notably, high folate concentrations were significantly associated with an increased risk of GDM [RR per 1‐SD increase: 1.16 (1.03, 1.30), p = .012] after adjustment for maternal age, parity, and body mass index (BMI) at enrollment. In the restricted cubic spline model, a test of the null hypothesis of the linear relationship was rejected (p = .001). Our study firstly showed that maternal RBC folate concentrations during the second trimester of pregnancy increase the risk of GDM in a Chinese population. Further randomized clinical trials (RCTs) are warranted to confirm the adverse effect.

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Association between maternal folate status and gestational diabetes mellitus

Yang

Cai

Zhang

2021

Food Science & Nutrition

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Studies on the association between maternal folate status and gestational diabetes mellitus (GDM) have yielded inconsistent results. This meta‐analysis was performed to determine whether there may exist some association between maternal folate status and GDM. Unrestricted searches of PubMed, Web of Science, Cochrane, and Embase were conducted. All relevant studies on the association between maternal folat status and GDM risk were screened. The standardized mean difference (SMD) with 95% CIs was used to determine the association between maternal folate and GDM. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random‐effects models to assess the impact of maternal folate status on GDM risk. 12 studies were included. The overall data revealed that compared with the non‐GDM group, women with GDM had higher level of folate (SMD 0.41, 95% CI 0.07 to 0.21, I2 = 17.2%) in second or third trimester. We also found that maternal high folate status may be associated with increased risk of GDM (OR 2.16, 95% CI 1.70 to 2.74, I2 = 0.0%). Compared with non‐GDM group, women with GDM are prone to higher folate level. Moreover, high maternal folate status may predict a higher risk of GDM. As the number of included studies was limited, further large population studies are needed in the future.

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High folate and low vitamin B12 status during pregnancy is associated with gestational diabetes mellitus

Abstract: Higher maternal folate coupled with vitamin B12 insufficiency was associated with higher GDM risk. This finding has potential implications for antenatal supplement recommendations but will require confirmation in future studies.

Cited by 86 publications

References 30 publications

Joint effects of folate and vitamin B₁₂ imbalance with maternal characteristics on gestational diabetes mellitus

Joint effects of folate and vitamin B₁₂ imbalance with maternal characteristics on gestational diabetes mellitus

Association of maternal folate status in the second trimester of pregnancy with the risk of gestational diabetes mellitus

Association between maternal folate status and gestational diabetes mellitus

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High folate and low vitamin B12 status during pregnancy is associated with gestational diabetes mellitus

Abstract: Higher maternal folate coupled with vitamin B12 insufficiency was associated with higher GDM risk. This finding has potential implications for antenatal supplement recommendations but will require confirmation in future studies.

Cited by 86 publications

References 30 publications

Joint effects of folate and vitamin B12 imbalance with maternal characteristics on gestational diabetes mellitus

Joint effects of folate and vitamin B12 imbalance with maternal characteristics on gestational diabetes mellitus

Association of maternal folate status in the second trimester of pregnancy with the risk of gestational diabetes mellitus

Association between maternal folate status and gestational diabetes mellitus

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Joint effects of folate and vitamin B₁₂ imbalance with maternal characteristics on gestational diabetes mellitus

Joint effects of folate and vitamin B₁₂ imbalance with maternal characteristics on gestational diabetes mellitus