Circulating vitamin D and the risk of gestational diabetes: a systematic review and dose-response meta-analysis
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META-ANALYSIS
Circulating vitamin D and the risk of gestational diabetes: a systematic review and dose-response meta-analysis Mehdi Sadeghian 1,2,3 Maryam Asadi1,2,3 Sepideh Rahmani4 Mohsen Akhavan Zanjani5 Omid Sadeghi6 Seyed Ahmad Hosseini1,2,3 Ahmad Zare Javid1,2,3 ●
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Received: 27 November 2019 / Accepted: 19 May 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Several meta-analyses of observational studies revealed a modest increase in the risk of gestational diabetes (GDM) among pregnant women with low levels of serum vitamin D. However, no study examined a dose-response meta-analysis as well as a high versus low analysis in this regard. Methods We systematically searched PubMed, Embase, ISI Web of Science, and Scopus up to August 2019 to find prospective observational studies investigating the association of serum 25(OH)D with the risk of developing GDM. Using a random-effects model, the reported risk estimates were pooled. Results Nine cohort studies and six nested case-control studies were included in the final analysis (40,788 participants and 1848 cases). Considering linear analysis, each 10 nmol/L increase in circulating 25(OH)D was associated with a 2% lower risk of GDM (effect size (ES): 0.98; 95% CI: 0.98, 0.99; I2 = 85.0%, P < 0.001). highest compared with the lowest category of circulating 25(OH)D was associated with a 29% lower risk of GDM, with low evidence of heterogeneity (I2 = 45.0%, P = 0.079). Conclusions In conclusion, lower levels of serum 25(OH)D were associated with a higher chance of GDM. Differential results existed between the overall and subgroup analysis, either based on vitamin D detection methods or based on maternal age, although these subgroups partially lowered the heterogeneity. Keywords Gestational diabetes mellitus Vitamin D Pregnancy Dose-response meta-analysis ●
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Introduction Supplementary Information The online version of this article (https://doi.org/10.1007/s12020-020-02360-y) contains supplementary material, which is available to authorised users. * Ahmad Zare Javid [email protected] 1
Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
2
Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
3
Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
4
Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
5
Division of Kinesiology, School of Health and Human Performance, Dalhousie University, Halifax, Canada
6
Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
Gestational diabetes (GDM) is a common outcome of pregnancy, defined as any grade glucose intolerance diagnosed during pregnancy, mostly after 24 weeks of gestation [1]. GDM is associated with an increased r
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