Association of Vitamin B12 with Gestational Diabetes Mellitus
Abstract
Background: Gestational diabetes mellitus is one of the most common metabolic disorders during pregnancy and associated with increased maternal and neonatal morbidities. Low serum vitamin B 12 level have been associated with the risk of developing gestational diabetes mellitus (GDM). Objectives: The aim of this study was to find out any association of serum vitamin B12 with GDM. Methods: This cross-sectional comparative study was conducted in the department of Obstetrics and Gynaecology, BSMMU during October, 2017 to February, 2020. A total of 86 pregnant women between 18 to 40 years of age attended antenatal clinic and admitted in hospital in their 29 to 40 weeks of pregnancy were included in this study from 211 pregnant women. Among them 43 diagnosed cases of GDM were considered as group A and rest 43 without GDM were considered as group B. Statistical analyses of the results were be obtained by using window-based Microsoft Excel and Statistical Packages for Social Sciences (SPSS-24). Results: Serum vitamin B12 concentration was measured. The mean serum vitamin B12 level was 148.88±13.91 in group A and 182.70±27.16 in group B. The mean vitamin B12 level was statistically significantly low in GDM group than non GDM group (p=0.001). There was a significant negative correlation of serum vitamin B12 level with fasting plasma glucose (r=-0.561, p<0.001) and plasma glucose 2 hours after 75g glucose in GDM patient (r=-0.258, p=0.017). Therefore, low serum vitamin B12 can be regarded as a significant risk factor for the development of GDM. Conclusion: The association of Vitamin B12 with gestational diabetes mellitus (GDM) generally highlights that low Vitamin B12 levels may be associated with an increased risk of developing GDM. Vitamin B12 levels during pregnancy may play a role in reducing the risk of GDM. Regular monitoring and possible supplementation in deficient women could be beneficial as part of prenatal care.
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References
Harlev A, Wiznitzer A. New insights on glucose pathophysiology in gestational diabetes and insulin resistance. Current diabetes reports. 2010 Jun; 10:242-7.
Jesmin S, Akter S, Akashi H, Al-Mamun A, Rahman MA, Islam MM, Sohael F, Okazaki O, Moroi M, Kawano S, Mizutani T. Screening for gestational diabetes mellitus and its prevalence in Bangladesh. Diabetes research and clinical practice. 2014 Jan 1;103(1):57-62.
Kiani F, Naz MS, Sayehmiri F, Sayehmiri K, Zali H. The risk factors of gestational diabetes mellitus: a systematic review and meta-analysis study. diabetes. 2017; 10:17.
Lipschitz DA, Cook JD, Finch CA. A clinical evaluation of serum ferritin as an index of iron stores. New England Journal of Medicine. 1974 May 30;290(22):1213-6.
Briani C, Dalla Torre C, Citton V, Manara R, Pompanin S, Binotto G, Adami F. Cobalamin deficiency: clinical picture and radiological findings. Nutrients. 2013 Nov 15;5(11):4521-39.
Rush EC, Katre P, Yajnik CS. Vitamin B12: one carbon metabolism, fetal growth and programming for chronic disease. European journal of clinical nutrition. 2014 Jan;68(1):2-7.
Lindström E, Hossain MB, Lönnerdal BO, Raqib R, El Arifeen S, EKSTRÖM EC. Prevalence of anemia and micronutrient deficiencies in early pregnancy in rural Bangladesh, the MINIMat trial. Acta obstetricia et gynecologica Scandinavica. 2011 Jan;90(1):47-56.
Scott J, Weir D. The methyl folate trap: A physiological response in man to prevent methyl group deficiency in kwashiorkor (methionine deficiency) and an explanation for folic-acid-induced exacerbation of subacute combined degeneration in pernicious anaemia. The Lancet. 1981 Aug 15;318(8242):337-40.
Horvath K, Koch K, Jeitler K, Matyas E, Bender R, Bastian H, Lange S, Siebenhofer A. Effects of treatment in women with gestational diabetes mellitus: systematic review and meta-analysis. Bmj. 2010 Apr 1;340.
Fatima SS, Rehman R, Alam F, Madhani S, Chaudhry B, Khan TA. Gestational diabetes mellitus and the predisposing factors. Journal of Pakistan Medical Association. 2017;67(2):261.
Tasnim SD, Auny FM, Hassan Y, Yesmin R, Ara I, Mohiuddin MS, Kaggwa MM, Gozal D, Mamun MA. Antenatal depression among women with gestational diabetes mellitus: A pilot study. Reproductive Health. 2022 Mar 19;19(1):71.
Begum P, Shaha DR, Walid KM. Gestational diabetes mellitus and associated risk factors in patients attending diabetic association medical college hospital in Faridpur. Journal Enam Medical College. 2017 Sep;7(3):126-33.
Dudley AE, Jenner ZB, Mendez-Figueroa H, Ellis VS, Chauhan SP. Diabetes during pregnancy: influence of body mass index on composite morbidity. American Journal of Perinatology Reports. 2017 Apr;7(02):e128-33.
Sukumar N, Venkataraman H, Wilson S, Goljan I, Selvamoni S, Patel V, Saravanan P. Vitamin B12 status among pregnant women in the UK and its association with obesity and gestational diabetes. Nutrients. 2016 Dec 1;8(12):768.
Li S, Hou Y, Yan X, Wang Y, Shi C, Wu X, Liu H, Zhang L, Zhang X, Liu J, Zhang M. Joint effects of folate and vitamin B12 imbalance with maternal characteristics on gestational diabetes mellitus. Journal of diabetes. 2019 Sep;11(9):744-51.
Krishnaveni GV, Hill JC, Veena SR, Bhat DS, Wills AK, Karat CL, Yajnik CS, Fall CH. Low plasma vitamin B 12 in pregnancy is associated with gestational ‘diabesity’and later diabetes. Diabetologia. 2009 Nov; 52:2350-8.
Ruderman NB, Saha AK, Kraegen EW. Minireview: malonyl CoA, AMP-activated protein kinase, and adiposity. Endocrinology. 2003 Dec 1;144(12):5166-71.
Cassinadane AV, Ramaswamy R, Hussain SA, Govindarajan R, Srinivasan AR. Evaluation of Vitamin B12 status in type 2 Diabetes Mellitus Patients on Metformin therapy. Asian Journal of Medical Sciences. 2018 Mar 1;9(2):9-12.
Ouzilleau C, Roy MA, Leblanc L, Carpentier A, Maheux P. An observational study comparing 2-hour 75-g oral glucose tolerance with fasting plasma glucose in pregnant women: both poorly predictive of birth weight. Cmaj. 2003 Feb 18;168(4):403-9.
