The Weak Relationship between Vitamin D Compounds and Glucose Homeostasis Measures in Pregnant Women with Obesity: An Exploratory Sub-Analysis of the DALI Study

Lilian Cristina Mendoza, Jürgen Harreiter, Gernot Desoye, David Simmons, Juan M Adelantado, Alexandra Kautzky-Willer, Agnieszka Zawiejska, Ewa Wender-Ozegowska, Annunziata Lapolla, Maria G Dalfra, Alessandra Bertolotto, Roland Devlieger, Fidelma Dunne, Elisabeth R Mathiesen, Peter Damm, Lisse Lotte Andersen, Dorte Moller Jensen, David Hill, Mireille Nicoline Maria van Poppel, Rosa Corcoy

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Studies on the relationship between vitamin D (VitD) and glucose homeostasis usually consider either total VitD or 25OHD3 but not 25OHD2 and epimers. We aimed to evaluate the cross-sectional association of VitD compounds with glucose homeostasis measurements in pregnant women with overweight/obesity participating in the Vitamin D And Lifestyle Intervention for Gestational Diabetes Mellitus Prevention study. Methods: The analysis included 912 women. Inclusion criteria: <20 weeks gestation, body mass index ≥29 kg/m 2 and information on exposure and outcome variables at baseline. Measurements: A 75 g OGTT at <20, 24–28 and 35–37 weeks gestation (except if previous diabetes diagnosis). Exposure variables: 25OHD2, 25OHD3 and C3-epimer. Outcome variables: fasting and post-challenge insulin sensitivity and secretion indices, corresponding disposition indices (DI), plasma glucose at fasting and 1 and 2 h, hyperglycemia in pregnancy (HiP). Statistics: Multivariate regression analyses with adjustment. Results: Baseline VitD sufficiency was 66.3%. Overall, VitD compounds did not show strong associations with any glucose homeostasis measures. 25OHD3 showed direct significant associations with: FPG at <20 and 24–28 weeks (standardized β coefficient (β) 0.124, p = 0.030 and 0.111, p = 0.026 respectively), 2 h plasma glucose at 24–28 weeks (β 0.120, p = 0.018), and insulin sensitivity (1/HOMA-IR, β 0.127, p = 0.027) at 35–37 weeks; it showed an inverse association with fasting DI (QUCKI*HOMA-β) at <20 and 24–28 weeks (β −0.124, p = 0.045 and β −0.148, p = 0.004 respectively). 25OHD2 showed direct associations with post-challenge insulin sensitivity (Matsuda, β 0.149, p = 0.048) at 24–28 weeks) and post-challenge DI (Matsuda*Stumvoll phase 1) at 24–28 and 35–37 weeks (β 0.168, p = 0.030, β 0.239, p = 0.006). No significant association with C3-epimer was observed at any time period. Conclusions: In these women with average baseline VitD in sufficiency range, VitD compounds did not show clear beneficial associations with glucose homeostasis measures.

Original languageEnglish
Article number3256
Issue number16
Number of pages13
Publication statusPublished - 9. Aug 2022


  • 25OHD2
  • 25OHD3
  • C3-epimer
  • glucose homeostasis
  • obesity
  • pregnancy
  • vitamin D compounds
  • Diabetes, Gestational
  • Obesity
  • Cross-Sectional Studies
  • Humans
  • Insulin Resistance
  • Homeostasis
  • Blood Glucose
  • Calcifediol
  • Insulin
  • Vitamins
  • Pregnancy
  • Vitamin D
  • Pregnant Women
  • Female
  • Insulin-Secreting Cells


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