J Nutr. 2022 Jan 11;152(1):163-170. doi: 10.1093/jn/nxab352.
Vitamin B12 and Folate Markers Are Associated with Insulin Resistance During the Third Trimester of Pregnancy in South Asian Women, Living in the United Kingdom, with Gestational Diabetes and Normal Glucose Tolerance.
The Journal of nutrition
Agata Sobczyńska-Malefora, Chittaranjan S Yajnik, Dominic J Harrington, Graham A Hitman, Sarah Finer
Affiliations
Affiliations
- Nutristasis Unit, Viapath, St. Thomas' Hospital, London, United Kingdom.
- Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom.
- Diabetes Unit, KEM Hospital, Pune, India.
- Blizard Institute, Queen Mary University of London, London, United Kingdom.
- Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom.
- Barts Health NHS Trust, London, United Kingdom.
PMID: 34601603
PMCID: PMC8754569 DOI: 10.1093/jn/nxab352
Abstract
BACKGROUND: Gestational diabetes mellitus (GDM) can adversely affect the health of the developing fetus. Women of South Asian origin are particularly at risk of developing GDM. Insulin resistance (IR) contributes to the etiology of GDM, and although studies have shown associations of vitamin B12 (B12) and folate status with GDM and IR, only a limited number of B12 and folate markers have been used.
OBJECTIVE: We used a comprehensive panel of B12 and folate markers to examine their association with IR in pregnant women with diet-controlled GDM and normal glucose tolerance (NGT).
METHODS: In this cross-sectional study, 59 British-Bangladeshi women (24 GDM and 35 NGT) with a mean age of 29 y, BMI (in kg/m2) 26.7 and gestational age 33 wk were recruited. Serum total B12, holotranscobalamin, folate, methylmalonic acid, plasma homocysteine, 5-methyltetrahydrofolate, and red cell folate (RCF) were measured along with other parameters. The independent sample t-test and chi-squared test were used to assess differences in markers between GDM and NGT women. Spearman's test was used to look for correlations. A simple multiple regression analysis was used to investigate if markers of B12 and folate status predicted IR, using the HOMA-IR and adjusting for age, GDM status, and BMI.
RESULTS: There were no differences in concentrations of B12 and folate markers between GDM and NGT women. In Spearman's analysis HOMA-IR correlated negatively with total serum B12 (P < 0.001) and holotranscobalamin (P < 0.05), and positively with BMI (P < 0.001), blood pressure (P < 0.05) and triglycerides (P < 0.05) in all women. MMA did not correlate with any of the B12 markers. In regression analysis, total B12 (β = -0.622, P = 0.004), RCF (β = 0.387, P = 0.018), and BMI (β = 0.024, P < 0.001) were the significant predictors of HOMA-IR variance.
CONCLUSIONS: Significant associations between markers of B12 and folate status with HOMA-IR were found during the third trimester in British-Bangladeshi women. B12 markers correlated poorly with each other.
© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.
Keywords: folate; gestational diabetes; insulin resistance; pregnancy; vitamin B12
References
- Biochem J. 1985 Nov 15;232(1):177-82 - PubMed
- BMJ Open. 2016 Aug 12;6(8):e011247 - PubMed
- Endocrine. 2019 Nov;66(2):149-156 - PubMed
- J Dev Orig Health Dis. 2021 May 11;:1-9 - PubMed
- Eur J Clin Nutr. 2017 Feb;71(2):159-163 - PubMed
- Clin Chem. 2002 Jun;48(6 Pt 1):928-33 - PubMed
- Diabetes Res Clin Pract. 2014 Feb;103(2):176-85 - PubMed
- Clin Nutr. 2018 Jun;37(3):940-947 - PubMed
- Diabetologia. 2008 Jan;51(1):29-38 - PubMed
- Lancet. 2004 Jan 10;363(9403):157-63 - PubMed
- Diabetologia. 2009 Nov;52(11):2350-8 - PubMed
- Adv Hematol. 2014;2014:465623 - PubMed
- Am J Clin Nutr. 1982 Jan;35(1):87-94 - PubMed
- J Nutr. 2007 Aug;137(8):1863-7 - PubMed
- Crit Rev Clin Lab Sci. 2021 Sep;58(6):399-429 - PubMed
- Am J Clin Nutr. 2003 Jul;78(1):7-21 - PubMed
- Cardiovasc Diabetol. 2014 Sep 26;13:129 - PubMed
- Nutrients. 2016 Dec 01;8(12): - PubMed
- Acta Obstet Gynecol Scand. 2004 Jun;83(6):543-7 - PubMed
- Ginekol Pol. 2019;90(7):381-387 - PubMed
- J Nutr. 2003 May;133(5 Suppl 2):1674S-1683S - PubMed
- Clin Chem Lab Med. 2015 Jul;53(8):1215-25 - PubMed
- Clin Biochem. 2014 Jan;47(1-2):82-6 - PubMed
- Metabolism. 2003 Jun;52(6):720-3 - PubMed
- J Family Reprod Health. 2021 Sep;15(3):141-149 - PubMed
- N Engl J Med. 2012 Jul 26;367(4):385-6 - PubMed
- Diabet Med. 2014 Mar;31(3):263-72 - PubMed
- Haematologica. 2007 Dec;92(12):1711-2 - PubMed
- Hum Mol Genet. 2015 Jun 1;24(11):3021-9 - PubMed
- Kidney Int. 1999 Mar;55(3):1028-35 - PubMed
- J Intern Med. 2000 Feb;247(2):287-94 - PubMed
- Adv Nutr. 2017 Nov 15;8(6):971-979 - PubMed
- Arch Gynecol Obstet. 2006 Oct;274(6):333-7 - PubMed
- Am J Obstet Gynecol. 1999 Apr;180(4):903-16 - PubMed
- Diabetologia. 2019 Dec;62(12):2171-2178 - PubMed
- J Clin Endocrinol Metab. 2017 Nov 1;102(11):4200-4209 - PubMed
- Clin Epigenetics. 2015 Feb 27;7:14 - PubMed
- J Clin Pathol. 2018 Nov;71(11):949-956 - PubMed
- Arch Gynecol Obstet. 2008 Oct;278(4):309-13 - PubMed
- Front Pediatr. 2014 Oct 17;2:112 - PubMed
- Eur J Endocrinol. 2016 Feb;174(2):R43-51 - PubMed
- PLoS Med. 2020 Nov 5;17(11):e1003229 - PubMed
- BMC Public Health. 2016 Mar 01;16:207 - PubMed
- PLoS One. 2015 Aug 19;10(8):e0135268 - PubMed
- Diabet Med. 2015 Mar;32(3):291-4 - PubMed
- Clin Chem. 2004 Jan;50(1):3-32 - PubMed
- J Nutr. 2004 Jan;134(1):205-10 - PubMed
- Diabetes Care. 1998 Dec;21(12):2191-2 - PubMed
- Diabetes Care. 2007 Jul;30 Suppl 2:S112-9 - PubMed
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