Low plasma vitamin B12 in pregnancy is associated with gestational 'diabesity' and later diabetes.
Low plasma vitamin B12 in pregnancy is associated with gestational 'diabesity' and later diabetes.
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DOI：
10.1007/s00125-009-1499-0
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发表时间：
2009-11
期刊：
影响因子：
8.2
通讯作者：
Fall, C. H. D.
中科院分区：
文献类型：
--
作者：
Krishnaveni, G. V.;Hill, J. C.;Veena, S. R.;Bhat, D. S.;Wills, A. K.;Karat, C. L. S.;Yajnik, C. S.;Fall, C. H. D.
为了验证这一假设，即妊娠期间血浆维生素B12浓度低和叶酸浓度高与妊娠期糖尿病(GDM)和后来的糖尿病发病率较高相关。在印度迈索尔Holdsworth纪念医院的产前诊所就诊的妇女(N=785)在怀孕30周(100g口服葡萄糖耐量试验/OGTT；Carpenter-Coustant标准)和产后5年(75g OGTT，WHO 1999年)进行了人体测量、胰岛素抵抗(稳态模型评估)和葡萄糖耐量评估。测定孕妇冷冻血浆样品中维生素B12和叶酸的浓度。43%的女性维生素B12浓度低(150pmol/L，B12缺乏)，4%的女性叶酸浓度低(<；7nmol/L)。维生素B12缺乏妇女的体重指数(BMI；P<；0.001)、皮褶总和(P<；0.001)、胰岛素抵抗(P=0.02)、妊娠期糖尿病(GDM)发生率(8.7%vs4.6%；OR=2.14，P=0.02；校正母亲体重指数后P=0.1)均高于非维生素B12缺乏妇女。在维生素B12缺乏的妇女中，GDM的发病率随着叶酸浓度的升高而增加(从低到高依次为5.6%、8.8%、12.8%；交互作用P=0.2)。孕期B12缺乏预示着更大的皮褶，增加胰岛素抵抗(P<；0.05)，并在5年的随访中发生糖尿病(调整当前的BMI后，P=0.02)。母亲维生素B12缺乏与肥胖增加有关，反过来又与胰岛素抵抗和妊娠期糖尿病增加有关，特别是在叶酸浓度较高的情况下。缺乏维生素B12可能是导致南亚印度人患糖尿病风险高的一个重要因素。
To test the hypothesis that low plasma vitamin B12 concentrations combined with high folate concentrations in pregnancy are associated with higher incidence of gestational diabetes (GDM) and later diabetes. Women (N=785) attending the antenatal clinics of the Holdsworth Memorial Hospital, Mysore, India had their anthropometry, insulin resistance (Homeostasis Model Assessment) and glucose tolerance assessed at 30 weeks gestation (100g Oral Glucose Tolerance Test/ OGTT; Carpenter-Coustan criteria), and five years after delivery (75g OGTT, WHO 1999). Vitamin B12 and folate concentrations in pregnancy were measured in stored frozen plasma samples. Low vitamin B12 concentrations (<150 pmol/l, B12 deficiency) were observed in 43% of women and low folate concentrations (<7 nmol/l) in 4%. Women with vitamin B12 deficiency had higher body mass index (BMI; P<0.001), sum of skinfolds (P<0.001), insulin resistance (P=0.02) and a higher incidence of GDM (8.7% v 4.6%; OR=2.14, P=0.02; P=0.1 after adjusting for maternal BMI) than non-deficient women. Among vitamin B12-deficient women the incidence of GDM increased with folate concentration (5.6%, 8.8%, 12.8% respectively from lowest to highest third; P for interaction=0.2). B12 deficiency during pregnancy predicted larger skinfolds, increased insulin resistance (P<0.05) and incident diabetes at 5-year follow-up (P=0.02, after adjusting for current BMI). Maternal vitamin B12 deficiency is associated with increased adiposity and, in turn, with increased insulin resistance and GDM, especially in the presence of high folate concentrations. Vitamin B12 deficiency may be an important factor underlying the high risk of diabesity in south Asian Indians.
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影响因子：
7.1
作者：
Savaria Morris, Martha;Jacques, Paul F.;Selhub, Jacob
通讯作者：
Selhub, Jacob
影响因子：
4.2
作者：
Yajnik, CS
通讯作者：
Yajnik, CS
影响因子：
6.7
作者：
Clarke, R;Evans, JG;Scott, JM
通讯作者：
Scott, JM
DOI：
10.1111/j.0001-6349.2005.00670.x
发表时间：
2005-02-01
影响因子：
4.3
作者：
Hill, JC;Krishnaveni, GV;Fall, CHD
通讯作者：
Fall, CHD
影响因子：
7
作者：
SCOTT, JM
通讯作者：
SCOTT, JM