Lower Circulating B12 Is Associated with Higher Obesity and Insulin Resistance during Pregnancy in a Non-Diabetic White British Population.
Lower Circulating B12 Is Associated with Higher Obesity and Insulin Resistance during Pregnancy in a Non-Diabetic White British Population.
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DOI：
10.1371/journal.pone.0135268
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Yajnik CS
中科院分区：
文献类型：
--
作者：
Knight BA;Shields BM;Brook A;Hill A;Bhat DS;Hattersley AT;Yajnik CS
维生素B12和叶酸是支持妊娠增加的代谢需求所需的关键微量营养素。印度最近的研究表明，怀孕期间维生素B12和叶酸浓度低与肥胖增加有关；然而，饮食、产前维生素补充和社会经济地位的差异可能会限制这些发现的普遍性。我们的目的是在一个非糖尿病的英国白人产科队列中探讨妊娠28周时循环血清维生素B12和叶酸与母亲肥胖及相关生化指标的横断面关系。埃克塞特儿童健康家庭研究招募了995名怀孕28周的女性，获得了人体测量和生化数据。通过回归分析，调整潜在的混杂因素(社会经济地位、素食、维生素补充、产次、血液稀释(红细胞压积))，探讨B12和叶酸与母亲BMI和其他肥胖相关生化因素(HOMA-R、空腹血糖、甘油三酯、高密度脂蛋白和AST)的关系。高28周体重指数与低循环维生素B12(r=-0.25P<；0.001)和低叶酸(r=-0.15P<；0.001)相关。在多元回归分析中，高28周体重指数仍是低循环B12的独立预测因素(β(95%CI)=-0.59(-0.74，-0.44)，即体重指数每增加1%，循环B12下降0.6%)。肥胖/体脂代谢的其他标记物(HOMA-R、甘油三酯和AST)也与循环B12独立相关。在类似的多元回归中，AST是唯一与血清叶酸相关的独立肥胖相关标记物(β(95%CI)=0.16(0.21，0.51))。总之，我们的研究重复了印度以前的研究结果，即在非糖尿病的英国白人人群中，较低的血清B12与较高的肥胖和胰岛素抵抗之间的关系。这些发现可能对肥胖孕妇的胎儿和产妇健康有重要影响。
Vitamin B12 and folate are critical micronutrients needed to support the increased metabolic demands of pregnancy. Recent studies from India have suggested that low vitamin B12 and folate concentrations in pregnancy are associated with increased obesity; however differences in diet, antenatal vitamin supplementation, and socioeconomic status may limit the generalisability of these findings. We aimed to explore the cross-sectional relationship of circulating serum vitamin B12 and folate at 28 weeks’ gestation with maternal adiposity and related biochemical markers in a white non diabetic UK obstetric cohort. Anthropometry and biochemistry data was available on 995 women recruited at 28 weeks gestation to the Exeter Family Study of Childhood Health. Associations between B12 and folate with maternal BMI and other obesity-related biochemical factors (HOMA-R, fasting glucose, triglycerides, HDL and AST) were explored using regression analysis, adjusting for potential confounders (socioeconomic status, vegetarian diet, vitamin supplementation, parity, haemodilution (haematocrit)). Higher 28 week BMI was associated with lower circulating vitamin B12 (r = -0.25; P<0.001) and folate (r = -0.15; P<0.001). In multiple regression analysis higher 28 week BMI remained an independent predictor of lower circulating B12 (β (95% CI) = -0.59 (-0.74, -0.44) i.e. for every 1% increase in BMI there was a 0.6% decrease in circulating B12). Other markers of adiposity/body fat metabolism (HOMA-R, triglycerides and AST) were also independently associated with circulating B12. In a similar multiple regression AST was the only independent obesity-related marker associated with serum folate (β (95% CI) = 0.16 (0.21, 0.51)) In conclusion, our study has replicated the previous Indian findings of associations between lower serum B12 and higher obesity and insulin resistance during pregnancy in a non-diabetic White British population. These findings may have important implications for fetal and maternal health in obese pregnancies.