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Abstract

Introduction: Oxidative stress is linked to the development of gestational diabetes mellitus (GDM). Maternal antioxidant vitamins in early pregnancy may play a role in GDM occurrence. We aimed to investigate the associations of vitamins A and E in early pregnancy with the risk of GDM and to explore whether these antioxidant vitamins can be biomarkers for the early prediction of GDM.

Methods: We carried out a prospective cohort study conducted in Beijing and enrolled pregnant women with vitamins A and E measurements at 9 weeks of gestation and having one-step GDM screened with a 75-g oral glucose tolerance test between 24 and 28 weeks of gestation.

Results: The vitamin A levels in early pregnancy were significantly higher in women with GDM than in those without GDM and positively correlated with fasting blood glucose. In multivariate models, vitamin A levels were significantly associated with GDM per SD. A significant trend of risk effect on GDM risk across quartiles of vitamin A was observed. No significant association of serum vitamin E with GDM was observed overall. However, a noted trend of protective effect on GDM risk across quartiles of vitamin E/cholesterol ratio was observed. In ROC analysis, the multivariate model consisting of vitamin A and other risk factors showed the best predictive performance.

Conclusions: Higher levels of vitamin A in early pregnancy were significantly associated with an increased risk of GDM. Vitamin A has the potential to be a biomarker indicating pathogenesis of GDM.