The DALI vitamin D randomized controlled trial for gestational diabetes mellitus prevention: No major benefit shown besides vitamin D sufficiency
Por:
Corcoy, R, Mendoza, LC, Simmons, D, Desoye, G, Adelantado, JM, Chico, A, Devlieger, R, van Assche, A, Galjaard, S, Timmerman, D, Lapolla, A, Dalfra, MG, Bertolotto, A, Harreiter, J, Wender-Ozegowska, E, Zawiejska, A, Kautzky-Willer, A, Dunne, FP, Damm, P, Mathiesen, ER, Jensen, DM, Andersen, LLT, Tanvig, M, Hill, DJ, Jelsma, JG, Snoek, FJ, Kofeler, H, Trotzmuller, M, Lips, P, van Poppel, MNM
Publicada:
1 mar 2020
Resumen:
Background & aims: As vitamin D deficiency is associated with an increased risk of gestational diabetes mellitus (GDM), we aimed to test vitamin D supplementation as a strategy to reduce GDM risk (evaluated after fasting plasma glucose (FPG), insulin resistance and weight gain) in pregnant overweight/obese women.
Methods: The DALI vitamin D multicenter study enrolled women with prepregnancy body mass index (BMI) >= 29 kg/m(2), <= 19 + 6 weeks of gestation and without GDM. Participants were randomized to receive 1600 IU/day vitamin D3 or placebo (each with or without lifestyle intervention) on top of (multi) vitamins supplements. Women were assessed for vitamin D status (sufficiency defined as serum 25-hydroxyvitamin D (25(OH)D) >= 50 nmol/l), FPG, insulin resistance and weight at baseline, 24-28 and 35-37 weeks. Linear or logistic regression analyses were performed to assess intervention effects.
Results: Average baseline serum 25(OH)D was >= 50 nmol/l across all study sites. In the vitamin D intervention arm (n = 79), 97% of participants achieved target serum vitamin 25(OH)D (>= 50 nmol/l) at 24 -28 weeks and 98% at 35-37 weeks vs 74% and 78% respectively in the placebo arm (n = 75, p < 0.001). A small but significantly lower FPG (-0.14 mmol/l: CI95 -0.28, -0.00) was observed at 35-37 weeks with the vitamin D intervention without any additional difference in metabolic status, perinatal outcomes or adverse event rates.
Conclusion: In the DALI vitamin D trial, supplementation with 1600 lU vitamin D3/day achieved vitamin D sufficiency in virtually all pregnant women and a small effect in FPG at 35-37 weeks. The potential of vitamin D supplementation for GDM prevention in vitamin D sufficient populations appears to be limited. (C) 2019 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Filiaciones:
Corcoy, R:
Univ Autonoma Barcelona, Dept Med, Avgda St Antoni Maria Claret 167, Barcelona 08025, Spain
Hosp Santa Creu & Sant Pau, Inst Recerca, Barcelona, Spain
Inst Salud Carlos III, CIBER Bioengn Biomat & Nanotechnol, Madrid, Spain
Mendoza, LC:
Univ Autonoma Barcelona, Dept Med, Avgda St Antoni Maria Claret 167, Barcelona 08025, Spain
Simmons, D:
Addenbrookes Hosp, Inst Metab Sci, Cambridge, England
Western Sydney Univ, Macarthur Clin Sch, Sydney, NSW, Australia
Desoye, G:
Med Univ Graz, Dept Obstet & Gynecol, Graz, Austria
Adelantado, JM:
Hosp Santa Creu & Sant Pau, Inst Recerca, Barcelona, Spain
Chico, A:
Univ Autonoma Barcelona, Dept Med, Avgda St Antoni Maria Claret 167, Barcelona 08025, Spain
Hosp Santa Creu & Sant Pau, Inst Recerca, Barcelona, Spain
Inst Salud Carlos III, CIBER Bioengn Biomat & Nanotechnol, Madrid, Spain
Devlieger, R:
Katholieke Univ Leuven, Dept Dev & Regenerat Pregnancy Fetus & Neonate, Leuven, Belgium
Univ Hosp Leuven, Gynaecol & Obstet, Leuven, Belgium
van Assche, A:
Katholieke Univ Leuven, Dept Dev & Regenerat Pregnancy Fetus & Neonate, Leuven, Belgium
Univ Hosp Leuven, Gynaecol & Obstet, Leuven, Belgium
Galjaard, S:
Katholieke Univ Leuven, Dept Dev & Regenerat Pregnancy Fetus & Neonate, Leuven, Belgium
Univ Hosp Leuven, Gynaecol & Obstet, Leuven, Belgium
Timmerman, D:
Katholieke Univ Leuven, Dept Dev & Regenerat Pregnancy Fetus & Neonate, Leuven, Belgium
Univ Hosp Leuven, Gynaecol & Obstet, Leuven, Belgium
Lapolla, A:
Univ Padua, Padua, Italy
Dalfra, MG:
Univ Padua, Padua, Italy
Bertolotto, A:
Azienda Osped Univ Pisana, Pisa, Italy
Harreiter, J:
Med Univ Vienna, Dept Med 3, Div Endocrinol, Gender Med Unit, Vienna, Austria
Wender-Ozegowska, E:
Poznan Univ Med Sci, Med Fac 1, Div Reprod, Poznan, Poland
Zawiejska, A:
Poznan Univ Med Sci, Med Fac 1, Div Reprod, Poznan, Poland
Kautzky-Willer, A:
Med Univ Vienna, Dept Med 3, Div Endocrinol, Gender Med Unit, Vienna, Austria
Dunne, FP:
Natl Univ Ireland, Galway, Ireland
Damm, P:
Rigshosp, Ctr Pregnant Women Diabet, Dept Endocrinol & Obstet, Copenhagen, Denmark
Univ Copenhagen, Fac Hlth & Med Sci, Inst Clin Med, Copenhagen, Denmark
Mathiesen, ER:
Rigshosp, Ctr Pregnant Women Diabet, Dept Endocrinol & Obstet, Copenhagen, Denmark
Univ Copenhagen, Fac Hlth & Med Sci, Inst Clin Med, Copenhagen, Denmark
Jensen, DM:
Odense Univ Hosp, Dept Gynaecol & Obstet, Odense, Denmark
Univ Southern Denmark, Fac Hlth Sci, Dept Clin Res, Odense, Denmark
Odense Univ, Steno Diabet Ctr Odense, Odense, Denmark
Andersen, LLT:
Odense Univ Hosp, Dept Gynaecol & Obstet, Odense, Denmark
Univ Southern Denmark, Fac Hlth Sci, Dept Clin Res, Odense, Denmark
Tanvig, M:
Odense Univ Hosp, Dept Gynaecol & Obstet, Odense, Denmark
Univ Southern Denmark, Fac Hlth Sci, Dept Clin Res, Odense, Denmark
Hill, DJ:
Rech Sante Lawson SA, St Gallen, Switzerland
Jelsma, JG:
Vrije Univ Amsterdam, Amsterdam Publ Hlth Res Inst, Dept Publ & Occupat Hlth, Amsterdam UMC, Amsterdam, Netherlands
Snoek, FJ:
Vrije Univ Amsterdam, Dept Med Psychol, Amsterdam UMC, Amsterdam, Netherlands
Kofeler, H:
Med Univ Graz, Core Facil Mass Spectrometry, Stiftingtalstr 24, A-8010 Graz, Austria
Omics Ctr Graz, Stiftingtalstr 24, A-8010 Graz, Austria
Trotzmuller, M:
Med Univ Graz, Core Facil Mass Spectrometry, Stiftingtalstr 24, A-8010 Graz, Austria
Omics Ctr Graz, Stiftingtalstr 24, A-8010 Graz, Austria
Lips, P:
Vrije Univ Amsterdam, Dept Internal Med, Endocrine Sect, Med Ctr, Amsterdam, Netherlands
van Poppel, MNM:
Vrije Univ Amsterdam, Amsterdam Publ Hlth Res Inst, Dept Publ & Occupat Hlth, Amsterdam UMC, Amsterdam, Netherlands
Karl Franzens Univ Graz, Inst Sport Sci, Graz, Austria
Green Accepted
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