Author
LEPSCH, JAQUELINE - UNIVERSIDADE FEDERAL DO RIO DE JANEIRO | |
ESCHRIQUI, ILANA - UNIVERSIDADE FEDERAL DO RIO DE JANEIRO | |
RODRIGUEZ-FARIAS, DAYANA - UNIVERSIDADE FEDERAL DO RIO DE JANEIRO | |
VAZ, JULIANA - FEDERAL UNIVERSITY OF PELOTAS | |
CUNHA FIGUEIREDO, AMANDA - UNIVERSIDADE FEDERAL DO RIO DE JANEIRO | |
AMORIM ADEGBOYE, AMANDA - UNIVERSITY OF WESTMINSTER | |
BRITO, ALEX - UNIVERSITY OF MOSCOW | |
MOKHTAR, RANA - BOSTON UNIVERSITY | |
Allen, Lindsay - A | |
HOLICK, MICHAEL - BOSTON UNIVERSITY | |
KAC, GILBERTO - UNIVERSIDADE FEDERAL DO RIO DE JANEIRO |
Submitted to: Metabolism
Publication Type: Peer Reviewed Journal Publication Acceptance Date: 2/5/2017 Publication Date: 2/12/2017 Citation: Lepsch, J., Eschriqui, I., Rodriguez-Farias, D., Vaz, J.S., Cunha Figueiredo, A.C., Amorim Adegboye, A.R., Brito, A., Mokhtar, R., Allen, L.H., Holick, M.F., Kac, G. 2017. Association between early pregnancy vitamin D status and changes in serum lipid profiles throughout pregnancy. Metabolism. 70:85-97. https://doi.org/10.1016/j.metabol.2017.02.004. DOI: https://doi.org/10.1016/j.metabol.2017.02.004 Interpretive Summary: The objective of this study was to evaluate the associations between first trimester 25-hydroxyvitamin D [25(OH)D] levels in serum (a marker of vitamin D status) and changes in high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), total cholesterol (TC), triglyceride (TG) concentrations, TG/HDL-c, and TC/HDL-c ratios throughout pregnancy. We hypothesized that low 25(OH)D in the first trimester is associated with lower concentrations of HDL-c and higher LDL-c, TC, TG, TG/HDL-c, and TC/HDL-c ratios throughout pregnancy. A total of 194 women attending a public health center in Rio de Janeiro, Brazil, were recruited in early pregnancy and studied at 3 visits: 5–13 weeks (baseline), 20–26, and 30–36 gestational weeks. Plasma 25(OH)D concentrations were measured in the first trimester using liquid chromatography–tandem mass spectrometry. 25(OH)D concentrations were classified as adequate (= 75 nmol/L) or inadequate (< 75 nmol/L). Serum TC, HDL-c, and TG concentrations were measured enzymatically. Statistical longitudinal models were used to evaluate the association between first trimester 25(OH)D status and changes in serum lipid concentrations throughout pregnancy. Confounders adjusted for in the multiple analysis were age, HOMA (an indicator of insulin resistance), early pregnancy body mass index, leisure time physical activity before pregnancy, energy intake, and gestational age. At baseline, 69% of the women had inadequate concentrations of 25(OH)D. Women with 25(OH)D inadequacy had higher mean LDL-c than those with adequate concentrations (91.3 vs. 97.5 mg/dL; P = 0.064) at baseline. TC, HDL-c, LDL-c TG, TG/HDL-c ratios, and TC/HDL-c ratios, increased significantly throughout pregnancy independently of 25(OH)D concentrations. There were direct associations between first trimester 25(OH)D status and changes in TC (ß = 9.53; 95%CI = 1.12–17.94), LDL-c (ß = 9.99; 95% CI = 3.62–16.36) concentrations, and TC/HDL-c ratios (ß = 0.16; 95% CI = 0.01–0.31) throughout pregnancy. We conclude that low plasma 25(OH)D concentrations in early pregnancy were associated with more pronounced changes in TC, LDL-c concentrations, and TC/HDL-c ratios throughout pregnancy. Changes in these cardiovascular markers suggest the importance of ensuring adequate vitamin D status at the beginning of pregnancy. Technical Abstract: Objective: To evaluate the associations between first trimester 25-hydroxyvitamin D [25(OH)D] status and changes in high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), total cholesterol (TC), triglyceride (TG) concentrations, TG/HDL-c, and TC/HDL-c ratios throughout pregnancy. We hypothesized that first trimester 25(OH)D inadequacy is associated with lower concentrations of HDL-c and higher LDL-c, TC, TG, TG/HDL-c, and TC/HDL-c ratios throughout pregnancy. Methods: A prospective cohort study with 3 visits at 5–13 (baseline), 20–26, and 30–36 gestational weeks, recruited 194 pregnant women attending a public health care center in Rio de Janeiro, Brazil. Plasma 25(OH)D concentrations were measured in the first trimester using liquid chromatography–tandem mass spectrometry. 25(OH)D concentrations were classified as adequate (= 75 nmol/L) or inadequate (< 75 nmol/L). Serum TC, HDL-c, and TG concentrations were measured enzymatically. Crude and adjusted longitudinal linear mixed-effects models were employed to evaluate the association between the first trimester 25(OH)D status and changes in serum lipid concentrations throughout pregnancy. Confounders adjusted for in the multiple analysis were age, homeostatic model assessment (HOMA), early pregnancy BMI, leisure time physical activity before pregnancy, energy intake, and gestational age. Results: At baseline, 69% of the women had inadequate concentrations of 25(OH)D. Women with 25(OH)D inadequacy had higher mean LDL-c than those with adequate concentrations (91.3 vs. 97.5 mg/dL; P = 0.064) at baseline. TC, HDL-c, LDL-c TG, TG/HDL-c ratios, and TC/HDL-c ratios, increased throughout pregnancy independently of 25(OH)D concentrations (ANOVA for repeated measures P < 0.001). The adjusted models showed direct associations between the first trimester 25(OH)D status and changes in TC (ß = 9.53; 95%CI = 1.12–17.94), LDL-c (ß = 9.99; 95% CI = 3.62–16.36) concentrations, and TC/HDL-c ratios (ß = 0.16; 95% CI = 0.01–0.31) throughout pregnancy. |