Effects of High-Dose Vitamin D Supplementation on Metabolic Status and Pregnancy Outcomes in Pregnant Women at Risk for Pre-Eclampsia

摘要

This study was designed to assess the beneficial effects of high-dose (cholecalciferol) vitamin D supplementation on metabolic profiles and pregnancy outcomes among pregnant women at risk for pre-eclampsia. This randomized double-blind placebo-controlled clinical trial was performed among 60 pregnant women at risk for pre-eclampsia according to abnormal uterine artery Doppler waveform. Subjects were randomly divided into 2 groups to receive 50000 IU vitamin D supplements (n=30) or receive placebo (n=30) every 2 weeks from 20 to 32 weeks of gestation. Fasting blood samples were taken at baseline study and 12 weeks after the intervention to quantify relevant variables. Newborn's anthropometric measurements were determined. Pregnant women who received cholecalciferol supplements had significantly increased serum 25-hydroxyvitamin D concentrations (+17.92 +/- 2.28 vs. +0.27 +/- 3.19ng/ml, p<0.001) compared with the placebo. The administration of cholecalciferol supplements, compared with the placebo, resulted in significant differences in serum insulin concentrations (+1.08 +/- 6.80 vs. +9.57 +/- 10.32IU/ml, p<0.001), homeostasis model of assessment-insulin resistance (HOMA-IR) (+0.19 +/- 1.47 vs. +2.10 +/- 2.67, p<0.001), homeostatic model assessment-beta cell function (HOMA-B) (+5.82 +/- 29.58 vs. +39.81 +/- 38.00, p<0.001) and quantitative insulin sensitivity check index (QUICKI) score (-0.009 +/- 0.03 vs. -0.04 +/- 0.03, p=0.004). Furthermore, cholecalciferol-supplemented pregnant women had increased HDL-cholesterol concentrations (+2.67 +/- 8.83 vs. -3.23 +/- 7.76mg/dl, p=0.008) compared with the placebo. Finally, cholecalciferol supplementation led to a significant rise in plasma total antioxidant capacity (TAC) concentrations (+79.00 +/- 136.69 vs. -66.91 +/- 176.02mmol/l, p=0.001) compared with the placebo. Totally, the administration of cholecalciferol supplements among pregnant women at risk for pre-eclampsia for 12 weeks had favorable effects on insulin metabolism parameters, serum HDL-cholesterol, and plasma TAC concentrations.