Serum Carotenoids and Fat-Soluble Vitamins in Women With Type 1 Diabetes and Preeclampsia

A longitudinal study

  1. Timothy J. Lyons, MD1,11
  1. 1Harold Hamm Oklahoma Diabetes Center and Section of Endocrinology and Diabetes, University of Oklahoma Health Sciences Center, WP 1345, Oklahoma City, Oklahoma
  2. 2Department of Nutritional Sciences, Human Environmental Sciences, Oklahoma State University, Stillwater, Oklahoma
  3. 3Department of Medicine, The University of Melbourne, St Vincent’s Hospital, Melbourne, VIC, Australia
  4. 4Diabetes Service, The Royal Women’s Hospital, Melbourne, VIC, Australia
  5. 5Department of Gynecology and Obstetrics, Oslo University Hospital, Oslo, Norway
  6. 6Department of Endocrinology, Oslo University Hospital, Oslo, Norway
  7. 7Institute of Clinical Medicine, University of Oslo, Oslo, Norway
  8. 8Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, Aurora, Colorado
  9. 9Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, South Carolina
  10. 10Spartanburg Regional Medical Center, Spartanburg, South Carolina
  11. 11General Clinical Research Center, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma
  1. Corresponding author: Timothy J. Lyons, timothy-lyons{at}ouhsc.edu.
  1. M.A. and A.B. contributed equally to this work.

Abstract

OBJECTIVE Increased oxidative stress and immune dysfunction are implicated in preeclampsia (PE) and may contribute to the two- to fourfold increase in PE prevalence among women with type 1 diabetes. Prospective measures of fat-soluble vitamins in diabetic pregnancy are therefore of interest.

RESEARCH DESIGN AND METHODS Maternal serum carotenoids (α- and β-carotene, lycopene, and lutein) and vitamins A, D, and E (α- and γ-tocopherols) were measured at first (12.2 ± 1.9 weeks [mean ± SD], visit 1), second (21.6 ± 1.5 weeks, visit 2), and third (31.5 ± 1.7 weeks, visit 3) trimesters of pregnancy in 23 women with type 1 diabetes who subsequently developed PE (DM PE+) and 24 women with type 1 diabetes, matched for age, diabetes duration, HbA1c, and parity, who did not develop PE (DM PE−). Data were analyzed without and with adjustment for baseline differences in BMI, HDL cholesterol, and prandial status.

RESULTS In unadjusted analysis, in DM PE+ versus DM PE−, α-carotene and β-carotene were 45 and 53% lower, respectively, at visit 3 (P < 0.05), before PE onset. In adjusted analyses, the difference in β-carotene at visit 3 remained significant. Most participants were vitamin D deficient (<20 ng/mL), and vitamin D levels were lower in DM PE+ versus DM PE− throughout the pregnancy, although this did not reach statistical significance.

CONCLUSIONS In pregnant women with type 1 diabetes, low serum α- and β-carotene were associated with subsequent development of PE, and vitamin D deficiency may also be implicated.

Footnotes

    • Received November 14, 2010.
    • Accepted March 3, 2011.

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    This Article

    1. Diabetes Care
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