Serum Carotenoids and Fat-Soluble Vitamins in Women With Type 1 Diabetes and Preeclampsia
A longitudinal study
- Madona Azar, MD1,
- Arpita Basu, PHD2,
- Alicia J. Jenkins, MD1,3,
- Alison J. Nankervis, MD4,
- Kristian F. Hanssen, MD5,6,7,
- Hanne Scholz, PHD5,7,
- Tore Henriksen, MD5,7,
- Satish K. Garg, MD8,
- Samar M. Hammad, PHD9,
- James A. Scardo, MD10,
- Christopher E. Aston, PHD11 and
- Timothy J. Lyons, MD1,11
- 1Harold Hamm Oklahoma Diabetes Center and Section of Endocrinology and Diabetes, University of Oklahoma Health Sciences Center, WP 1345, Oklahoma City, Oklahoma
- 2Department of Nutritional Sciences, Human Environmental Sciences, Oklahoma State University, Stillwater, Oklahoma
- 3Department of Medicine, The University of Melbourne, St Vincent’s Hospital, Melbourne, VIC, Australia
- 4Diabetes Service, The Royal Women’s Hospital, Melbourne, VIC, Australia
- 5Department of Gynecology and Obstetrics, Oslo University Hospital, Oslo, Norway
- 6Department of Endocrinology, Oslo University Hospital, Oslo, Norway
- 7Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- 8Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, Aurora, Colorado
- 9Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, South Carolina
- 10Spartanburg Regional Medical Center, Spartanburg, South Carolina
- 11General Clinical Research Center, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma
- ↵Corresponding author: Timothy J. Lyons, .
M.A. and A.B. contributed equally to this work.
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.
- Received November 14, 2010.
- Accepted March 3, 2011.
- © 2011 by the American Diabetes Association.
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