Relationship between mean platelet volume and vitamin D deficiency in gestational diabetes mellitus

Gur, Esra Bahar; Karadeniz, Muammer; Genc, Mine; Eskicioglu, Fatma; Yalcin, Murat; Hepyilmaz, Irem; Guclu, Serkan

doi:10.1590/2359-3997000000063

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Original Articles • Arch. Endocrinol. Metab. 59 (5) • Oct 2015 • https://doi.org/10.1590/2359-3997000000063 copy

Relationship between mean platelet volume and vitamin D deficiency in gestational diabetes mellitus

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective

To investigate whether vitamin D deficiency is associated with high mean platelet volume (MPV) in pregnancies diagnosed with gestational diabetes mellitus (GDM) compared to healthy pregnancies.

Subjects and methods

This study included 200 pregnant women. 25-hydroxyvitamin D₃(25(OH)D₃) and MPV values were monitored between pregnant women with GDM and normal glucose metabolism. Correlation between 25(OH)D₃ and MPV was calculated both in GDM and healthy pregnancies. Both 25(OH)D₃ level in different MPV percentile (≤ 50, 50-75, 75-90, ≥ 90 percentile) and MPV value in different 25(OH)D₃ level (≤ 10, 10-20, ≥ 20 ng/mL) were calculated.

Results

Low 25(OH)D₃ level and high MPV were observed both in GDM group (p = 0.007, p = 0.06, respectively) and in glucose metabolism disorders (GMD) group (p = 0.03, p = 0.04, respectively). There was no significant relationship between 25(OH)D₃ and MPV in healthy pregnancies. Whereas, it is observed that there is a negative, but statistically insignificant correlation between MPV and 25(OH)D₃ pregnant women with GMD (r = 0.1, r = -0.7, respectively). MPV values had significantly higher in vitamin D deficient group than pregnant women with normal 25(OH)D₃ level in GMD group (p = 0.04). The optimal 25(OH)D₃ cut off point for predicting future cardiovascular risk was 10.4 ng/ mL (area under curve (AUC) = 0.58).

Conclusions

Vitamin D deficiency may contribute to an increased risk for future cardiovascular diseases and a risk of thrombotic complications in pregnant women with GDM.

Gestational diabetes mellitus; vitamin D deficiency; mean platelet volume

	Normal glucose metabolism n = 167	IGT n = 17	GDM n = 16	P1	GMD n = 33	P2
Age (yr)	28.7 (5)	28.2 (3.6)	29 (3.1)	0.08	28.4 (3.0)	0.6
Gestational week	24.9 (0.9)	24.8 (1)	24.9 (0.9)	0.2	24.8 (1)	0.9
BMI	26.6 (3.5)	26.8 (3.1)	27.1 (3.6)	0.8	26.9 (3.5)	0.4
Sun exposure, ≥ 3 day/week and ≥ 30 min/day n,%	54, 32.3	6, 35.3	5, 31.2	0.7	12, 36.3	0.8
Covered clothing style n,%	82, 49.1	9, 52.9	9, 56,2	0.09	18, 54.5	0.06
Mean vitamin D level (ng/mL)	21.6 (10.7)^a	20.9 (14.3)^a	15.5(16.1)^b	0.007	17.1 (15.3)	0.03
Vitamin D deficiency (≤ 10 ng/mL) (n, %)	23, 13.7^a	8, 47^b	7, 43.7^b	< 0.01	15, 45.4	< 0.01
Vitamin D insufficiency (10-20 ng/mL) (n,%)	88, 52.6^a	5, 29.4^b	6, 37.5^b	< 0.01	11, 33.3	< 0.01
Normal level (≥ 20 ng/mL) (n, %)	56,33.5^a	3, 17.6^b	4, 25^c	0.05	7, 21.2	0.04
MPV (fL)	9.6 (1)	9.8 (0.7)	10.9 (1)	0.06	10.5 (0.9)	0.04
Hb (g/dL)	12 (1)	11.8 (1)	12.1 (0.8)	0.3	12 (0.9)	0.4
Platelets (×109/L)	235 (52)^a	248 (74)^b	228 (34)^c	0.01	234 (42)	0.7

MPV quartile (MPV, n)	Mean vitamin D level in normal glucose metabolism n = 167 (±SD, %95 confidence interval)	P₁	MPV quartile (MPV, n)	Mean vitamin D level in GMD n = 33 (±SD, %95 confidence interval)	P₂
≤ 50 percentile (9.8, 103)	19.9 (10.3, 18-21.9)	0.3	≤ 50 percentile ( 9.6, 7)	20.7 (10.1, 16-21.7)	0.07
50-75 percentile (10.5, 36)	22.5 (10.6, 19.4-25.7)		50-75 percentile (10.8, 12)	19.9 (11.2, 17.2-23)
75-90 percentile (11.3, 24)	23 (12.9, 18.4-27.5)		75-90 percentile (12, 10)	17.4 (9.9, 16-19.9)
≥ 90 percentile (12.2, 4)	23.2 (9, 17.7-28.7)		≥ 90 percentile (12.5, 4)	16.1 (10.3, 15.8-19)

	Normal glucose metabolism n = 167	Glucose metabolism disorders (IGT+GDM) n = 33
MPV – Vitamin D correlation coefficient (r)	r = 0.1	r = -0.7
p	0.6	0.06

		Vitamin D deficiency (≤ 10 ng/mL)	Vitamin D insufficiency (10-20 ng/mL)	Normal level (≥ 20 ng/mL)	P
Normal glucose metabolism n = 167	MPV (mean ± SD)	10.0 (1) n = 23	9.8 (0.8) n = 88	9.9 (0.9) n = 56	0.9
Glucose metabolism disorders (IGT+GDM) n = 33	MPV (mean ± SD)	12.1 (1.1)^a n = 15	10.5 (1)^b n = 11	9.7 (0.8)^b n = 7	0.04

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[1] Correspondence to: Esra Bahar Gur. Sifa University Faculty of Medicine, Department of Obstetrics and Gynecology, 35100 – Bornova, İZMİR, Turkey. esrabaharg@yahoo.com