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Hypovitaminosis D, insulin resistance and hypertension in pregnancy

European Journal of Clinical Nutrition volume 59, pages 805–806 (2005)Cite this article

Understanding insulin resistance in pregnancy is a big challenge, yet may provide key insight into insulin action and type II diabetes (Ryan, 2003). One apparently less famous mechanism causing insulin resistance is hypovitaminosis D, although it is a well-established cause of both insulin resistance as well as contributing to hypertension (Rutz, 2002). Significantly, vitamin D-depleted mammals (including pregnant humans) are not only more resistant to insulin signalling but moreover, they secrete significantly less insulin. Strikingly, this condition is reversible upon supplementation of the lacking vitamin either as cholecalciferol (vitamin D3), or as 1,25-dihydroxy-cholecalciferol (Norman et al, 1980; Chertow et al, 1983; Nyomba et al, 1984; Cade & Norman, 1986; Gedik & Akalin, 1986; Cade & Norman, 1987; Boucher et al, 1995; Baynes et al, 1997; Rudnicki & Molsted-Pedersen, 1997; Borissova et al, 2003). These extant data should be appreciated, especially given the fact that that hypovitaminosis D is common in pregnancy (MacLennan et al, 1980; Bashir et al, 1981; Brooke et al, 1981; Dumont, 1991; Zeghoud et al, 1991; Alfaham et al, 1995; Fogelman et al, 1995; Sanchez et al, 1997; Vinutha et al, 2000; Bassir et al, 2001; Grover & Morley, 2001; Mukamel et al, 2001; Nozza & Rodda, 2001; Souberbielle et al, 2001; Datta et al, 2002; Islam et al, 2002). Along the same line of thinking as the one proposed earlier (Rutz, 2002), hypovitaminosis D may hence also predispose to gestational hypertension (Magee et al, 2003; Ryan, 2003), namely, through ensuing activation of the renin-angiotensin system, and under the influence of additional hormonal factors, such as those mentioned (Ryan, 2003). Moreover, hypovitaminosis D in the mother provokes hypovitaminosis D in the child, notoriously a risk factor for rickets (Nozza & Rodda, 2001).

Consequently, I conclude that vitamin D should be determined in pregnancy, and that adequate and individualised substitution of the lacking vitamin be prescribed.

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  1. Life Sciences Department, Paul Scherrer Institute, Switzerland

    H P Rutz

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Rutz, H. Hypovitaminosis D, insulin resistance and hypertension in pregnancy. Eur J Clin Nutr 59, 805–806 (2005). https://doi.org/10.1038/sj.ejcn.1602128

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