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

OBJECTIVE-Increased oxidative stress and immune dysfunction are implicated in pre-eclampsia (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 (alpha- and beta-carotene, lycopene, and lutein) and vitamins A, D, and E (alpha- and gamma-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, HbA(1c), 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-, alpha-carotene and beta-carotene were 45 and 53% lower, respectively, at visit 3 (P < 0.05), before PE onset. In adjusted analyses, the difference in beta-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 alpha- and beta-carotene were associated with subsequent development of PE, and vitamin D deficiency may also be implicated.