Serum Levels of Vitamin B12, Folic Acid, Thyroid Stimulating Hormone and Homocystiene Among First Trimester Pregnant Saudi Women at Different Glycemic Status

Abstract

There is limited information regarding the metabolic abnormalities that precede poor glycemic regulation. This study was conducted to determine the association between serum levels of vitamin B12, folic acid, TSH and homocystiene among pregnant women with normal glycemic control, diabetes and prediabetes. A cross-section study included 1159 healthy first trimester pregnant women who were randomly selected from antenatal clinics in two hospitals and 21 health care centers across Al-Madinah, Saudi Arabia. Data collected included clinical history and lab analysis (serum levels of folic acid, vitamins B12, TSH, homocystine and A1C. Participant were classified based on their A1C levels as normal (A1C <5.7%), prediabetic (A1C ≥5.7 and <6.5%), and undiagnosed type two diabetics (A1C ≥6.5%). Results revealed that 79.5% of the participents had normal A1C, while 19.3% and 1.21% had A1C in the range of prediabetes and diabetes, respectively. Serum levels of vitamin B12 and folic acid were lower among prediabetics compared to participants with normal A1C levels, while serum levels of TSH and homocysteine were significantly higher. There was a strong negative correlation between the levels of A1C, vitamin B12, and folic acid, while positive correlations between A1C, TSH and homocysteine levels was reported. Regression analysis identified TSH as having the strongest impact on A1C levels. Complex metabolic changes occur at the prediabetic stage involving TSH, HCY, folic acid, and vitamin B12. Funding Statement: This study was funded by KACST grant no 113-28. Declaration of Interests: There is no conflict of interest to report. Ethics Approval Statement: Ethical approval was obtained from KACST. All participants included in this study provided signed consent form.