title: Vitamin-D Deficiency Is Associated with Gallbladder Stasis Among Pregnant Women.
abstract: BACKGROUND
  Pregnant women are at increased risk of gallbladder (GB) stasis, an important risk factor for gallstones (GS). In non-pregnant women, Vitamin-D deficiency (VDD) is associated with GB stasis, which improves on supplementation. Relationship of VDD with GB stasis among pregnant women is not known.
  
  
  METHODS
  This is a prospective study in tertiary care centre. Consecutive healthy pregnant women (12-16 weeks gestation) were enrolled. Serum 25(OH) vitamin-D was estimated, and levels <20 ng ml(-1) were considered as VDD. Risk factors and clinical features of VDD were assessed. Gallbladder ejection fraction (GBEF) was assessed by ultrasound after a standard fatty meal, and <40 % was defined as stasis. Statistical analysis was performed to assess relationship of GB stasis and vitamin-D levels and identify factors associated with VDD.
  
  
  RESULTS
  Median serum vitamin-D in 304 women was 7.9 ng ml(-1) (IQR 5.7, 12). VDD afflicted 92 % of them. Women with VDD more often had GB stasis (20 % vs 0 %; p = 0.015) and had lower GBEF [53.7 ± 17 % vs 59 ± 10 %; p = 0.026] compared to those with normal vitamin-D. GBEF showed positive correlation with vitamin-D levels (r = 0.117; p = 0.042). Risk factors for low vitamin-D levels were urban residence (p = 0.001), lower sun-exposure time (p = 0.005), limited skin exposure (p < 0.001), higher BMI (p = 0.05) and higher socioeconomic status (p = 0.02). Vitamin-D deficiency was associated with low serum calcium (ρ = 0.457; p < 0.001).
  
  
  CONCLUSIONS
  Vitamin D deficiency is highly prevalent among pregnant Indian women. It is associated with GB stasis and lower GBEF. The risk factors for VDD were reduced sun exposure, inadequate dietary intake and urban lifestyle.
authors.affiliation: Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Rimpi
authors.initials: R
authors.lastname: Singla
authors.forename: Usha
authors.initials: U
authors.lastname: Dutta
authors.forename: Neelam
authors.initials: N
authors.lastname: Aggarwal
authors.forename: Sanjay Kumar
authors.initials: SK
authors.lastname: Bhadada
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kochhar
authors.forename: Lakhbir K
authors.initials: LK
authors.lastname: Dhaliwal
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D005705:Gallbladder Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D016473:Gallbladder Emptying; D006801:Humans; D006996:Hypocalcemia / Q000453:epidemiology; D007194:India / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013472:Sunlight; D014463:Ultrasonography; D014505:Urban Population; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D