{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T12:17:49Z","timestamp":1780661869487,"version":"3.54.1"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,2,14]],"date-time":"2019-02-14T00:00:00Z","timestamp":1550102400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81302390"],"award-info":[{"award-number":["81302390"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2016T90210"],"award-info":[{"award-number":["2016T90210"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Diabetes"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This study examined whether folate and vitamin B<jats:sub>12<\/jats:sub> imbalance is associated with gestational diabetes mellitus (GDM) and explored interactions between B vitamin imbalance and maternal risk factors for GDM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross\u2010sectional study was performed in 406 Chinese pregnant women. Serum folate, vitamin B<jats:sub>12<\/jats:sub>, and blood glucose concentrations were measured at 24 to 28 weeks gestation during GDM screening. A diagnosis of GDM was made based on International Association of Diabetes and Pregnancy Study Groups criteria (fasting plasma glucose [FPG] \u22655.1 mM, 1\u2010hour plasma glucose \u226510.0 mM, or 2\u2010hour plasma glucose \u22658.5 mM). Binary logistic regression was used to obtain odds ratios (ORs) after controlling for different confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Higher folate levels were associated with higher glucose concentrations and a higher risk of GDM (OR 1.98; 95% confidence interval [CI] 1.00\u20103.90), whereas higher vitamin B<jats:sub>12<\/jats:sub> levels were associated with lower FPG and a lower risk of GDM (OR 0.30; 95% CI 0.15\u20100.60). A higher folate:  vitamin B<jats:sub>12<\/jats:sub> ratio was associated with higher glucose and a higher risk of GDM (OR 3.08; 95% CI 1.63\u20105.83). The presence of both a higher folate:  vitamin B<jats:sub>12<\/jats:sub> ratio and advanced age further increased the OR to 2.13 (95% CI 1.09\u20104.15) with a significant additive interaction. Furthermore, a higher folate:  vitamin B<jats:sub>12<\/jats:sub> ratio and a higher prepregnancy body mass index (pp\u2010BMI) were synergistically associated with an increased risk of GDM (OR 3.03; 95% CI 1.40\u20106.57).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>An imbalance between folate and vitamin B<jats:sub>12<\/jats:sub>, represented by a higher folate:  vitamin B<jats:sub>12<\/jats:sub> ratio, was highly associated with GDM risk, and this association could be further modified by maternal age and pp\u2010BMI.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1753-0407.12899","type":"journal-article","created":{"date-parts":[[2019,1,8]],"date-time":"2019-01-08T21:14:41Z","timestamp":1546982081000},"page":"744-751","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":55,"title":["Joint effects of folate and vitamin B<sub>12<\/sub> imbalance with maternal characteristics on gestational diabetes mellitus"],"prefix":"10.1111","volume":"11","author":[{"given":"Shuying","family":"Li","sequence":"first","affiliation":[{"name":"Key Laboratory of Hormones and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital and Tianjin Institute of Endocrinology Tianjin Medical University  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaxing","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Occupational and Environmental Health School of Public Health, Tianjin Medical University  Tianjin China"},{"name":"Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health School of Public Health, Tianjin Medical University  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinxin","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of 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