A prospective study of early pregnancy essential metal(loid)s and glucose levels late in the second trimester.
A prospective study of early pregnancy essential metal(loid)s and glucose levels late in the second trimester.
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DOI：
10.1210/jc.2019-00109
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发表时间：
2019-10
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通讯作者：
Yinnan Zheng;Cuilin Zhang;M. Weisskopf;Paige L. Williams;P. Parsons;C. Palmer;G. B. Buck Louis;T. James-Todd
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作者：
Yinnan Zheng;Cuilin Zhang;M. Weisskopf;Paige L. Williams;P. Parsons;C. Palmer;G. B. Buck Louis;T. James-Todd
背景研究表明，许多必需微量金属(Loid)S参与了葡萄糖代谢，但孕妇之间的关联尚不清楚。目的探讨妊娠早期血浆锌、硒、铜、钼水平与孕中期血糖水平的关系。设计尤尼斯·肯尼迪·施莱弗国家儿童健康和人类发展研究所(NICHD)胎儿生长研究-Singleton队列，一项2009年7月至2013年1月的前瞻性队列研究。在美国12家学术研究医院设置患者1857名，为多种族非肥胖健康女性。主要观察指标为妊娠24周至28周的50克妊娠负荷试验(GLT)1小时血糖水平。结果在调整了母亲的社会人口学特征和生育史后，妊娠早期铜浓度升高与GLT的血糖水平升高有关(即铜浓度每增加50%与血糖水平升高4.9 mg/dL相关，95%CI：2.2，7.5)。相比之下，钼浓度每增加50%，平均血糖水平降低1.2 mg/dL(95%可信区间：-2.3，-0.1)。根据第10、50和90个百分位数的分位数回归，这些相关性的大小在血糖水平分布的上尾更大。结论较高的铜和较低的钼浓度可增加妊娠期糖代谢紊乱的风险，妊娠期糖尿病风险较高的妇女可能受到更大程度的影响。妊娠早期必需金属(LoID)S的作用机制尚需进一步研究，以便为临床诊断和预防妊娠期糖耐量异常提供依据。
CONTEXT Studies suggest many essential trace metal(loid)s are involved in glucose metabolism, but the associations among pregnant women are unclear. OBJECTIVE To assess associations between early pregnancy plasma zinc, selenium, copper and molybdenum and blood glucose levels later in the 2nd trimester. DESIGN Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies - Singleton cohort, a prospective cohort study between July 2009 and January 2013. SETTING 12 academic research hospitals in the U.S. PATIENTS 1857 multi-racial non-obese healthy women. MAIN OUTCOME MEASURES Blood glucose levels from 1-hour 50-g gestational load test (GLT) at 24 to 28 weeks of gestation. RESULTS Higher concentrations of 1st trimester copper were associated with higher glucose levels from GLT (i.e. per 50% increase in copper concentrations was related to 4.9 mg/dL higher glucose level, 95% CI: 2.2, 7.5) adjusted for maternal socio-demographic characteristics and reproductive history. In contrast, per 50% increase in molybdenum concentrations were associated with 1.2 mg/dL lower mean glucose levels (95% CI: -2.3, -0.1). The magnitudes of these associations were greater at the upper tails of glucose level distribution based on quantile regressions of the 10th, 50th, and 90th percentiles. CONCLUSIONS Higher copper and lower molybdenum concentrations could increase the risk of glucose dysregulation during pregnancy, with women at higher risk of GDM potentially affected to a greater extent. Further work is needed to understand the mechanisms involved with early pregnancy essential metal(loid)s in order to inform clinical diagnosis and prevention for glucose intolerance during pregnancy.