Yinnan Zheng1, Cuilin Zhang2, Marc Weisskopf1,3, Paige L Williams3,4, Patrick J Parsons5,6, Christopher D Palmer5,6, Germaine M Buck Louis7, Tamarra James-Todd1,3. 1. Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts. 2. Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland. 3. Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts. 4. Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts. 5. Wadsworth Center, New York State Department of Health, Albany, New York. 6. Department of Environmental Health Sciences, University at Albany, Rensselaer, New York. 7. Dean's Office, George Mason University, Fairfax, Virginia.
Abstract
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 levels and blood glucose levels later in the second trimester. DESIGN: The Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies‒Singleton Cohort is a prospective cohort study conducted between July 2009 and January 2013. SETTING: Twelve academic research hospitals in the United States. PATIENTS: A total of 1857 multiracial, nonobese, healthy women. MAIN OUTCOME MEASURE: Blood glucose levels from 1-hour 50-g gestational load test (GLT) at 24 to 28 weeks of gestation. RESULTS: Higher concentrations of first-trimester copper were associated with higher glucose levels from the GLT (i.e., every 50% increase in copper concentration was related to 4.9 mg/dL higher glucose level; 95% CI: 2.2, 7.5 mg/dL) adjusted for maternal sociodemographic characteristics and reproductive history. In contrast, every 50% increase in molybdenum concentration was associated with 1.2 mg/dL lower mean glucose level (95% CI: -2.3, -0.1 mg/dL). The magnitude of these associations was 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 gestational diabetes mellitus potentially affected to a greater extent. Further work is needed to understand the mechanisms involved with early pregnancy essential metal(loid)s to inform clinical diagnosis and prevention of glucose intolerance during pregnancy.
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 levels and blood glucose levels later in the second trimester. DESIGN: The Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies‒Singleton Cohort is a prospective cohort study conducted between July 2009 and January 2013. SETTING: Twelve academic research hospitals in the United States. PATIENTS: A total of 1857 multiracial, nonobese, healthy women. MAIN OUTCOME MEASURE: Blood glucose levels from 1-hour 50-g gestational load test (GLT) at 24 to 28 weeks of gestation. RESULTS: Higher concentrations of first-trimester copper were associated with higher glucose levels from the GLT (i.e., every 50% increase in copper concentration was related to 4.9 mg/dL higher glucose level; 95% CI: 2.2, 7.5 mg/dL) adjusted for maternal sociodemographic characteristics and reproductive history. In contrast, every 50% increase in molybdenum concentration was associated with 1.2 mg/dL lower mean glucose level (95% CI: -2.3, -0.1 mg/dL). The magnitude of these associations was 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 gestational diabetes mellitus potentially affected to a greater extent. Further work is needed to understand the mechanisms involved with early pregnancy essential metal(loid)s to inform clinical diagnosis and prevention of glucose intolerance during pregnancy.
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