孕期全血金属暴露与妊娠期糖尿病风险的关联OA

Objective To evaluate the associations between early-pregnancy whole blood concentrations of lead(Pb),copper(Cu),zinc(Zn),calcium(Ca),magnesium(Mg),and iron(Fe)and the risk of gestational diabetes mellitus(GDM)using both single-metal and mixture-based analytical approaches.Methods A total of 191 pregnant women at 10-12+6 weeks of gestation were recruited from the Longhua District Maternal and Child Health Hospital in Shenzhen between June and October 2023.Blood samples were collected at 10-12+6 weeks of gestation,and metal concentrations were measured using atomic absorption spectrometry.GDM was diagnosed by a 75 g oral glucose tolerance test(OGTT)at 24-28 weeks of gestation.Multivariable logistic regression was applied to assess associations between individual metals and GDM risk,and Bayesian kernel machine regression(BKMR)was used to evaluate the effects of metal mixture exposure.Results Among the 191 participants,79(41.4%)were diagnosed with GDM.Blood Zn concentrations were significantly higher in the GDM group than in the non-GDM group(Z=-2.086,P=0.038).After multivariable adjustment,higher Zn levels were positively associated with GDM risk(OR=1.975,95%CI:1.036-3.766).BKMR analysis suggested an overall positive association between metal mixture exposure and GDM risk,with Zn showing a robust positive association and Cu exhibiting an inverse association.Conclusion Early pregnancy exposure to whole-blood metal mixture exposure was associated with GDM risk.Zn demonstrated a consistent positive association across multiple models,whereas Cu may have a protective effect.