Manganese (Mn) intake has been found to be linked with risk of type 2 diabetes. However, the role of Mn in the development of gestational diabetes mellitus (GDM) remains to be investigated. This prospective study included pregnant women from the Tongji Maternal and Child Health Cohort. A total of 2327 participants with plasma specimens before 20 weeks were included. Among the pregnant women, 9.7% (225/2327) were diagnosed with GDM. After adjustment, pregnant women with the third and highest quartile of plasma Mn levels had 1.31-fold (RR, 2.31 [1.48, 3.61]) and 2.35-fold (RR, 3.35 [2.17, 5.17]) increased risk of GDM compared with those with the lowest quartile. A 1 standard deviation increment of ln-transformed plasma Mn levels (0.53 μg/L) was related to elevated risks of GDM with RRs of 1. 28 [1.17, 1.40]. The positive associations between Mn and GDM remained consistent in all the subgroups. The weighted quantile sum index was significantly related to GDM (RR, 1.60 [1.37, 1.86]). The contribution of Mn (58.69%) to the metal mixture index was the highest related to GDM. Higher plasma Mn levels were found to be linked with elevated fasting and 2 h post-load blood glucose. This study revealed relationships of higher plasma Mn levels in early pregnancy and increased risk of GDM, suggesting that though essential, excess Mn in the body might be a potential important risk factor for GDM.
Context The association between remnant cholesterol (RC) and gestational diabetes mellitus (GDM) risk is unclear. Objective This study investigated the association between RC and GDM. Methods We used data from the Tongji Maternal and Child Health Cohort, a prospective cohort study in China. Fasting lipid concentrations were measured around 16 weeks’ gestation. RC was calculated as total cholesterol minus low-density lipoprotein cholesterol and high-density lipoprotein cholesterol. GDM was diagnosed by a 75-g oral-glucose-tolerance test (OGTT) at 24–28 weeks’ gestation. Log-Poisson regression models were performed to estimate RRs of GDM across quartiles of RC levels and triglyceride (TG) levels after adjustment for potential confounds. TG and RC were mutually adjusted. Results Among 2528 women, 256 (10.1%) of them developed GDM. The adjusted RRs (95% CIs) for GDM across increasing quartiles of RC were 1.00 (reference), 1.35 (0.91, 1.99), 1.68 (1.16, 2.45), and 1.73 (1.19, 2.50), respectively. Compared to pregnant women without three risk indicators (TG <2.08 mmol/L, RC <0.40 mmol/L, and pre-BMI <24.0kg/m2), the risk of GDM elevated in those with normal pre-BMI but high RC (aRR:1.54; 95%CI: 1.08, 2.19) or high TG (aRR:2.15; 95%CI: 1.33, 3.49). For those with all three risk indicators, the risk of GDM was the highest (aRR:4.80; 95%CI: 3.20, 7.18). Conclusion Elevated RC levels were associated with the increased risk of GDM and independent of traditional risk factors. Pregnant women with high pre-BMI, high TG, and high RC were greatly increased the risk of GDM.
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