A nested case-control study indicating heavy metal residues in meconium associate with maternal gestational diabetes mellitus risk

Abstract

BackgroundEnvironmental pollutant exposure may play certain roles in the pathogenesis and progression of diabetes mellitus including gestational diabetes mellitus (GDM). We hypothesize that heavy metal exposure may trigger GDM during pregnancy. The objective of this study was to investigate the possible associations between selected heavy metal exposure and GDM risk.MethodsThis investigation is a retrospective case–control study nested within a cohort of 1359 pregnant women. These participants were recruited in Xiamen Maternity and Child Care Hospital, China, during June to July, 2012. All their newborns’ meconium samples were collected. By reviewing the antenatal care records, 166 GDM mothers were screened out from the 1359 participants; 137 of 166 GDM mothers offered their newborns’ meconium samples for the metal analysis. Those 137 mothers were set as the case group. Similarly, 294 healthy mothers without any gestational complication were initially screened out from the rest 1193 non-GDM mothers. 190 of the 294 healthy mothers offered their newborns’ meconium samples for the metal analysis. Those 190 mothers were set as the control group. Arsenic (As), mercury (Hg), lead (Pb), cadmium (Cd), and chromium (Cr) levels in these case–control meconium samples were measured by inductively coupled plasma mass spectrometry. The possible association between the metal levels and maternal GDM risk of studied subjects was assessed by binary logistic regression.ResultsGDM prevalence of 12.21% was observed in the investigated 1359 participants. The concentrations of As, Hg, Cr and Cd in studied cases were significantly higher (p < 0.05) than those of controls. After adjustments for maternal age, pre-pregnant body mass index, gravidity, parity, hepatitis B virus infection, and newborn sex, As, Cd and Cr were found to be positively associated with GDM prevalence in dose-dependent manners. Among them, As was detected in all samples and its levels associated the maternal GDM with the adjusted odds ratios of 3.28 [95% CI 1.24, 8.71], 3.35 [95% CI 1.28, 8.75] and 5.25 [95% CI 1.99, 13.86] for the 2nd, 3rd and 4th quartiles, respectively.ConclusionsThe present work implies that exposure to some of the selected metals (noticeably As) may contribute to maternal GDM risk during pregnancy.Electronic supplementary materialThe online version of this article (doi:10.1186/s12940-015-0004-0) contains supplementary material, which is available to authorized users.

Exposure to phthalates, bisphenol A and metals in pregnancy and the association with impaired glucose tolerance and gestational diabetes mellitus: The MIREC study

“…Two previous studies, a U.S. based cohort study (Ettinger et al, 2009) and a Chinese case-control study (Peng et al, 2015), both found significant associations between arsenic exposure and gestational diabetes. Other studies have examined arsenic exposure in relation to type 2 diabetes.…”

“…The third and fourth quartiles of cadmium exposure were associated with a significantly increased risk of gestational diabetes. Interestingly, they found significantly reduced odds ratios for the second and third quartile of lead compared to the first quartile (Peng et al, 2015).…”

Maternal arsenic exposure and gestational diabetes and glucose intolerance in the New Hampshire birth cohort study

“…A nested case–control study within pregnancy cohort of Chinese women compared metals, including As, in meconium samples from infants born to healthy mothers ( n  = 190) or mothers with GDM ( n  = 137). Meconium As was dose-dependently associated with maternal GDM (OR: 3.3, 95 % CI: 1.2, 8.7; OR: 3.4, 95 % CI: 1.3, 8.8; and OR: 5.3, 95 % CI: 2.0, 13.9, for the 2nd, 3rd and 4th quartiles of meconium As, respectively) [23]. …”

“…Although few epidemiological studies have examined As exposure and GDM, data are beginning to emerge on the potential role for As in the development of impaired gestational glucose control [21–23]. Specifically, only three prior studies have examined the association between As and GDM, and of these, two were limited in that they relied solely on postpartum As exposure assessments.…”

Gestational diabetes and offspring birth size at elevated environmental pollutant exposures

“…Exposures to persistent organic pollutants (POPs), such as organochlorine compounds (OCs) and perfluoroalkyl substances (PFASs), and exposures to metals, such as mercury, have been associated with increased risk for type 2 diabetes (reviewed in Lee et al 2014; Kuo et al 2013; Magliano et al 2014; Taylor et al 2013). However, only a few previous studies, with inconclusive findings, have specifically focused on risk of GDM (Jaacks et al 2016; Peng et al 2015; Shapiro et al 2015 and 2016; Smarr et al 2016; Vafeiadi et al 2016; Zhang et al 2015). …”