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镉暴露与妊娠糖尿病的关系。

Relation between cadmium exposure and gestational diabetes mellitus.

机构信息

Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.

Wuhan Medical and Health Center for Women and Children, Wuhan, Hubei, People's Republic of China.

出版信息

Environ Int. 2018 Apr;113:300-305. doi: 10.1016/j.envint.2018.01.001. Epub 2018 Jan 17.

Abstract

BACKGROUND

Cadmium (Cd) has been associated with type 2 diabetes in general population. However, the role of Cd in the occurrence of Gestational diabetes mellitus (GDM) remains unclear.

OBJECTIVES

Our study was aimed at investigating whether Cd exposure during pregnancy was associated with increased risk of GDM.

METHODS

Cd concentrations were measured in urine samples from 6837 pregnant women in Wuhan, China, from 2012 to 2014. A "modified Poisson" model with a robust error variance was used to examine the association of GDM with continuous natural logarithm (ln) transformed urinary Cd or quartiles of urinary Cd levels.

RESULTS

For about 3-fold increase in Cd concentrations, there were 16% [relative risk (RR) =1.16; 95% confidence interval (CI): 1.03, 1.33] increase in risk of GDM. Compared with women in the lowest quartile of urinary Cd levels, women in the highest quartile had 1.30 higher risk of GDM [95% CI: 1.05, 1.61; p-trend <0.05]. Further analyses indicated overweight/obese women with higher urinary Cd levels had significantly higher risk of GDM, compared with women in the reference category of lowest quartile of Cd and normal pre-pregnancy body mass index [RR =2.71; 95% CI: 1.81, 4.07].

CONCLUSIONS

Our study presented a significantly positive association between urinary Cd levels and risk of GDM, supporting the hypothesis that environmental exposure to Cd may contribute to the development of GDM.

摘要

背景

镉(Cd)已与一般人群中的 2 型糖尿病相关。然而,妊娠期间 Cd 暴露与妊娠糖尿病(GDM)的发生之间的关系尚不清楚。

目的

本研究旨在探讨妊娠期间 Cd 暴露是否与 GDM 风险增加有关。

方法

我们测量了 2012 年至 2014 年期间来自中国武汉的 6837 名孕妇尿液样本中的 Cd 浓度。采用稳健误差方差的“修正泊松”模型,以检验 GDM 与连续自然对数(ln)转换尿 Cd 或尿 Cd 水平四分位值之间的关系。

结果

大约 Cd 浓度增加 3 倍,GDM 的风险增加 16%[相对风险(RR)=1.16;95%置信区间(CI):1.03,1.33]。与尿 Cd 水平最低四分位数的女性相比,尿 Cd 水平最高四分位数的女性患 GDM 的风险高 1.30 倍[95%CI:1.05,1.61;p 趋势<0.05]。进一步的分析表明,与最低四分位数 Cd 和正常妊娠前体重指数的参考类别相比,超重/肥胖女性的尿 Cd 水平较高,患 GDM 的风险显著增加[RR=2.71;95%CI:1.81,4.07]。

结论

本研究表明,尿 Cd 水平与 GDM 风险之间存在显著正相关,支持了环境暴露 Cd 可能导致 GDM 发展的假说。

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