Sorbonne Université and INSERM, Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Pierre Louis Institute of Epidemiology and Public Health (IPLESP UMRS 1136), Saint-Antoine Medical School, 27 rue Chaligny, 75571 Paris CEDEX 12, France.
Sorbonne Université and INSERM, Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Pierre Louis Institute of Epidemiology and Public Health (IPLESP UMRS 1136), Saint-Antoine Medical School, 27 rue Chaligny, 75571 Paris CEDEX 12, France.
Sci Total Environ. 2019 Mar 15;656:870-876. doi: 10.1016/j.scitotenv.2018.11.422. Epub 2018 Nov 29.
Evidence is cumulating on the adverse health effects of environmental exposures on health of the fetus and the childbearing mothers. Among mother's conditions, gestational diabetes mellitus has been considered rarely in spite of its importance for both mother and child. We determined the role of maternal exposure to lead (Pb), cadmium (Cd) and manganese (Mn) to gestational diabetes mellitus (GDM) on diagnosed GDM and impaired glucose tolerance (IGT) in diabetes-free mothers from the French EDEN mother-child cohort. 623 pregnant women without pre-existing diabetes were included in the study. GDM and IGT were diagnosed by a gynecologist during consultations after blood analysis. Pb, Cd and Mn were measured in second-trimester blood samples. Associations between ln-transformed concentrations of metals and GDM and IGT respectively were examined using multiple logistic regression analysis adjusted for potential confounders. The prevalences of GDM and IGT were 7.1% and 10.1% respectively. After adjustment for confounders, Cd was statistically related to having had a diagnosis of GDM or IGT (Adjusted Odds-Ratio (AOR): 1.61, 1.05-2.48), and Pb to GDM at borderline significance (AOR: 1.65, 0.82-3.34). Our findings add to the growing evidence supporting the role of maternal exposure to heavy toxic metals that persist longtime in the environment as a risk factor for GDM.
越来越多的证据表明,环境暴露对胎儿和产妇健康的不良影响。在母亲的疾病中,妊娠糖尿病虽然对母亲和孩子都很重要,但却很少被考虑。我们确定了母体暴露于铅(Pb)、镉(Cd)和锰(Mn)与妊娠糖尿病(GDM)的关系,在法国 EDEN 母婴队列中,对无糖尿病前期的母亲进行了诊断性 GDM 和糖耐量受损(IGT)的研究。共有 623 名无糖尿病前期的孕妇纳入研究。GDM 和 IGT 由妇科医生在血液分析后咨询时诊断。在妊娠中期的血液样本中测量了 Pb、Cd 和 Mn。采用多因素逻辑回归分析,调整了潜在混杂因素后,分别研究了金属 ln 转换浓度与 GDM 和 IGT 之间的关系。GDM 和 IGT 的患病率分别为 7.1%和 10.1%。在调整了混杂因素后,Cd 与 GDM 或 IGT 的诊断呈统计学相关(调整后的优势比(AOR):1.61,1.05-2.48),而 Pb 与 GDM 呈边缘显著相关(AOR:1.65,0.82-3.34)。我们的研究结果为母体暴露于环境中持久存在的重金属作为 GDM 风险因素的作用提供了更多的证据。