Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
J Clin Endocrinol Metab. 2019 Oct 1;104(10):4295-4303. doi: 10.1210/jc.2019-00109.
Studies suggest many essential trace metal(loid)s are involved in glucose metabolism, but the associations among pregnant women are unclear.
To assess associations between early pregnancy plasma zinc, selenium, copper, and molybdenum levels and blood glucose levels later in the second trimester.
The Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies‒Singleton Cohort is a prospective cohort study conducted between July 2009 and January 2013.
Twelve academic research hospitals in the United States.
A total of 1857 multiracial, nonobese, healthy women.
Blood glucose levels from 1-hour 50-g gestational load test (GLT) at 24 to 28 weeks of gestation.
Higher concentrations of first-trimester copper were associated with higher glucose levels from the GLT (i.e., every 50% increase in copper concentration was related to 4.9 mg/dL higher glucose level; 95% CI: 2.2, 7.5 mg/dL) adjusted for maternal sociodemographic characteristics and reproductive history. In contrast, every 50% increase in molybdenum concentration was associated with 1.2 mg/dL lower mean glucose level (95% CI: -2.3, -0.1 mg/dL). The magnitude of these associations was greater at the upper tails of glucose level distribution based on quantile regressions of the 10th, 50th, and 90th percentiles.
Higher copper and lower molybdenum concentrations could increase the risk of glucose dysregulation during pregnancy, with women at higher risk of gestational diabetes mellitus potentially affected to a greater extent. Further work is needed to understand the mechanisms involved with early pregnancy essential metal(loid)s to inform clinical diagnosis and prevention of glucose intolerance during pregnancy.
研究表明，许多必需痕量金属（类金属）参与葡萄糖代谢，但孕妇的相关情况尚不清楚。
评估孕早期血浆锌、硒、铜和钼水平与孕中期后期血糖水平之间的关系。
美国国立儿童健康与人类发展 Eunice Kennedy Shriver 研究所胎儿生长研究 - 单胎队列是一项前瞻性队列研究，于 2009 年 7 月至 2013 年 1 月进行。
美国 12 家学术研究医院。
共 1857 名多种族、非肥胖、健康的女性。
妊娠 24 至 28 周时 1 小时 50g 口服葡萄糖耐量试验（GLT）的血糖水平。
孕早期铜浓度较高与 GLT 血糖水平较高相关（即铜浓度增加 50%，则血糖水平升高 4.9mg/dL；95%CI：2.2，7.5mg/dL），调整了母体社会人口统计学特征和生殖史。相比之下，钼浓度每增加 50%，平均血糖水平降低 1.2mg/dL（95%CI：-2.3，-0.1mg/dL）。基于第 10、50 和 90 百分位数的分位数回归，在血糖水平分布的上尾，这些关联的幅度更大。
较高的铜浓度和较低的钼浓度可能会增加妊娠期间葡萄糖失调的风险，妊娠糖尿病风险较高的女性可能会受到更大的影响。需要进一步研究早期妊娠必需金属（类金属）的相关机制，为临床诊断和预防妊娠期间葡萄糖不耐受提供依据。
