School of Environment and Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 510632, Guangdong, China.
Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
Environ Sci Technol. 2020 Apr 21;54(8):5031-5040. doi: 10.1021/acs.est.9b07180. Epub 2020 Apr 1.
As the earth's third most abundant element with various industrial applications, aluminum (Al) has received increasing concerns over its potential adverse health effects. Although Al exposure has been suggested to increase the risks of type 2 diabetes, little has been done to explore Al exposure in pregnant women and potential impact on the incidence of gestational diabetes mellitus (GDM). Our present study demonstrated positive associations between Al concentrations in maternal plasma collected in the first trimester of pregnancy and GDM risks ( < 0.001) based on a nested case-control study from Wuhan, China, including 305 GDM cases and 305 healthy controls. The highest tertile of plasma Al concentrations corresponded to an odds ratio of 4.03 (95% confidence interval: [2.14, 7.58]) relative to the lowest tertile, after the adjustment for established GDM risk factors and other plasma metals. We also observed significant correlations between plasma Al and several plasma polyunsaturated fatty acids (PUFA; e.g., linoleic acid 18:2 n-6) levels. In addition, mediation effects on the associations of Al exposure with GDM risks were observed for n-6 PUFAs (estimated mediation percentage: 48.3%) and total PUFAs (48.9%). Our study is not only by far the largest study of its kind to demonstrate maternal Al exposure and the association with GDM risks, but it also offers an insight into the potential mediation roles of n-6 PUFAs in an epidemiological setting. These findings contribute to a better understanding of perinatal Al exposure and GDM risks.
作为地球上含量第三丰富的元素，具有多种工业应用，铝（Al）因其潜在的不良健康影响而受到越来越多的关注。尽管已经有研究表明铝暴露会增加 2 型糖尿病的风险，但对于孕妇铝暴露及其对妊娠糖尿病（GDM）发病率的潜在影响，研究甚少。我们的研究基于中国武汉的一项巢式病例对照研究，在妊娠早期收集的母体血浆中铝浓度与 GDM 风险呈正相关（<0.001），该研究包括 305 例 GDM 病例和 305 例健康对照。与最低三分位相比，最高三分位的血浆铝浓度对应的比值比为 4.03（95%置信区间：[2.14, 7.58]），校正了已确定的 GDM 危险因素和其他血浆金属后。我们还观察到血浆铝与几种多不饱和脂肪酸（PUFA；例如亚油酸 18:2 n-6）水平之间存在显著相关性。此外，在 n-6PUFA（估计中介百分比：48.3%）和总多不饱和脂肪酸（48.9%）方面，观察到铝暴露与 GDM 风险之间的关联存在中介效应。我们的研究不仅是迄今为止最大规模的研究之一，证明了母体铝暴露与 GDM 风险之间的关联，而且还提供了在流行病学环境中 n-6PUFA 潜在中介作用的深入了解。这些发现有助于更好地理解围产期铝暴露和 GDM 风险。
