Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut.
Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China.
J Clin Endocrinol Metab. 2020 Jul 1;105(7). doi: 10.1210/clinem/dgaa171.
Zinc (Zn) has been suggested to impact fetal growth. However, the effect may be complicated by gestational diabetes mellitus (GDM) due to its impact on fetal growth and placental transport. This study aims to investigate whether GDM modifies the association between Zn levels and birth weight.
A cohort matched by GDM was established in Taiyuan, China, between 2012 and 2016, including 752 women with GDM and 744 women without. Dietary Zn intake was assessed during pregnancy. Maternal blood (MB) and cord blood (CB) Zn levels were measured at birth. Birth weight was standardized as the z score and categorized as high (HBW, >4000 g) and low (LBW, <2500 g) groups. Multivariate linear regression and multinomial logistic regression were used to examine the association between Zn levels and birth weight in offspring born to women with or without GDM.
88.8% (N = 1328) of the population had inadequate Zn intake during pregnancy. In women with GDM, MB Zn level was inversely associated with birth weight (β = -.17; 95% confidence interval (CI), -0.34 to -0.01), while CB Zn level was positively associated with birth weight (β = .38; 95% CI, 0.06-0.70); suggestive associations were observed between MB Zn level and LBW (odds ratio 2.01; 95% CI, 0.95-4.24) and between CB Zn level and HBW (odds ratio 2.37; 95% CI, 1.08-5.21).
GDM may modify the associations between MB and CB Zn levels and birth weight in this population characterized by insufficient Zn intake. These findings suggest a previously unidentified path of adverse effects of GDM.
锌（Zn）被认为会影响胎儿生长。然而，由于其对胎儿生长和胎盘转运的影响，妊娠期糖尿病（GDM）可能会使这种影响变得复杂。本研究旨在探讨 GDM 是否会改变 Zn 水平与出生体重之间的关系。
在中国太原，2012 年至 2016 年间，按 GDM 进行了队列匹配，包括 752 名患有 GDM 的女性和 744 名未患有 GDM 的女性。在妊娠期间评估了膳食 Zn 摄入量。在出生时测量了母体血液（MB）和脐血（CB）中的 Zn 水平。将出生体重标准化为 z 分数，并分为高（HBW，>4000g）和低（LBW，<2500g）组。使用多元线性回归和多项逻辑回归分析了患有或未患有 GDM 的女性所生孩子的 Zn 水平与出生体重之间的关系。
88.8%（N=1328）的人群在妊娠期间 Zn 摄入量不足。在患有 GDM 的女性中，MB Zn 水平与出生体重呈负相关（β=-.17；95%置信区间（CI），-0.34 至 -0.01），而 CB Zn 水平与出生体重呈正相关（β=0.38；95% CI，0.06-0.70）；MB Zn 水平与 LBW 之间存在提示性关联（比值比 2.01；95% CI，0.95-4.24），而 CB Zn 水平与 HBW 之间存在提示性关联（比值比 2.37；95% CI，1.08-5.21）。
在 Zn 摄入不足的人群中，GDM 可能会改变 MB 和 CB Zn 水平与出生体重之间的关系。这些发现提示了 GDM 存在一种以前未被识别的不良影响途径。
