Zhang Yuqing, Chen Ting, Zhang Yiyun, Hu Qi, Wang Xu, Chang Hang, Mao Jian-Hua, Snijders Antoine M, Xia Yankai
Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Hospital, Nanjing, China; State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China.
State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China.
Environ Int. 2021 Aug;153:106520. doi: 10.1016/j.envint.2021.106520. Epub 2021 Mar 25.
A healthy gut microbiome is critical for glucose metabolism during pregnancy. In vivo studies indicate that trace element affects the composition and function of the gut microbiome and potentially leads to metabolic disorders but their relationships are largely unknown. We aimed to investigate whether the gut microbiome plays a role in the relationship between trace element exposure and gestational diabetes mellitus (GDM).
In a prospective cohort study, serum levels of 22 trace elements and the fecal gut microbiome composition were assessed in 837 pregnant women in the second trimester between 22 and 24 weeks of pregnancy prior to GDM diagnosis. Regression and mediation analysis were used to explore the link between element exposure, the gut microbiome, and GDM.
128 pregnant women (15.3%) were diagnosed with GDM. No individual trace elements were found significantly associated with GDM. In contrast, the composition of the gut microbiome was dramatically altered in women later diagnosed with GDM and characterized by lower alpha diversity and lower abundance of co-abundance groups (CAGs) composed of genera belonging to Ruminococcaceae, Coriobacteriales, and Lachnospiraceae. Rubidium (Rb) was positively associated with alpha diversity indices while mercury (Hg) and vanadium (V) showed negative associations. Elements including rubidium (Rb), thallium (Tl), arsenic (As), and antimony (Sb) were significantly correlated with GDM-related CAGs and mediation analysis revealed that Rb and Sb were inversely related to GDM risk by altering abundance levels of CAGs enriched for Lachnospiraceae, Coriobacteriales, and Ruminococcaceae.
Our study indicates that trace element exposure is associated with specific gut microbiome features that may contribute to GDM development, which could provide a new avenue for intervening in environmental exposure-related GDM.
健康的肠道微生物群对孕期葡萄糖代谢至关重要。体内研究表明，微量元素会影响肠道微生物群的组成和功能，并可能导致代谢紊乱，但其关系在很大程度上尚不清楚。我们旨在研究肠道微生物群在微量元素暴露与妊娠期糖尿病（GDM）之间的关系中是否起作用。
在一项前瞻性队列研究中，在妊娠22至24周的孕中期、GDM诊断之前，对837名孕妇的22种微量元素血清水平和粪便肠道微生物群组成进行了评估。采用回归和中介分析来探索元素暴露、肠道微生物群和GDM之间的联系。
128名孕妇（15.3%）被诊断为GDM。未发现单个微量元素与GDM有显著关联。相比之下，后来被诊断为GDM的女性肠道微生物群组成发生了显著变化，其特征是较低的α多样性以及由属于瘤胃球菌科、棒状杆菌目和毛螺菌科的属组成的共丰度组（CAG）丰度较低。铷（Rb）与α多样性指数呈正相关，而汞（Hg）和钒（V）呈负相关。包括铷（Rb）、铊（Tl）、砷（As）和锑（Sb）在内的元素与GDM相关的CAG显著相关，中介分析显示，Rb和Sb通过改变富含瘤胃球菌科、棒状杆菌目和毛螺菌科的CAG丰度水平与GDM风险呈负相关。
我们的研究表明，微量元素暴露与特定的肠道微生物群特征有关，这些特征可能导致GDM的发生，这可能为干预与环境暴露相关的GDM提供一条新途径。
