砷形态尿与血清一碳代谢营养物对妊娠糖尿病的联合效应：中国孕妇的横断面研究。
Joint effect of urinary arsenic species and serum one-carbon metabolism nutrients on gestational diabetes mellitus: A cross-sectional study of Chinese pregnant women.
机构信息
Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China.
Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin 300070, China.
出版信息
Environ Int. 2021 Nov;156:106741. doi: 10.1016/j.envint.2021.106741. Epub 2021 Jun 30.
BACKGROUND
Growing evidence indicates that arsenic (As) exposure can increase the risk of gestational diabetes mellitus (GDM). However, little is known about As species and GDM and the combined effect of As and one-carbon metabolism (OCM) on GDM.
OBJECTIVES
We aimed to examine the associations between As species and GDM and evaluate the potential interactions of folate, vitamin B, and homocysteine (Hcy) with As species on GDM prevalence.
METHOD
We measured levels of arsenite (As), arsenate (As), dimethylarsinic acid (DMA), and arsenobetaine (AsB) species in urine and folate, vitamin B, and Hcy in serum from 396 pregnant women in Tianjin, China. The diagnosis of GDM was based on an oral glucose tolerance test. Associations of As species in urine with GDM were evaluated using generalized linear models (GLMs) and Bayesian kernel machine regression (BKMR). Additive interactions of As and OCM with GDM were estimated by determining the relative excess risk due to interaction (RERI).
RESULTS
Of the 396 pregnant women, 89 were diagnosed with GDM. Continuous increases in urinary inorganic As were associated with GDM in the GLMs, with adjusted odds ratios of 2.12 (95% CI: 0.96, 4.71) for As, and 0.27 (95% CI: 0.07, 0.98) for As. The BKMR in estimating the exposure-response functions showed that As and AsB were positively associated with GDM. However, As showed a negative relationship with GDM. Although the additive interactions between As exposure and OCM indicators were not significant, we found that pregnant women with higher urinary As and total As accompanied by lower serum vitamin B were more likely to have higher odds of GDM (3.12, 95% CI: 1.32, 7.38 and 3.10, 95% CI: 1.30, 7.38, respectively).
CONCLUSIONS
Our data suggest a positive relation between As and GDM but a negative relation between As and GDM. Potential additive interaction of As and OCM with GDM requires further investigation.
背景
越来越多的证据表明，砷（As）暴露会增加妊娠糖尿病（GDM）的风险。然而，关于砷形态与 GDM 以及砷与一碳代谢（OCM）联合对 GDM 的影响知之甚少。
目的
本研究旨在探讨砷形态与 GDM 的关系，并评估叶酸、维生素 B 和同型半胱氨酸（Hcy）与砷形态对 GDM 患病率的潜在交互作用。
方法
我们测量了中国天津 396 名孕妇尿液中的亚砷酸盐（As）、砷酸盐（As）、二甲基砷酸（DMA）和砷甜菜碱（AsB）以及血清中的叶酸、维生素 B 和 Hcy 水平。GDM 的诊断基于口服葡萄糖耐量试验。使用广义线性模型（GLMs）和贝叶斯核机器回归（BKMR）评估尿液中砷形态与 GDM 的关系。通过确定交互归因超额相对危险度（RERI）来估计砷与 OCM 对 GDM 的相加交互作用。
结果
在 396 名孕妇中，有 89 名被诊断为 GDM。GLMs 分析结果显示，尿液中无机砷含量的连续增加与 GDM 相关，调整后的比值比（OR）分别为 2.12（95%CI：0.96，4.71）和 0.27（95%CI：0.07，0.98）。BKMR 估计暴露-反应函数显示，As 和 AsB 与 GDM 呈正相关，但 As 与 GDM 呈负相关。尽管砷暴露与 OCM 指标之间的相加交互作用不显著，但我们发现，尿液中砷含量较高且总砷含量较高，同时血清维生素 B 水平较低的孕妇发生 GDM 的可能性更高（OR 分别为 3.12，95%CI：1.32，7.38 和 3.10，95%CI：1.30，7.38）。
结论
本研究数据提示砷与 GDM 呈正相关，而砷与 GDM 呈负相关。砷与 OCM 对 GDM 的潜在相加交互作用需要进一步研究。
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