A prospective study of early pregnancy metal concentrations and gestational diabetes mellitus based on a birth cohort in Northwest China
Abstract Background Exposure to metals during early pregnancy may affect maternal glucose metabolism. We were aimed to assess the associations between early pregnancy whole blood concentrations of copper (Cu), zinc (Zn), calcium (Ca), iron (Fe), and magnesium (Mg) with GDM later in the second trimes...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-04-01
|
| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-025-07336-2 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850153537579778048 |
|---|---|
| author | Doudou Zhao Jie Chen Xiayang Li Yishuai Huang Yu Zhang Fuyang Zhao Danmeng Liu Li Shan Yang Mi Lei Shang Pengfei Qu |
| author_facet | Doudou Zhao Jie Chen Xiayang Li Yishuai Huang Yu Zhang Fuyang Zhao Danmeng Liu Li Shan Yang Mi Lei Shang Pengfei Qu |
| author_sort | Doudou Zhao |
| collection | DOAJ |
| description | Abstract Background Exposure to metals during early pregnancy may affect maternal glucose metabolism. We were aimed to assess the associations between early pregnancy whole blood concentrations of copper (Cu), zinc (Zn), calcium (Ca), iron (Fe), and magnesium (Mg) with GDM later in the second trimester among pregnant women in Northwest China. Methods This study included 5478 first-trimester pregnant women who participated in the birth cohort of the Northwest Women’s and Children’s Hospital between July 2018 and December 2023. Metal concentrations, basic demographic characteristics, lifestyle and behavior patterns were collected. An oral glucose tolerance test was performed in the second trimester. A generalized linear model was used to analyze the effects of metal concentrations on GDM. A two-piecewise regression model was adopted to examine the threshold effect and find out the turning point. Weighted Quantile Sum (WQS) regression was conducted using a dataset randomly split into training and validation sets at a 4:6 ratio to investigate the association between metal mixtures and GDM. Results Compared to the lowest tertile, the middle (RR = 0.82, 95%CI = 0.71, 0.95) and highest (RR = 0.84, 95%CI = 0.73, 0.97) tertiles of Ca concentrations could decrease the risk of GDM. However, the highest tertile of Cu concentration could increase the risk of GDM (RR = 1.18, 95%CI = 1.01, 1.39). Additionally, a non-linear relationship between Ca concentration with GDM and FPG was observed. The risk of GDM (RR = 0.08, 95%CI: 0.02, 0.31) and FPG (β=-0.56, 95%CI: -0.99, -0.12) decreased with 1 unit increase in ln-transformed Ca concentration below the turning point. However, the WQS index of maternal mixed metals was not correlated with the incidence of GDM (RR = 1.08, 95%CI = 0.98, 1.19). Conclusions Higher Cu concentration during early pregnancy may increase the risk of GDM in mothers. Increased Ca concentration may reduce the risk of GDM and lower the concentration of FPG below the turning point. Our findings could provide an early marker for potentially modifiable risk factors associated with maternal glucose dysregulation during pregnancy. |
| format | Article |
| id | doaj-art-e6a9a720bd91429fbcbdc484c5d765c6 |
| institution | OA Journals |
| issn | 1471-2393 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-e6a9a720bd91429fbcbdc484c5d765c62025-08-20T02:25:41ZengBMCBMC Pregnancy and Childbirth1471-23932025-04-0125111110.1186/s12884-025-07336-2A prospective study of early pregnancy metal concentrations and gestational diabetes mellitus based on a birth cohort in Northwest ChinaDoudou Zhao0Jie Chen1Xiayang Li2Yishuai Huang3Yu Zhang4Fuyang Zhao5Danmeng Liu6Li Shan7Yang Mi8Lei Shang9Pengfei Qu10Translational Medicine Center, Northwest Women’s and Children’s HospitalDepartment of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science CenterDepartment of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science CenterDepartment of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science CenterDepartment of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science CenterSchool of Nursing, Shaanxi University of Chinese MedicineTranslational Medicine Center, Northwest Women’s and Children’s HospitalDepartment of Gynecology, Northwest Women’s and Children’s HospitalDepartment of Obstetrics, Northwest Women’s and Children’s HospitalDepartment of Health Statistics, Fourth Military Medical UniversityTranslational Medicine Center, Northwest Women’s and Children’s HospitalAbstract Background Exposure to metals during early pregnancy may affect maternal glucose metabolism. We were aimed to assess the associations between early pregnancy whole blood concentrations of copper (Cu), zinc (Zn), calcium (Ca), iron (Fe), and magnesium (Mg) with GDM later in the second trimester among pregnant women in Northwest China. Methods This study included 5478 first-trimester pregnant women who participated in the birth cohort of the Northwest Women’s and Children’s Hospital between July 2018 and December 2023. Metal concentrations, basic demographic characteristics, lifestyle and behavior patterns were collected. An oral glucose tolerance test was performed in the second trimester. A generalized linear model was used to analyze the effects of metal concentrations on GDM. A two-piecewise regression model was adopted to examine the threshold effect and find out the turning point. Weighted Quantile Sum (WQS) regression was conducted using a dataset randomly split into training and validation sets at a 4:6 ratio to investigate the association between metal mixtures and GDM. Results Compared to the lowest tertile, the middle (RR = 0.82, 95%CI = 0.71, 0.95) and highest (RR = 0.84, 95%CI = 0.73, 0.97) tertiles of Ca concentrations could decrease the risk of GDM. However, the highest tertile of Cu concentration could increase the risk of GDM (RR = 1.18, 95%CI = 1.01, 1.39). Additionally, a non-linear relationship between Ca concentration with GDM and FPG was observed. The risk of GDM (RR = 0.08, 95%CI: 0.02, 0.31) and FPG (β=-0.56, 95%CI: -0.99, -0.12) decreased with 1 unit increase in ln-transformed Ca concentration below the turning point. However, the WQS index of maternal mixed metals was not correlated with the incidence of GDM (RR = 1.08, 95%CI = 0.98, 1.19). Conclusions Higher Cu concentration during early pregnancy may increase the risk of GDM in mothers. Increased Ca concentration may reduce the risk of GDM and lower the concentration of FPG below the turning point. Our findings could provide an early marker for potentially modifiable risk factors associated with maternal glucose dysregulation during pregnancy.https://doi.org/10.1186/s12884-025-07336-2Gestational diabetes mellitusMetal levelCuCaBlood glucoseThreshold effect |
| spellingShingle | Doudou Zhao Jie Chen Xiayang Li Yishuai Huang Yu Zhang Fuyang Zhao Danmeng Liu Li Shan Yang Mi Lei Shang Pengfei Qu A prospective study of early pregnancy metal concentrations and gestational diabetes mellitus based on a birth cohort in Northwest China BMC Pregnancy and Childbirth Gestational diabetes mellitus Metal level Cu Ca Blood glucose Threshold effect |
| title | A prospective study of early pregnancy metal concentrations and gestational diabetes mellitus based on a birth cohort in Northwest China |
| title_full | A prospective study of early pregnancy metal concentrations and gestational diabetes mellitus based on a birth cohort in Northwest China |
| title_fullStr | A prospective study of early pregnancy metal concentrations and gestational diabetes mellitus based on a birth cohort in Northwest China |
| title_full_unstemmed | A prospective study of early pregnancy metal concentrations and gestational diabetes mellitus based on a birth cohort in Northwest China |
| title_short | A prospective study of early pregnancy metal concentrations and gestational diabetes mellitus based on a birth cohort in Northwest China |
| title_sort | prospective study of early pregnancy metal concentrations and gestational diabetes mellitus based on a birth cohort in northwest china |
| topic | Gestational diabetes mellitus Metal level Cu Ca Blood glucose Threshold effect |
| url | https://doi.org/10.1186/s12884-025-07336-2 |
| work_keys_str_mv | AT doudouzhao aprospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina AT jiechen aprospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina AT xiayangli aprospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina AT yishuaihuang aprospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina AT yuzhang aprospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina AT fuyangzhao aprospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina AT danmengliu aprospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina AT lishan aprospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina AT yangmi aprospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina AT leishang aprospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina AT pengfeiqu aprospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina AT doudouzhao prospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina AT jiechen prospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina AT xiayangli prospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina AT yishuaihuang prospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina AT yuzhang prospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina AT fuyangzhao prospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina AT danmengliu prospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina AT lishan prospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina AT yangmi prospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina AT leishang prospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina AT pengfeiqu prospectivestudyofearlypregnancymetalconcentrationsandgestationaldiabetesmellitusbasedonabirthcohortinnorthwestchina |