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Cadmium Body Burden and Gestational Diabetes Mellitus: A Prospective Study.

Cadmium Body Burden and Gestational Diabetes Mellitus: A Prospective Study.
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Liu W, Zhang B, Huang Z, Pan X, Chen X, Hu C, Liu H, Jiang Y, Sun X, Peng Y, Xia W, Xu S, Li Y,


Liu W, Zhang B, Huang Z, Pan X, Chen X, Hu C, Liu H, Jiang Y, Sun X, Peng Y, Xia W, Xu S, Li Y, (click to view)

Liu W, Zhang B, Huang Z, Pan X, Chen X, Hu C, Liu H, Jiang Y, Sun X, Peng Y, Xia W, Xu S, Li Y,

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Environmental health perspectives 2018 02 08126(2) 027006 doi 10.1289/EHP2716
Abstract
BACKGROUND
Several studies have reported that cadmium (Cd) is associated with type 2 diabetes. However, little is known about Cd exposure and the risk of gestational diabetes mellitus (GDM).

OBJECTIVE
We examined the association between Cd body burden in early pregnancy and the risk of GDM.

METHODS
We conducted a prospective study of 2,026 pregnant women from a single tertiary medical center between 2013 and 2016 in Wuhan, China. Cd body burden was reflected by Cd concentrations in urine samples collected between gestational weeks 8 and 14. GDM was diagnosed according to International Association of Diabetes and Pregnancy Study Groups Consensus Panel (IADPSG) recommendations.

RESULTS
The geometric mean of Cd concentrations in maternal urine of all pregnant women was 0.59μg/L. A total of 198 (9.8%) women were diagnosed with GDM. After adjustment for potential confounders, the risk ratios (RRs) of GDM were 1.04 (95% CI: 0.74, 1.44) for the middle tertile of Cd levels and 1.36 (95%: CI: 0.98, 1.90) for the top tertile compared with the bottom tertile. In addition, we found a significant interaction between fetal sex and maternal Cd levels on the risk of GDM (p for interaction=0.03). Among women carrying male fetuses, the RR of GDM was 1.86 (95% CI: 1.14, 2.93) for the top tertile of Cd levels compared with the bottom tertile.

CONCLUSIONS
To our knowledge, this is the first report of an association between urinary Cd levels in early pregnancy and GDM. Our findings suggest that Cd body burden increases the risk of GDM and that the association may be modified by fetal sex. https://doi.org/10.1289/EHP2716.

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