A Prospective Study of Early Pregnancy Essential Metal(loid)s and Glucose Levels Late in the Second Trimester

J Clin Endocrinol Metab. 2019 Oct 1;104(10):4295-4303. doi: 10.1210/jc.2019-00109.

Abstract

Context: Studies suggest many essential trace metal(loid)s are involved in glucose metabolism, but the associations among pregnant women are unclear.

Objective: To assess associations between early pregnancy plasma zinc, selenium, copper, and molybdenum levels and blood glucose levels later in the second trimester.

Design: The Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies‒Singleton Cohort is a prospective cohort study conducted between July 2009 and January 2013.

Setting: Twelve academic research hospitals in the United States.

Patients: A total of 1857 multiracial, nonobese, healthy women.

Main outcome measure: Blood glucose levels from 1-hour 50-g gestational load test (GLT) at 24 to 28 weeks of gestation.

Results: Higher concentrations of first-trimester copper were associated with higher glucose levels from the GLT (i.e., every 50% increase in copper concentration was related to 4.9 mg/dL higher glucose level; 95% CI: 2.2, 7.5 mg/dL) adjusted for maternal sociodemographic characteristics and reproductive history. In contrast, every 50% increase in molybdenum concentration was associated with 1.2 mg/dL lower mean glucose level (95% CI: -2.3, -0.1 mg/dL). The magnitude of these associations was greater at the upper tails of glucose level distribution based on quantile regressions of the 10th, 50th, and 90th percentiles.

Conclusions: Higher copper and lower molybdenum concentrations could increase the risk of glucose dysregulation during pregnancy, with women at higher risk of gestational diabetes mellitus potentially affected to a greater extent. Further work is needed to understand the mechanisms involved with early pregnancy essential metal(loid)s to inform clinical diagnosis and prevention of glucose intolerance during pregnancy.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Biomarkers
  • Blood Glucose / analysis*
  • Cohort Studies
  • Copper / blood*
  • Databases, Factual
  • Diabetes, Gestational / blood*
  • Diabetes, Gestational / diagnosis
  • Female
  • Follow-Up Studies
  • Gestational Weight Gain
  • Humans
  • Linear Models
  • Maternal Age
  • Molybdenum / blood
  • Multivariate Analysis
  • Pregnancy
  • Pregnancy Outcome*
  • Pregnancy Trimester, Second*
  • Prenatal Care / methods
  • Prospective Studies
  • Risk Assessment
  • Selenium / blood
  • United States
  • Young Adult
  • Zinc / blood

Substances

  • Biomarkers
  • Blood Glucose
  • Copper
  • Molybdenum
  • Selenium
  • Zinc