Abstract
Various studies have shown an association between metals exposure and gestational diabetes mellitus (GDM). However, the mediating mechanisms underlying this relationship remain unclear. This study mainly investigate the mediation effect of blood cell count in the relationship between metals exposure with blood glucose homeostasis during pregnancy.
Blood cell counts and six blood metals were measured in pregnant women at 10–12 weeks of gestation. An oral glucose tolerance test (OGTT) was performed to diagnose GDM in the second trimester. Bayesian kernel machine regression (BKMR) was used to analyze mixed- and single-metal exposure models. Linear and logistic regression models were used to assess associations of metal levels with blood cell counts, blood glucose levels, and GDM risk. The role of blood cell counts on the association between metal concentrations and levels of blood glucose was assessed using mediation analysis.
The single-exposure analysis indicated that blood zinc (Zn) exposure levels were significantly and positively correlated with OGTT glucose values and GDM risk. Mediation analysis revealed that the association of Zn with 1 h glucose, 2 h glucose, and AUC (area under the curve) was mediated by WBC counts and neutrophil counts.
This study demonstrated that WBC and neutrophil counts mediated the relationship between blood Zn exposure in early pregnancy and blood glucose homeostasis in the second trimester. These findings provide inspiration for further mechanism research.
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•The overexposure to zinc increase the risk of gestational diabetes mellitus.•White blood cell and neutrophil counts are positively associated with gestational diabetes mellitus.•White blood cell and neutrophil counts mediated the relationship between blood zinc exposure and gestational blood glucose.