Background

Epidemiological and toxicological evidence suggests that maternal total arsenic (As) levels are associated with an elevated risk of gestational diabetes (GDM). Uncertainty remains regarding the metabolic toxicity of specific arsenic species, comprised of both organic and inorganic sources of arsenic exposure.

Objectives

We assessed associations between speciated As and GDM using data from the Maternal-Infant Research on Environmental Chemicals (MIREC) Study.

Methods

Concentrations of speciated As [(inorganic (trivalent, pentavalent)), methylated arsenic species metabolites (monomethylarsonic acid (MMA), dimethylarsinic acid (DMA)), and organic (arsenobetaine)] were measured in first trimester maternal urine samples. GDM cases were identified in accordance with Canadian guidelines. Multivariable regression models were used to estimate associations between speciated As and GDM, evaluate potential interaction between speciated As exposures, and assess fetal sex-specific findings.

Results

Among 1243 women who had a live, singleton birth and no previous history of diabetes, 4% met the diagnostic criteria for GDM. Our analyses focused on DMA and arsenobetaine as these were the subtypes with detectable concentrations in at least 40% of samples. Compared to women in the lowest tertile of DMA (<1.49 μg As/L), women with concentrations exceeding 3.52 μg As/L (3rd tertile) experienced an increased risk of GDM (aOR = 3.86; 95% CI: 1.18, 12.57) (p-value for trend across tertiles = 0.04). When restricted to women carrying male infants, the magnitude of this association increased (aOR 3rd tertile = 4.71; 95% CI: 1.05, 21.10).

Conclusions

These results suggest a positive relation between DMA and GDM; potential differences in risk by fetal sex requires further investigation.

中文翻译：

---

加拿大女性队列中孕妇尿中特定砷浓度与妊娠糖尿病之间的关联

背景

流行病学和毒理学证据表明，孕妇总砷（As）水平与妊娠糖尿病（GDM）风险升高有关。关于特定砷物种的代谢毒性仍存在不确定性，这些砷包括有机和无机砷暴露源。

目标

我们使用来自母婴环境化学研究（MIREC）研究的数据评估了特定砷与GDM之间的关联。

方法

在孕早期的孕妇尿液样品中测量了特定砷的浓度（（无机（三价，五价）），甲基化的砷物质代谢物（单甲基ar酸（MMA），二甲基ar酸（DMA）和有机物（砷甜菜碱））的浓度。根据加拿大指南确定了GDM病例。多变量回归模型用于估计特定砷与GDM之间的关联，评估特定砷暴露之间的潜在相互作用以及评估胎儿性别特异性发现。

结果

在有活产，单胎出生且无糖尿病史的1243名妇女中，有4％符合GDM的诊断标准。我们的分析重点是DMA和砷基甜菜碱，因为它们是至少40％的样品中可检测到浓度的亚型。与DMA最低三分位数（<1.49μgAs / L）的女性相比，浓度超过3.52μgAs / L（第三三分位数）的女性发生GDM的风险增加（aOR = 3.86; 95％CI：1.18，12.57） （三分位数趋势的p值= 0.04）。当仅限于携带男婴的妇女时，这种关联的程度会增加（第三三分位数的aOR = 4.71； 95％CI：1.05，21.10）。

结论

这些结果表明DMA与GDM之间存在正相关关系。胎儿性别风险的潜在差异需要进一步调查。