孕妇尿砷水平与妊娠期糖尿病的相关性分析

Correlation Analysis Between Pregnant Women’s Urine Arsenic and Gestational Diabetes

目的探讨孕妇尿砷水平与妊娠期糖尿病的相关性。方法选择2017年2月至2018年1月在我院进行产检的孕妇244例进行研究。对孕妇尿砷水平进行检测并对数据进行孕妇社会人口信息采集及妊娠糖尿病诊断。根据妊娠糖尿病诊断结果将孕妇分为两组。采用多logistic回归模型,并根据年龄、教育水平、种族和孕前体质指数进行调整,评估孕妇砷暴露与妊娠期糖尿病的相关性。结果 244例孕妇中,21例被确诊为妊娠糖尿病。妊娠糖尿病与非妊娠糖尿病孕妇年龄、受教育年限、民族、婚姻状况、体质指数、孕次、吸烟史、饮用水类型等一般资料差异无统计学意义(P>0.05)。两组尿中总无机砷浓度、无机砷、MMA、DMA的平均百分比以及PMI、SMI对比差异均无统计学意义(P>0.05)。两组尿砷含量及甲基化指数差异无统计学意义(P>0.05)。两组DMA均占无机砷重量的80%以上。根据尿中总无机砷水平对患者进行分类,其中2.05~11.08μg/L为T1组,n=77;11.09~19.90μg/L为T2组,n=77,19.91~69.30μ/L为T3组,n=76。将尿无机砷模拟为连续变量和对数转化后均无关联(OR=0.98;95%IC=0.94~1.03)。粗略分析表明,中、高水平的总无机砷暴露增加了妊娠糖尿病的风险(OR=3.04,95%CI=0.92-10.02和OR=1.28,95%CI=0.33-4.98),但两者之间的关系无统计学意义。根据年龄、受教育程度、种族和体质指数进行调整后,差异无统计学意义。结论尿无机砷浓度与妊娠期糖尿病的发生未显示显著关系,其具体机制尚有待进一步研究。

Objective To explore the correlation between pregnant women’s urinary arsenic and gestational diabetes.Methods From February 2017 to January 2018,244 pregnant women who underwent obstetric examination in our hospital were selected for study.Urinary arsenic of pregnant women was tested,and the data were used to collect the social and demographic information of pregnant women and to diagnose gestational diabetes.According to the diagnosis of gestational diabetes,pregnant women were divided into 2 groups.A multiple logistic regression model was used and adjusted according to age,education level,ethnicity,and pre-pregnancy body mass index to assess the correlation between arsenic exposure in pregnant women and gestational diabetes.Results 244 pregnant women,21 were diagnosed with gestational diabetes.There was no statistically significant difference in general data such as age,education years,ethnicity,marital status,body mass index,second trimester,smoking history,drinking water type of pregnant women( P>0.05).There was no statistically significant difference in urine total arsenic concentration,average percentage of inorganic arsenic,MMA,DMA,and PMI,SMI( P>0.05).There was no significant difference in urine arsenic content and methylation index( P>0.05).All DMA accounted for more than 80% of the weight of inorganic arsenic.According to the total inorganic arsenic in urine,patients were classified: 2.05-11.08μg/L was T1 group,n = 77;11.09 ~ 19.90μg/L was T2 group,n = 77;19.91-69.30μ/L was T3 group,n = 76.Simulating urine inorganic arsenic as a continuous variable was not associated with logarithmic conversion( OR = 0.98,95% IC = 0.94 ~ 1.03).A rough analysis showed that medium and high levels of total inorganic arsenic exposure increased the risk of gestational diabetes( OR = 3.04,95% CI = 0.92-10.02 and OR = 1.28,95% CI =0.33-4.98),but the relationship is not statistically significant.After adjusting for age,education,race,and body mass index,the results did not change statistically.Conclusion Urinary inorganic arsenic has no a significant relationship with the occurrence of gestational diabetes,and its specific mechanism remains to be further studied.