Urine exposure level of trace element in early pregnancy and the risk of gestational diabetes mellitus: a Wuhan cohort study.

Trace elements play an important role in gestational diabetes mellitus (GDM), but the results from reported studies are inconsistent. This study aimed to explore the association between urine exposure levels of Zinc (Zn), Copper (Cu), Selenium (Se), Strontium (Sr), Iron (Fe), Manganese (Mn), and Chromium (Cr) in early pregnancy and the risk of GDM. Additionally, the potential modifying effects of infant sex and maternal age were assessed. This was a nested case-control study with data from the Wuhan Healthy Baby Cohort (WHBC) in 2016-2018. A total of 300 GDM cases and individually matched 300 cases in control group were included in the study. The conditional logistic regression model was used to analyze the association between trace elements exposure in urine and the risk of GDM. We also explored whether the urine exposure levels of trace elements-GDM risk associations were modified by maternal age and infant sex. An interquartile range in urine exposure levels of Fe, Mn, and Cr was associated with a significant decrease in risk of GDM [OR = 0.79 (95% CI 0.66-0.86), OR = 0.56 (95% CI 0.44-0.72), OR = 0.45 (95% CI 0.35-0.59)], respectively. Further analyses indicated infant sex had an interaction between Cr and GDM risk (p-interaction = 0.03). Urine exposure levels of Fe, Mn, and Cr were negatively associated with the risk of GDM. Compared to male fetal pregnant women, the association of GDM risk with Cr was more significant decrease in female fetal pregnant women.