1. A Case-Cohort Study of Cadmium Body Burden and Gestational Diabetes Mellitus in American Women.
- Author
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Romano, Megan E, Enquobahrie, Daniel A, Simpson, Christopher D, Checkoway, Harvey, and Williams, Michelle A
- Subjects
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AGE distribution , *BLACK people , *CADMIUM , *CHILDBIRTH , *CONFIDENCE intervals , *CREATININE , *GESTATIONAL diabetes , *GLUCOSE , *LONGITUDINAL method , *MATERNAL health services , *OBESITY , *RESEARCH funding , *WOMEN'S health , *ENVIRONMENTAL exposure , *CROSS-sectional method , *DATA analysis software , *DESCRIPTIVE statistics , *ODDS ratio - Abstract
BACKGROUND: Environmental cadmium (Cd) exposure is associated with type 2 diabetes. However, the association of Cd and gestational diabetes mellitus (GDM) is unknown. OBJECTIVES: We examined the association between body burden of Cd and GDM risk. METHODS: We used 140 GDM cases and 481 randomly selected noncase subcohort members from the Omega Study to conduct a case-cohort study. Creatinine (Cr)--corrected Cd in early pregnancy urine (U-Cd) was measured by inductively coupled plasma mass spectrometry. Tertiles (< 0.29; 0.29--0.42; > 0.43 μg/g Cr) were defined using the subcohort's U-Cd distribution. GDM was diagnosed using the 2004 American Diabetes Association guidelines. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression. RESULTS: GDM cases had higher geometric mean U-Cd (0.39 μg/g Cr; 95% CI: 0.37, 0.41) than noncases (0.31 μg/g Cr; 95% CI: 0.29, 0.33). Odds ratios for GDM increased with increasing U-Cd tertile (OR = 1.64; 95% CI: 0.88, 3.05 for middle vs. low tertile; OR = 2.07; 95% CI: 1.15, 3.73 for high vs. low tertile; p-trend = 0.015). Overweight/obesity (body mass index ≥ 25 kg/m²) did not modify the association between U-Cd and GDM (p = 0.26). CONCLUSIONS: Our findings suggest that body burden of Cd increases risk of GDM in a dose-dependent manner. Improved understanding of environmental factors influencing GDM may facilitate early identification of women at high risk of GDM. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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