暴露于环境重金属可能是通过干预改良的先兆子痫(PE)的危险因素。这项病例对照研究旨在研究孕妇血清重金属浓度与PE之间的关系,以及激素是否在重金属对PE的影响中起中介作用。2020年10月至2022年,在东莞市松山湖中心医院招募PE患者160例、正常分娩孕妇160例。血清锰(Mn)浓度,镍(Ni),铜(Cu),锌(Zn),砷(As),镉(Cd),铅(Pb),β-人绒毛膜促性腺激素(β-hCG),孕酮(P),雌二醇(E2),睾酮(T),皮质醇(Cort),和可的松(Cor)进行测量。物流,受限三次样条,采用加权分位数和多元线性回归模型来解释不同方面,探索重金属之间的关系,荷尔蒙,和PE。进行了中介模型分析以评估激素在中介中的作用。Mn的中值浓度,PE组的E2和Cort低于对照组。铜的中值浓度,Zn,β-hCG,PE和T高于对照。Mn,E2和Cort与PE呈负相关,而Cu,Zn,β-hCG,T表现出积极的关联,通过逻辑回归确定。Mn,Cu,Zn与PE呈线性剂量-反应关系。Zn和Cu在混合重金属暴露与PE的正相关模型中具有很高的权重。中介分析显示血清E2、P、T,科特,和Cort/Cor可能是重金属(Mn,Cu,和Zn)和PE。
Exposure to environmental heavy metals may pose a risk factor for developing preeclampsia (PE) modified through intervention. This case-control
study aimed to investigate the association between serum heavy metal concentrations and PE in pregnant women and whether hormones served as mediating factors in the impact of heavy metals on PE. From October 2020 to 2022, 160 patients with PE and 160 pregnant women with normal deliveries were recruited at Dongguan Songshan Lake Central Hospital. Serum concentrations of manganese (Mn), nickel (Ni), copper (Cu), zinc (Zn), arsenic (As), cadmium (Cd), lead (Pb), β-human chorionic gonadotropin (β-hCG), progesterone (P), estradiol (E2), testosterone (T), cortisol (Cort), and cortisone (Cor) were measured. Logistic, restricted cubic splines, weighted quantile sum and multivariate linear regression models were employed to account for different aspects and explore the relationships among heavy metals, hormones, and PE. Mediation model analysis was performed to assess the role of hormones in mediation. The median concentrations of Mn, E2, and Cort were lower in the PE group than in the control group. The median concentrations of Cu, Zn, β-hCG, and T were higher in the PE than in the control. Mn, E2, and Cort showed negative associations with PE, while Cu, Zn, β-hCG, and T demonstrated positive associations, as determined through logistic regression. Mn, Cu, and Zn displayed linear dose-response relationships with PE. Zn and Cu had high weights in the positive association model of mixed heavy metal exposure with PE. The mediation analysis revealed that serum E2, P, T, Cort, and Cort/Cor might be potential mediators of the association between heavy metals (Mn, Cu, and Zn) and PE.