夫妇孕前尿中必需微量元素浓度与自然流产风险：一项社区人群巢式病例对照研究

Couples' preconception urinary essential trace elements concentration and spontaneous abortion risk: A nested case-control study in a community population      

夫妇孕前尿中必需微量元素浓度与自然流产风险：一项社区人群巢式病例对照研究

Authors: Liao T, Ni F, Yang X, Liu J, Xia L, Yang Q, Gao X, Li C, Wang X, Wu C, Wang L, Bao S, Pan G, Liang C, Jiang H, Tao F, Shao S.

Source：Ecotoxicol Environ Saf. 2024 Jul 26;283:116764. doi: 10.1016/j.ecoenv.2024.116764.

Abstract

Background: Previous studies have indicated a correlation between maternal imbalances in essential trace elements during pregnancy and the occurrence of spontaneous abortion (SA). Nonetheless, the impact of these elements from both partners and during the preconception period remains unexplored.

Objective: This study sought to evaluate the relationship between preconception essential trace elements and spontaneous abortion (SA) based on husband-wife dyads.

Methods: This study selected 390 couples with spontaneous abortion (SA) and 390 matched couples with live births from a preconception cohort of 33,687 couples. Urine samples collected prior to pregnancy were analyzed for ten essential trace elements (Se, Cr, Mo, Cu, Zn, Fe, Mn, V, Co, and Ni) using inductively coupled plasma mass spectrometry (ICP-MS).

Results: Multivariate conditional logistic regression analysis identified that elevated concentrations of Zn (OR = 0.73) and Ni (OR = 0.69) in couples were associated with a reduced risk of SA, whereas elevated levels of Cr (OR = 1.30) and Mn (OR = 1.39) were linked to an increased risk. Restricted cubic spline models suggested a U-shaped association between couples' Cu and Co concentrations and SA. Bayesian Kernel Machine Regression further supported a U-shaped relationship between the mixture of ten elements and SA, showing significant protection at the 50th and 55th percentiles compared to the 10th percentile. Additionally, the effects of Cr, Zn, Mn, and Ni on SA varied when the concentrations of the other nine elements were held constant at their 25th, 50th, and 75th percentiles. Stratified analysis revealed that maternal Cu (OR = 0.43) and Fe (OR = 0.63) reduced the risk of SA when paternal Cu and Fe were in the lower quartile. Conversely, maternal Cu (OR = 2.03) and Fe (OR = 1.77) increased the risk of SA when paternal concentrations were in the higher quartile. Similar patterns were observed for Cr, Mn, Co, and Zn.

Conclusion: Elevated urinary concentrations of Zn and Ni in couples were associated with a reduced risk of SA, while higher levels of Cr and Mn were linked to an increased risk. Cu, Co, and a mixture of ten essential trace elements exhibited a U-shaped relationship with SA. The impact of certain essential trace elements (Cu, Fe, Cr, Mn, Co, and Zn) on SA in one partner was influenced by their concentrations in the other partner.

Keywords: Couples; Essential trace elements; Nested case-control study; Spontaneous abortion.

摘要

背景资料：以往的研究表明，母亲在怀孕期间的必需微量元素的不平衡和自然流产（SA）的发生之间的相关性。然而，来自伴侣双方和在怀孕前阶段的这些因素的影响仍然没有得到探讨。

目的：本研究以夫妻为研究对象，探讨孕前必需微量元素与自然流产的关系。

研究方法：本研究从33，687对夫妇的孕前队列中选择了390对自然流产（SA）夫妇和390对匹配的活产夫妇。采用电感耦合等离子体质谱法（ICP-MS）分析了妊娠前采集的尿液样本中的10种必需微量元素（Se、Cr、Mo、Cu、Zn、Fe、Mn、V、Co和Ni）。

结果如下：多变量条件逻辑回归分析发现，夫妇中锌（OR = 0.73）和镍（OR = 0.69）浓度升高与SA风险降低相关，而铬（OR = 1.30）和锰（OR = 1.39）水平升高与SA风险增加有关。限制性三次样条模型表明，夫妇的铜和钴浓度和SA之间的U形关联。贝叶斯核机器回归进一步支持十种元素的混合物和SA之间的U形关系，与第10百分位数相比，在第50和第55百分位数处显示出显著的保护作用。此外，铬，锌，锰，镍对SA的影响变化时，其他九种元素的浓度保持不变，在其第25，50，和75次。分层分析显示，当父亲铜和铁在下四分位数时，母亲铜（OR = 0.43）和铁（OR = 0.63）降低SA的风险。相反，母亲铜（OR = 2.03）和铁（OR = 1.77）增加SA的风险时，父亲的浓度在较高的四分位数。对于Cr、Mn、Co和Zn观察到类似的模式。

结论：夫妇中锌和镍的尿浓度升高与SA风险降低相关，而较高水平的铬和锰与风险增加相关。Cu、Co及10种必需微量元素的混合物与SA呈U型关系。某些必需的微量元素（铜，铁，铬，锰，钴，锌）对SA在一个合作伙伴的影响是由他们的浓度在其他合作伙伴。

关键词：夫妇;必需微量元素;巢式病例对照研究;自然流产