Relation between cadmium exposure and gestational diabetes mellitus

Environ Int. 2018 Apr;113:300-305. doi: 10.1016/j.envint.2018.01.001. Epub 2018 Jan 17.


Background: Cadmium (Cd) has been associated with type 2 diabetes in general population. However, the role of Cd in the occurrence of Gestational diabetes mellitus (GDM) remains unclear.

Objectives: Our study was aimed at investigating whether Cd exposure during pregnancy was associated with increased risk of GDM.

Methods: Cd concentrations were measured in urine samples from 6837 pregnant women in Wuhan, China, from 2012 to 2014. A "modified Poisson" model with a robust error variance was used to examine the association of GDM with continuous natural logarithm (ln) transformed urinary Cd or quartiles of urinary Cd levels.

Results: For about 3-fold increase in Cd concentrations, there were 16% [relative risk (RR) =1.16; 95% confidence interval (CI): 1.03, 1.33] increase in risk of GDM. Compared with women in the lowest quartile of urinary Cd levels, women in the highest quartile had 1.30 higher risk of GDM [95% CI: 1.05, 1.61; p-trend <0.05]. Further analyses indicated overweight/obese women with higher urinary Cd levels had significantly higher risk of GDM, compared with women in the reference category of lowest quartile of Cd and normal pre-pregnancy body mass index [RR =2.71; 95% CI: 1.81, 4.07].

Conclusions: Our study presented a significantly positive association between urinary Cd levels and risk of GDM, supporting the hypothesis that environmental exposure to Cd may contribute to the development of GDM.

Keywords: Cadmium exposure; Gestational diabetes mellitus; Pregnant women.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Body Mass Index
  • Cadmium / toxicity*
  • Cadmium / urine
  • China
  • Diabetes, Gestational / chemically induced*
  • Environmental Exposure / adverse effects
  • Female
  • Humans
  • Obesity
  • Overweight
  • Pregnancy
  • Retrospective Studies
  • Risk Factors


  • Cadmium