In utero exposure to mercury and childhood overweight or obesity: Counteracting effect of maternal folate status

Guoying Wang, Jessica Dibari, Eric Bind, Andrew M. Steffens, Jhindan Mukherjee, Tami R. Bartell, David C. Bellinger, Xiumei Hong, Yuelong Ji, Mei Cheng Wang, Marsha Wills-Karp, Tina L. Cheng, Xiaobin Wang

Research output: Contribution to journalArticle

Abstract

Background: Low-dose mercury (Hg) exposure has been associated with cardiovascular diseases, diabetes, and obesity in adults, but it is unknown the metabolic consequence of in utero Hg exposure. This study aimed to investigate the association between in utero Hg exposure and child overweight or obesity (OWO) and to explore if adequate maternal folate can mitigate Hg toxicity. Methods: This prospective study included 1442 mother-child pairs recruited at birth and followed up to age 15 years. Maternal Hg in red blood cells and plasma folate levels were measured in samples collected 1-3 days after delivery (a proxy for third trimester exposure). Adequate folate was defined as plasma folate ≥ 20.4 nmol/L. Childhood OWO was defined as body mass index ≥ 85% percentile for age and sex. Results: The median (interquartile range) of maternal Hg levels were 2.11 (1.04-3.70) μg/L. Geometric mean (95% CI) of maternal folate levels were 31.1 (30.1-32.1) nmol/L. Maternal Hg levels were positively associated with child OWO from age 2-15 years, independent of maternal pre-pregnancy OWO, diabetes, and other covariates. The relative risk (RR = 1.24, 95% CI 1.05-1.47) of child OWO associated with the highest quartile of Hg exposure was 24% higher than those with the lowest quartile. Maternal pre-pregnancy OWO and/or diabetes additively enhanced Hg toxicity. The highest risk of child OWO was found among children of OWO and diabetic mothers in the top Hg quartile (RR = 2.06; 95% CI 1.56-2.71) compared to their counterparts. Furthermore, adequate maternal folate status mitigated Hg toxicity. Given top quartile Hg exposure, adequate maternal folate was associated with a 34% reduction in child OWO risk (RR = 0.66, 95% CI 0.51-0.85) as compared with insufficient maternal folate. There was a suggestive interaction between maternal Hg and folate levels on child OWO risk (p for interaction = 0.086). Conclusions: In this US urban, multi-ethnic population, elevated in utero Hg exposure was associated with a higher risk of OWO in childhood, and such risk was enhanced by maternal OWO and/or diabetes and reduced by adequate maternal folate. These findings underscore the need to screen for Hg and to optimize maternal folate status, especially among mothers with OWO and/or diabetes.

Original languageEnglish (US)
Article number216
JournalBMC medicine
Volume17
Issue number1
DOIs
StatePublished - Nov 28 2019

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Mercury
Folic Acid
Obesity
Mothers
Maternal Exposure
Pregnancy
Pediatric Obesity
Third Pregnancy Trimester
Proxy
Body Mass Index

Keywords

  • Diabetes
  • Folate
  • In utero
  • Mercury
  • Metal
  • Nutrient
  • Obesity
  • Overweight

ASJC Scopus subject areas

  • Medicine(all)

Cite this

In utero exposure to mercury and childhood overweight or obesity : Counteracting effect of maternal folate status. / Wang, Guoying; Dibari, Jessica; Bind, Eric; Steffens, Andrew M.; Mukherjee, Jhindan; Bartell, Tami R.; Bellinger, David C.; Hong, Xiumei; Ji, Yuelong; Wang, Mei Cheng; Wills-Karp, Marsha; Cheng, Tina L.; Wang, Xiaobin.

In: BMC medicine, Vol. 17, No. 1, 216, 28.11.2019.

Research output: Contribution to journalArticle

Wang, G, Dibari, J, Bind, E, Steffens, AM, Mukherjee, J, Bartell, TR, Bellinger, DC, Hong, X, Ji, Y, Wang, MC, Wills-Karp, M, Cheng, TL & Wang, X 2019, 'In utero exposure to mercury and childhood overweight or obesity: Counteracting effect of maternal folate status', BMC medicine, vol. 17, no. 1, 216. https://doi.org/10.1186/s12916-019-1442-2
Wang, Guoying ; Dibari, Jessica ; Bind, Eric ; Steffens, Andrew M. ; Mukherjee, Jhindan ; Bartell, Tami R. ; Bellinger, David C. ; Hong, Xiumei ; Ji, Yuelong ; Wang, Mei Cheng ; Wills-Karp, Marsha ; Cheng, Tina L. ; Wang, Xiaobin. / In utero exposure to mercury and childhood overweight or obesity : Counteracting effect of maternal folate status. In: BMC medicine. 2019 ; Vol. 17, No. 1.
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title = "In utero exposure to mercury and childhood overweight or obesity: Counteracting effect of maternal folate status",
abstract = "Background: Low-dose mercury (Hg) exposure has been associated with cardiovascular diseases, diabetes, and obesity in adults, but it is unknown the metabolic consequence of in utero Hg exposure. This study aimed to investigate the association between in utero Hg exposure and child overweight or obesity (OWO) and to explore if adequate maternal folate can mitigate Hg toxicity. Methods: This prospective study included 1442 mother-child pairs recruited at birth and followed up to age 15 years. Maternal Hg in red blood cells and plasma folate levels were measured in samples collected 1-3 days after delivery (a proxy for third trimester exposure). Adequate folate was defined as plasma folate ≥ 20.4 nmol/L. Childhood OWO was defined as body mass index ≥ 85{\%} percentile for age and sex. Results: The median (interquartile range) of maternal Hg levels were 2.11 (1.04-3.70) μg/L. Geometric mean (95{\%} CI) of maternal folate levels were 31.1 (30.1-32.1) nmol/L. Maternal Hg levels were positively associated with child OWO from age 2-15 years, independent of maternal pre-pregnancy OWO, diabetes, and other covariates. The relative risk (RR = 1.24, 95{\%} CI 1.05-1.47) of child OWO associated with the highest quartile of Hg exposure was 24{\%} higher than those with the lowest quartile. Maternal pre-pregnancy OWO and/or diabetes additively enhanced Hg toxicity. The highest risk of child OWO was found among children of OWO and diabetic mothers in the top Hg quartile (RR = 2.06; 95{\%} CI 1.56-2.71) compared to their counterparts. Furthermore, adequate maternal folate status mitigated Hg toxicity. Given top quartile Hg exposure, adequate maternal folate was associated with a 34{\%} reduction in child OWO risk (RR = 0.66, 95{\%} CI 0.51-0.85) as compared with insufficient maternal folate. There was a suggestive interaction between maternal Hg and folate levels on child OWO risk (p for interaction = 0.086). Conclusions: In this US urban, multi-ethnic population, elevated in utero Hg exposure was associated with a higher risk of OWO in childhood, and such risk was enhanced by maternal OWO and/or diabetes and reduced by adequate maternal folate. These findings underscore the need to screen for Hg and to optimize maternal folate status, especially among mothers with OWO and/or diabetes.",
keywords = "Diabetes, Folate, In utero, Mercury, Metal, Nutrient, Obesity, Overweight",
author = "Guoying Wang and Jessica Dibari and Eric Bind and Steffens, {Andrew M.} and Jhindan Mukherjee and Bartell, {Tami R.} and Bellinger, {David C.} and Xiumei Hong and Yuelong Ji and Wang, {Mei Cheng} and Marsha Wills-Karp and Cheng, {Tina L.} and Xiaobin Wang",
year = "2019",
month = "11",
day = "28",
doi = "10.1186/s12916-019-1442-2",
language = "English (US)",
volume = "17",
journal = "BMC Medicine",
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TY - JOUR

T1 - In utero exposure to mercury and childhood overweight or obesity

T2 - Counteracting effect of maternal folate status

AU - Wang, Guoying

AU - Dibari, Jessica

AU - Bind, Eric

AU - Steffens, Andrew M.

AU - Mukherjee, Jhindan

AU - Bartell, Tami R.

AU - Bellinger, David C.

AU - Hong, Xiumei

AU - Ji, Yuelong

AU - Wang, Mei Cheng

AU - Wills-Karp, Marsha

AU - Cheng, Tina L.

AU - Wang, Xiaobin

PY - 2019/11/28

Y1 - 2019/11/28

N2 - Background: Low-dose mercury (Hg) exposure has been associated with cardiovascular diseases, diabetes, and obesity in adults, but it is unknown the metabolic consequence of in utero Hg exposure. This study aimed to investigate the association between in utero Hg exposure and child overweight or obesity (OWO) and to explore if adequate maternal folate can mitigate Hg toxicity. Methods: This prospective study included 1442 mother-child pairs recruited at birth and followed up to age 15 years. Maternal Hg in red blood cells and plasma folate levels were measured in samples collected 1-3 days after delivery (a proxy for third trimester exposure). Adequate folate was defined as plasma folate ≥ 20.4 nmol/L. Childhood OWO was defined as body mass index ≥ 85% percentile for age and sex. Results: The median (interquartile range) of maternal Hg levels were 2.11 (1.04-3.70) μg/L. Geometric mean (95% CI) of maternal folate levels were 31.1 (30.1-32.1) nmol/L. Maternal Hg levels were positively associated with child OWO from age 2-15 years, independent of maternal pre-pregnancy OWO, diabetes, and other covariates. The relative risk (RR = 1.24, 95% CI 1.05-1.47) of child OWO associated with the highest quartile of Hg exposure was 24% higher than those with the lowest quartile. Maternal pre-pregnancy OWO and/or diabetes additively enhanced Hg toxicity. The highest risk of child OWO was found among children of OWO and diabetic mothers in the top Hg quartile (RR = 2.06; 95% CI 1.56-2.71) compared to their counterparts. Furthermore, adequate maternal folate status mitigated Hg toxicity. Given top quartile Hg exposure, adequate maternal folate was associated with a 34% reduction in child OWO risk (RR = 0.66, 95% CI 0.51-0.85) as compared with insufficient maternal folate. There was a suggestive interaction between maternal Hg and folate levels on child OWO risk (p for interaction = 0.086). Conclusions: In this US urban, multi-ethnic population, elevated in utero Hg exposure was associated with a higher risk of OWO in childhood, and such risk was enhanced by maternal OWO and/or diabetes and reduced by adequate maternal folate. These findings underscore the need to screen for Hg and to optimize maternal folate status, especially among mothers with OWO and/or diabetes.

AB - Background: Low-dose mercury (Hg) exposure has been associated with cardiovascular diseases, diabetes, and obesity in adults, but it is unknown the metabolic consequence of in utero Hg exposure. This study aimed to investigate the association between in utero Hg exposure and child overweight or obesity (OWO) and to explore if adequate maternal folate can mitigate Hg toxicity. Methods: This prospective study included 1442 mother-child pairs recruited at birth and followed up to age 15 years. Maternal Hg in red blood cells and plasma folate levels were measured in samples collected 1-3 days after delivery (a proxy for third trimester exposure). Adequate folate was defined as plasma folate ≥ 20.4 nmol/L. Childhood OWO was defined as body mass index ≥ 85% percentile for age and sex. Results: The median (interquartile range) of maternal Hg levels were 2.11 (1.04-3.70) μg/L. Geometric mean (95% CI) of maternal folate levels were 31.1 (30.1-32.1) nmol/L. Maternal Hg levels were positively associated with child OWO from age 2-15 years, independent of maternal pre-pregnancy OWO, diabetes, and other covariates. The relative risk (RR = 1.24, 95% CI 1.05-1.47) of child OWO associated with the highest quartile of Hg exposure was 24% higher than those with the lowest quartile. Maternal pre-pregnancy OWO and/or diabetes additively enhanced Hg toxicity. The highest risk of child OWO was found among children of OWO and diabetic mothers in the top Hg quartile (RR = 2.06; 95% CI 1.56-2.71) compared to their counterparts. Furthermore, adequate maternal folate status mitigated Hg toxicity. Given top quartile Hg exposure, adequate maternal folate was associated with a 34% reduction in child OWO risk (RR = 0.66, 95% CI 0.51-0.85) as compared with insufficient maternal folate. There was a suggestive interaction between maternal Hg and folate levels on child OWO risk (p for interaction = 0.086). Conclusions: In this US urban, multi-ethnic population, elevated in utero Hg exposure was associated with a higher risk of OWO in childhood, and such risk was enhanced by maternal OWO and/or diabetes and reduced by adequate maternal folate. These findings underscore the need to screen for Hg and to optimize maternal folate status, especially among mothers with OWO and/or diabetes.

KW - Diabetes

KW - Folate

KW - In utero

KW - Mercury

KW - Metal

KW - Nutrient

KW - Obesity

KW - Overweight

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U2 - 10.1186/s12916-019-1442-2

DO - 10.1186/s12916-019-1442-2

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