Reference Values of 14 Serum Trace Elements for Pregnant Chinese Women: A Cross-Sectional Study in the China Nutrition and Health Survey 2010–2012
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Sample Collection, Preparation, and Determination
2.3. Anthropometric Status
2.4. Statistical Analysis
3. Results
3.1. Population Characteristics
3.2. Analytical Performances
3.3. Reference Values of Trace Elements in Serum
4. Discussions
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
- Strachan, S. Trace elements. Curr. Anaesth. Crit. Care 2010, 21, 44–48. [Google Scholar] [CrossRef]
- Angerer, J.; Ewers, U.; Wilhelm, M. Human biomonitoring: State of the art. Int. J. Hyg. Environ. Health 2007, 210, 201–228. [Google Scholar] [CrossRef] [PubMed]
- Rükgauer, M.; Klein, J.; Kruse-Jarres, J. Reference values for the trace elements copper, manganese, selenium, and zinc in the serum/plasma of children, adolescents, and adults. J. Trace Elem. Med. Biol. 1997, 11, 92–98. [Google Scholar] [CrossRef]
- Black, R.E. Micronutrients in pregnancy. Br. J. Nutr. 2001, 85, 193–197. [Google Scholar] [CrossRef]
- Ramakrishnan, U.; Manjrekar, R.; Rivera, J.; Gonzáles-Cossío, T.; Martorell, R. Micronutrients and pregnancy outcome: A review of the literature. Nutr. Res. 1999, 19, 103–159. [Google Scholar] [CrossRef]
- Schulz, C.; Wilhelm, M.; Heudorf, U.; Kolossa-Gehring, M. Update of the reference and HBM values derived by the German Human Biomonitoring Commission. Int. J. Hyg. Environ. Health 2011, 215, 26–35. [Google Scholar] [CrossRef] [PubMed]
- Woodruff, T.J.; Schwartz, J.M. Environmental chemicals in pregnant women in the United States: NHANES 2003–2004. Environ. Health Perspect. 2011, 119, 878–885. [Google Scholar] [CrossRef] [PubMed]
- Haines, D.A.; Saravanabhavan, G.; Werry, K.; Khoury, C. An overview of human biomonitoring of environmental chemicals in the Canadian Health Measures Survey: 2007–2019. Int. J. Hyg. Environ. Health 2016, S1438–S4639. [Google Scholar] [CrossRef] [PubMed]
- Lee, J.W.; Lee, C.K.; Moon, C.S.; Choi, I.J.; Lee, K.J.; Yi, S.-M.; Jang, B.-K.; Yoon, B.J.; Kim, D.S.; Peak, D.; et al. Korea National Survey for Environmental Pollutants in the Human Body 2008: Heavy metals in the blood or urine of the Korean population. Int. J. Hyg. Environ. Health 2012, 215, 449–457. [Google Scholar] [CrossRef] [PubMed]
- Freire, C.; Koifman, R.J.; Fujimoto, D.; de Oliveira Souza, V.C.; Barbosa, F.; Koifman, S. Reference values of cadmium, arsenic and manganese in blood and factors associated with exposure levels among adult population of Rio Branco, Acre, Brazil. Chemosphere 2015, 128, 70–78. [Google Scholar] [CrossRef] [PubMed]
- Clinical and Laboratory Standard Institute. Defining, Establishing, and Verifying Reference Intervals in The Clinical Laboratory; Approved Guideline; CLSI Document; Technical Report C280A3; Clinical and Laboratory Standards Institute: Wayne, PA, USA, October 2010. [Google Scholar]
- World Medical Association. Declaration of Helsinki: Ethical principles for medical research involving human subjects. J. Postgrad. Med. 2002, 48, 206. [Google Scholar]
- Liu, X.B.; Huang, Z.W.; Zhang, S.Q.; Li, W.D.; Tian, Y.; Yang, X.G. Determination of 16 selected trace elements in children plasma from China economical developed rural areas using high-resolution magnetic sector inductively coupled mass spectrometry. J. Anal. Methods Chem. 2014, 2014, 1–6. [Google Scholar] [CrossRef] [PubMed]
- World Health Organization. Obesity: Preventing and managing the global epidemic. WHO 2000, 894, 1–253. [Google Scholar]
- Sasse, E.A. How to Define And Determine Reference Intervals In The Clinical Laboratory: Approved Guideline; NCCLS document CA28-A2; Clinical and Laboratory Standards Institute: Wayne, PA, USA, 2000. [Google Scholar]
- Rodushkin, I.; Engström, E.; Stenberg, A.; Baxter, D.C. Determination of low-abundance elements at ultra-trace levels in urine and serum by inductively coupled plasma–sector field mass spectrometry. Anal. Bioanal. Chem. 2004, 380, 247–257. [Google Scholar] [CrossRef] [PubMed]
- Álvarez, S.I.; Castañón, S.G.; Ruata, M.L. C.; Aragüés, E.F.; Terraz, P.B.; Irazabal, Y.G.; Rodríguez, E.G. Updating of normal levels of copper, zinc and selenium in serum of pregnant women. J. Trace Elem. Med. Biol. 2007, 21, 49–52. [Google Scholar] [CrossRef] [PubMed]
- Martin-Lagos, F.; Navarro-Alarcon, M.; Terres-Martos, C.; Serrana, H.L.G.D.L.; Perez-Valero, V.; Lopez-Martinez, M.C. Zinc and copper concentrations in serum from Spanish women during pregnancy. Biol. Trace Elem. Res. 1998, 61, 61–70. [Google Scholar] [CrossRef] [PubMed]
- Shen, P.J.; Gong, B.; Xu, F.Y.; Luo, Y. Four trace elements in pregnant women and their relationships with adverse pregnancy outcomes. Eur. Rev. Med. Pharmacol. Sci. 2015, 19, 4690–4697. [Google Scholar] [PubMed]
- Wang, Y.; Tan, M.; Huang, Z.; Sheng, L.; Ge, Y.; Zhang, H.; Zhang, G. Elemental contents in serum of pregnant women with gestational diabetes mellitus. Biol. Trace Elem. Res. 2002, 88, 113–118. [Google Scholar] [CrossRef]
- Sarwar, M.S.; Ahmed, S.; Ullah, M.S.; Kabir, H.; Rahman, G.M.; Hasnat, A.; Islam, M.S. Comparative study of serum zinc, copper, manganese, and iron in preeclamptic pregnant women. Biol. Trace Elem. Res. 2013, 154, 14–20. [Google Scholar] [CrossRef] [PubMed]
- Al-Bader, A.; Hussain, T.; Al-Mosawi, M.; Otaibi, M.; Abul, H.; Khalifa, D.; Dashti, H. Serum zinc and copper concentrations in pregnant women from Kuwait. J. Trace Elem. Exp. Med. 1997, 10, 209–215. [Google Scholar] [CrossRef]
- Awadallah, S.M.; Abu-Elteen, K.H.; Elkarmi, A.Z.; Qaraein, S.H.; Salem, N.M.; Mubarak, M.S. Maternal and cord blood serum levels of zinc, copper, and iron in healthy pregnant Jordanian women. J. Trace Elem. Exp. Med. 2004, 17, 1–8. [Google Scholar] [CrossRef]
- Kilinc, M.; Coskun, A.; Bilge, F.; Imrek, S.S.; Atli, Y. Serum reference levels of selenium, zinc and copper in healthy pregnant women at a prenatal screening program in southeastern Mediterranean region of Turkey. J. Trace Elem. Med. Biol. 2010, 24, 152–156. [Google Scholar] [CrossRef] [PubMed]
- Al-Saleh, E.; Nandakumaran, M.; Al-Harmi, J.; Sadan, T.; Al-Enezi, H. Maternal-fetal status of copper, iron, molybdenum, selenium, and zinc in obese pregnant women in late gestation. Biol. Trace Elem. Res. 2006, 113, 113–123. [Google Scholar] [CrossRef]
- Omeljaniuk, W.J.; Socha, K.; Borawska, M.H.; Charkiewicz, A.E.; Laudański, T.; Kulikowski, M.; Kobylec, E. Antioxidant status in women who have had a miscarriage. Adv. Med. Sci. 2015, 60, 329–334. [Google Scholar] [CrossRef] [PubMed]
- Jain, R.B.; Choi, Y.C. Normal reference ranges for and variability in the levels of blood manganese and selenium by gender, age, and race/ethnicity for general US population. J. Trace Elem. Med. Biol. 2015, 30, 142–152. [Google Scholar] [CrossRef] [PubMed]
- Fatani, S.H.; Saleh, S.A.; Adly, H.M.; Abdulkhaliq, A.A. Trace Element Alterations in the Hair of Diabetic and Obese Women. Biol. Trace Elem. Res. 2016, 174, 32–39. [Google Scholar] [CrossRef] [PubMed]
- O’Brien, K.O.; Zavaleta, N.; Caulfield, L.E.; Wen, J.; Abrams, S.A. Prenatal iron supplements impair zinc absorption in pregnant Peruvian women. J. Nutr. 2000, 130, 2251–2255. [Google Scholar] [PubMed]
Variables | Number | Percent (%) |
---|---|---|
Total population | 1400 | 100 |
Age (year) | ||
18–25 | 528 | 39.5 |
26–30 | 505 | 37.8 |
31–44 | 304 | 22.7 |
Residences | ||
Urban | 586 | 46.9 |
Rural | 663 | 53.1 |
Anthropometric status | ||
Underweight | 78 | 5.8 |
Normal | 789 | 59.0 |
Overweight | 388 | 29.0 |
Obesity | 82 | 6.2 |
Pregnancy | ||
Trimester 1 | 291 | 21.8 |
Trimester 2 | 555 | 41.5 |
Trimester 3 | 491 | 36.7 |
Isotopes | LOQs (μg/L) | Concentration (μg/L) | CV % | Recoveries % | ||
---|---|---|---|---|---|---|
Certified/Spiked | Measured | Intra-Day | Inter-Day | |||
56Fe | 0.4 | 407 | 420 | 1.7 | 2.4 | 103.2 |
63Cu | 0.2 | 1390 ± 210 | 1426 ± 216 | 2.9 | 3.1 | 102.6 |
66Zn | 1.6 | 1090 ± 160 | 987 ± 145 | 1.8 | 1.9 | 90.6 |
85Rb | 0.2 | 244 | 220 | 2.7 | 3.1 | 90.2 |
77Se | 2.2 | 158 ± 31 | 174 ± 34 | 6.3 | 8.4 | 110.1 |
88Sr | 0.03 | 46 | 45 | 3.8 | 3.4 | 97.8 |
95Mo | 0.15 | 4.18 ± 1.26 | 4.4 ± 1.3 | 4.6 | 6.2 | 105.3 |
55Mn | 1.5 | 2.4 | 2.5 | 2.4 | 2.4 | 104.2 |
2°8Pb | 0.02 | 0.4 | 0.5 | 7.5 | 10.6 | 112.5 |
75As | 0.7 | 19.3 ± 3.8 | 20.3 ± 4.0 | 5.5 | 6.8 | 105.2 |
52Cr | 0.25 | 6.31 ± 1.26 | 6.5 ± 1.3 | 3.6 | 4.0 | 103.0 |
59Co | 0.06 | 5.77 ± 1.15 | 6.3 ± 1.3 | 2.8 | 2.9 | 109.2 |
51V | 0.02 | 12.6 ± 2.6 | 13.5 ± 2.8 | 2.7 | 2.9 | 107.1 |
111Cd | 0.02 | 5.39 ± 1.08 | 4.8 ± 1.0 | 4.4 | 3.5 | 89.1 |
Variables | Fe (μg/dL) | Cu (μg/dL) | Zn (μg/dL) | Rb (μg/dL) | Se (μg/L) | Sr (μg/L) | Mo (μg/L) | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
M0 | P2.5–P97.5 | M0 | P2.5–P97.5 | M0 | P2.5–P97.5 | M0 | P2.5–P97.5 | M0 | P2.5–P97.5 | M0 | P2.5–P97.5 | M0 | P2.5–P97.5 | |
Total | 131.5 | 55.8–265.0 | 195.5 | 107.0–362.4 | 74.0 | 51.8–111.3 | 22.3 | 14.0–62.0 | 72.2 | 39.9–111.6 | 45.9 | 23.8–104.3 | 1.8 | 1.2–3.6 |
Age (year) | ||||||||||||||
18-25 | 127.0 a | 55.6–247.0 | 196.0 a | 102.5–356.0 | 72.8 a | 51.3–107.4 | 22.4 a | 14.0–71.2 | 68.3 a | 37.3–107.5 | 47.8 a | 24.1–108.6 | 1.8 a | 1.2–3.5 |
26-30 | 138.0 a | 57.0–271.0 | 195.9 a | 109.0–360.5 | 75.2 b | 54.5–114.0 | 22.4 a | 14.4–61.0 | 75.0 b | 42.0–112.0 | 43.5 a | 24.0–100.5 | 1.8 a | 1.2–3.7 |
30-44 | 132.0 a | 56.0–273.0 | 194.0 a | 113.0–373.7 | 73.4 a,b | 51.6–110.0 | 21.6 b | 13.6–48.8 | 73.0 b | 41.0–118.0 | 45.0 a | 23.0–100.5 | 1.7 a | 1.1–3.5 |
Residences | ||||||||||||||
Urban | 135.0 a | 56.9–250.7 | 194.0 a | 108.0–302.0 | 74.8 a | 51.3–110.6 | 22.1 a | 14.0–43.2 | 75.2 a | 42.5–111.5 | 40.2 a | 23.0–97.3 | 1.7 a | 1.2–3.4 |
Rural | 127.6 a | 55.0–276.3 | 196.0 a | 107.0–426.0 | 73.2 a | 52.1–111.8 | 22.7 a | 14.0–80.4 | 69.5 b | 38.0–110.0 | 51.0 b | 24.3–109.8 | 1.8 b | 1.2–3.8 |
Anthropometric status | . | |||||||||||||
Underweight | 152.5 a | 82.7–281.4 | 193.0 a | 99.7–624.9 | 82.4 a | 58.0–150.3 | 24.9 a | 15.1–70.6 | 75.2 a | 52.2–144.1 | 43.4 a | 24.5–109.8 | 1.8 a | 1.2–3.9 |
Normal | 136.1 b | 57.0–265.3 | 193.2 a | 104.7–343.5 | 74.6 b | 53.4–110.5 | 22.4 a | 14.1–67.2 | 73.6 a | 40.6–111.9 | 44.9 a,b | 23.0–101.9 | 1.8 a | 1.2–3.7 |
Overweight | 118.8 c | 53.9–242.6 | 199.7 a | 117.0–378.4 | 72.7 c | 50.4–106.8 | 21.8 a | 13.9–60.9 | 68.2 b | 38.6–105.3 | 48.9 b,c | 24.9–109.9 | 1.8 a | 1.1–3.4 |
Obesity | 110.6 d | 48.8–222.7 | 212.2 b | 116.9–292.4 | 69.9 d | 50.9–90.8 | 21.5 a | 13.7–31.0 | 66.8 b | 37.3–99.5 | 50.1 c | 25.9–100.4 | 1.7 a | 1.1–2.8 |
Pregnancy | ||||||||||||||
Trimester 1 | 150.0 a | 70.9–285.6 | 157.5 a | 89.7–366.0 | 83.2 a | 57.7–129.5 | 22.9 a | 13.7–80.9 | 77.6 a | 44.0–112.0 | 43.2 a | 22.6–102.0 | 1.8 a | 1.2–3.6 |
Trimester 2 | 135.0 b | 59.2–261.3 | 198.6 b | 122.6–343.5 | 73.0 b | 53.4–102.6 | 21.9 a | 14.5–62.0 | 76.0 a | 42.5–112.0 | 42.2 a | 22.5–92.5 | 1.8 a | 1.2–3.5 |
Trimester 3 | 110.3 c | 52.2–260.7 | 208.2 c | 121.0–375.0 | 71.0 c | 49.4–110.0 | 22.4 a | 13.9–52.2 | 65.0 b | 38.0–105.0 | 52.8 b | 26.0–119.5 | 1.8 a | 1.1–3.7 |
Variables | Mn (μg/L) | Pb (μg/L) | As (μg/L) | Cr (ng/L) | Co (ng/L) | V (ng/L) | Cd (ng/L) | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
M0 | P2.5–P97.5 | M0 | P2.5–P97.5 | M0 | P2.5–P97.5 | M0 | P2.5–P97.5 | M0 | P2.5–P97.5 | M0 | P2.5–P97.5 | M0 | P2.5–P97.5 | |
Total | 2.4 | 1.2–8.4 | 1.9 | 0.6–9.0 | 1.1 | 0.3–5.6 | 835.6 | 219.8–4287.7 | 337.9 | 57.0–1130.0 | 193.2 | 23.6–2323.1 | 133.7 | 72.1–595.1 |
Age (year) | ||||||||||||||
18–25 | 2.4 | 1.3–9.0 | 1.9 | 0.6–8.2 | 1.1 a | 0.3–7.3 | 879.2 | 248.9–4295.3 | 353.2 | 68.5–1129.8 | 172.4 | 29.7–2130.5 | 126.2 a | 71.9–614.3 |
26–30 | 2.4 | 1.2–7.7 | 2.0 | 0.6–8.9 | 1.1 a | 0.4–4.5 | 798.0 | 205.0–3688.0 | 333.6 | 48.5–1085.5 | 208.3 | 17.5–2323.0 | 140.0 b | 73.0–549.0 |
31–44 | 2.3 | 1.1–8.4 | 2.0 | 0.5–10.5 | 1.3 b | 0.4–5.2 | 799.0 | 211.0–5546.0 | 333.0 | 89.0–1250.5 | 215.0 | 20.0–2486.0 | 137.5 b | 71.0–598.5 |
Residences | ||||||||||||||
Urban | 2.2 a | 1.1–8.4 | 2.1 a | 0.7–8.9 | 1.3 a | 0.4–4.7 | 845.5 | 79.0–5395.0 | 338.0 | 52.0–1250.6 | 218.4 a | 18.5–2625.5 | 139.3 a | 72.4–624.8 |
Rural | 2.5 b | 1.2–7.8 | 1.8 b | 0.5–9.2 | 1.0 b | 0.3–7.5 | 827.4 | 297.9–3387.0 | 339.0 | 73.9–1041.6 | 174.9 b | 31.0–1797.0 | 129.5 b | 71.3–563.9 |
Anthropometric status | ||||||||||||||
Underweight | 2.2 a | 1.2–6.5 | 2.2 a | 0.7–9.2 | 1.5 a | 0.4–4.4 | 909.0 a | 317.4–3135.6 | 234.0 a | 21.6–917.0 | 125.0 a | 13.6–2000.3 | 150.3 a | 72.8–426.2 |
Normal | 2.4 a | 1.2–9.2 | 1.9 a | 0.6–10.1 | 1.1 a | 0.4–5.4 | 815.2 a | 236.0–4587.5 | 317.9 b | 52.9–1083.3 | 201.2 b | 25.3–2485.7 | 137.8 a | 72.6–660.7 |
Overweight | 2.4 a | 1.2–7.0 | 1.9 a | 0.5–7.0 | 1.0 a | 0.3–5.7 | 835.5 a | 158.8–3913.2 | 391.0 c | 93.6–1219.9 | 209.3 b | 22.2–1965.6 | 125.5 b | 68.2–488.0 |
Obesity | 2.3 a | 1.4–9.2 | 1.7 a | 0.6–8.1 | 1.3 a | 0.4–7.3 | 881.9 a | 263.6–3320.8 | 394.3 c | 112.4–1113.1 | 182.0 b | 30.9–1885.6 | 115.3 b | 71.9–290.7 |
Pregnancy | ||||||||||||||
Trimester 1 | 2.4 | 1.1–9.2 | 2.1 a | 0.7–9.2 | 1.0 a | 0.4–4.7 | 888.0 a | 219.8–4287.7 | 217.6 a | 26.0–1093.9 | 206.8 a | 22.2–2401.3 | 136.5 a | 71.9–618.3 |
Trimester 2 | 2.3 | 1.1–8.4 | 1.8 b | 0.6–6.5 | 1.1 a | 0.3–6.4 | 789.5 a | 248.9–4295.3 | 313.0 b | 45.2–1083.0 | 178.4 a | 23.6–2564.2 | 133.2 a | 71.9–456.3 |
Trimester 3 | 2.5 | 1.4–7.7 | 2.0 a | 0.6–12.3 | 1.3 a | 0.3–5.0 | 837.0 a | 205.0–3688.0 | 432.0 c | 136.2–1206.0 | 203.0 a | 23.7–1965.6 | 134.0 a | 74.0–757.0 |
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Liu, X.; Zhang, Y.; Piao, J.; Mao, D.; Li, Y.; Li, W.; Yang, L.; Yang, X. Reference Values of 14 Serum Trace Elements for Pregnant Chinese Women: A Cross-Sectional Study in the China Nutrition and Health Survey 2010–2012. Nutrients 2017, 9, 309. https://doi.org/10.3390/nu9030309
Liu X, Zhang Y, Piao J, Mao D, Li Y, Li W, Yang L, Yang X. Reference Values of 14 Serum Trace Elements for Pregnant Chinese Women: A Cross-Sectional Study in the China Nutrition and Health Survey 2010–2012. Nutrients. 2017; 9(3):309. https://doi.org/10.3390/nu9030309
Chicago/Turabian StyleLiu, Xiaobing, Yu Zhang, Jianhua Piao, Deqian Mao, Yajie Li, Weidong Li, Lichen Yang, and Xiaoguang Yang. 2017. "Reference Values of 14 Serum Trace Elements for Pregnant Chinese Women: A Cross-Sectional Study in the China Nutrition and Health Survey 2010–2012" Nutrients 9, no. 3: 309. https://doi.org/10.3390/nu9030309