Prenatal exposure to polycyclic aromatic hydrocarbons and phthalate acid esters and gestational diabetes mellitus: A prospective cohort study

IF 4.5 2区医学 Q1 INFECTIOUS DISEASES

International journal of hygiene and environmental health Pub Date : 2024-07-04 DOI:10.1016/j.ijheh.2024.114419

Minghao Guo , Yiwei Fang , Meilin Peng , Chao He , Jin Chen , Borui Sun , Chunyan Liu , Yuanzhong Zhou , Huiping Zhang , Kai Zhao

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引用次数: 0

Abstract

Background

Polycyclic aromatic hydrocarbons and phthalate acid esters (PAHs & PAEs), known as endocrine disrupting chemicals (EDCs), widely exist in daily life and industrial production. Previous studies have suggested that PAHs & PAEs may modify the intrauterine homeostasis and have adverse effects on fetal development. However, epidemiological evidence on the associations between PAHs & PAEs and gestational diabetes mellitus (GDM) is still limited.

Objective

To investigate the effects of prenatal PAHs &PAEs exposure on the risk of GDM and hyperglycemia in pregnant women.

Methods

The study population was a total of 725 pregnant women from a prospective birth cohort study conducted from December 2019 to December 2021. Blood glucose levels were collected by the hospital information system. Urinary PAHs & PAEs concentrations were determined by gas chromatography tandem mass spectrometry. The Poisson regression in a generalized linear model (GLM), multiple linear regression, quantile-based g-computation method (qgcomp), and Bayesian kernel machine regression (BKMR) were applied to explore and verify the individual and overall effects of PAHs & PAEs on glucose homeostasis. Potential confounders were adjusted in all statistical models.

Results

A total of 179 (24.69%) women were diagnosed with GDM. The Poisson regression suggested that a ln-unit increment of 4-OHPHE (4-hydroxyphenanthrene) (adjusted Risk Ratio (aRR) = 1.13; 1.02–1.26) was associated with the increased GDM risk. Mixed-exposure models showed similar results. We additionally found that MBZP (mono-benzyl phthalate) (aRR = 1.19; 1.02–1.39) was positively related to GDM risk in qgcomp model. Although neither model demonstrated that 2-OHNAP (2-hydroxynaphthalene) and 9-OHFLU (9-hydroxyfluorene) increased the risk of GDM, 2-OHNAP and 9-OHFLU exposure significantly increased blood glucose levels. BKMR model further confirmed that overall effects of PAHs & PAEs were significantly associated with the gestational hyperglycemia and GDM risk.

Conclusions

Our study presents that environmental exposure to PAHs & PAEs was positively associated with gestational glucose levels and the risks of developing GDM. In particular, 2-OHNAP, 9-OHFLU, 4-OHPHE and MBZP may serve as important surveillance markers to prevent the development of GDM.

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产前接触多环芳烃和邻苯二甲酸酯与妊娠糖尿病：一项前瞻性队列研究。

背景：多环芳烃和邻苯二甲酸酯（PAHs & PAEs）被称为内分泌干扰化学品（EDCs），广泛存在于日常生活和工业生产中。以往的研究表明，PAHs 和 PAEs 可能会改变胎儿宫内的稳态，对胎儿发育产生不利影响。然而，有关 PAHs 和 PAEs 与妊娠糖尿病（GDM）之间关系的流行病学证据仍然有限：调查产前多环芳烃和多环芳烃暴露对孕妇妊娠糖尿病和高血糖风险的影响：研究对象为2019年12月至2021年12月进行的一项前瞻性出生队列研究中的725名孕妇。血糖水平由医院信息系统收集。通过气相色谱串联质谱法测定尿液中 PAHs 和 PAEs 的浓度。应用广义线性模型泊松回归法（GLM）、多元线性回归法、基于量级的g计算法（qgcomp）和贝叶斯核机回归法（BKMR）来探讨和验证PAHs和PAEs对葡萄糖稳态的个体和整体影响。所有统计模型均调整了潜在的混杂因素：共有 179 名妇女（24.69%）被确诊为 GDM。泊松回归表明，4-OHPHE（4-羟基菲）的ln-单位增量（调整风险比（aRR）=1.13；1.02-1.26）与GDM风险的增加有关。混合暴露模型显示了类似的结果。我们还发现，在 qgcomp 模型中，MBZP（邻苯二甲酸单苄酯）（aRR = 1.19；1.02-1.39）与 GDM 风险呈正相关。虽然这两个模型都没有证明 2-OHNAP（2-羟基萘）和 9-OHFLU（9-羟基芴）会增加 GDM 风险，但 2-OHNAP 和 9-OHFLU 暴露会显著增加血糖水平。BKMR模型进一步证实，PAHs和PAEs的总体效应与妊娠高血糖和GDM风险密切相关：我们的研究表明，环境中暴露于 PAHs 和 PAEs 与妊娠期血糖水平和患 GDM 的风险呈正相关。其中，2-OHNAP、9-OHFLU、4-OHPHE 和 MBZP 可作为预防 GDM 发生的重要监测指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of hygiene and environmental health 医学-传染病学

CiteScore

11.50

自引率

5.00%

发文量

151

审稿时长

22 days

期刊介绍： The International Journal of Hygiene and Environmental Health serves as a multidisciplinary forum for original reports on exposure assessment and the reactions to and consequences of human exposure to the biological, chemical, and physical environment. Research reports, short communications, reviews, scientific comments, technical notes, and editorials will be peer-reviewed before acceptance for publication. Priority will be given to articles on epidemiological aspects of environmental toxicology, health risk assessments, susceptible (sub) populations, sanitation and clean water, human biomonitoring, environmental medicine, and public health aspects of exposure-related outcomes.