Valvi Damaskini, Oulhote Youssef, Weihe Pal, Dalgård Christine, Bjerve Kristian S, Steuerwald Ulrike, Grandjean Philippe
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Environ Int. 2017 Oct;107:205-215. doi: 10.1016/j.envint.2017.07.016. Epub 2017 Jul 25.
Gestational diabetes mellitus (GDM) is associated with increased availability of glucose and macronutrients in fetal circulation and macrosomia. Therefore, the role of GDM in the association between metabolism-disrupting chemicals and birth size deserves attention.
We examined whether GDM may mediate or modify the associations between maternal environmental pollutant exposures and offspring birth size measures.
We analyzed 604 Faroese pregnant women and their offsprings born in 1997-2000. Maternal pregnancy serum concentrations of organochlorine compounds (OCs: polychlorinated biphenyl (PCB) congeners and dichlorodiphenyldichloroethylene (DDE)), and five perfluoroalkyl substances (PFASs), and hair and cord blood mercury concentrations were measured. We used regression (single-pollutants) and structural equation models (SEMs) (multiple-pollutant analyses using latent constructs of OCs, PFASs and mercury) to estimate the associations with GDM and birth size measures, accounting for mediation and/or effect modification by GDM.
Serum-DDE and hair-mercury concentrations were associated with GDM (adjusted OR per concentration doubling: 1.29; 95% CI: 0.94, 1.77 for DDE, and 0.79; 95% CI: 0.62, 0.99 for mercury), but in multiple pollutant-adjusted SEMs only a positive association between OC exposure and GDM remained significant (change in GDM odds per OC doubling: 0.45; 95% CI: 0.05, 0.86). PCB and overall OC exposure were positively associated with head circumference (SEM; mean change per OC doubling: 0.13cm; 95% CI, 0.01. 0.25). Overall PFAS exposure was inversely associated with birth weight (SEM; mean change per PFAS doubling: -169g; 95% CI: -359, 21), and for many single-PFASs we found a pattern of inverse associations with birth weight and head circumference in boys, and positive or null associations in girls. None of the environmental pollutants was associated with offspring length. GDM neither modified nor mediated the associations with birth size measures.
We found associations with GDM and offspring birth size to be specific to the environmental pollutant or pollutant group. Associations with birth size measures appear to be independent of GDM occurrence.
妊娠期糖尿病（GDM）与胎儿循环中葡萄糖和大量营养素的可利用性增加以及巨大儿有关。因此，GDM在破坏代谢的化学物质与出生体重之间的关联中所起的作用值得关注。
我们研究了GDM是否可能介导或改变母体环境污染物暴露与后代出生体重指标之间的关联。
我们分析了1997 - 2000年出生的604名法罗群岛孕妇及其后代。测量了孕妇孕期血清中有机氯化合物（OCs：多氯联苯（PCB）同系物和二氯二苯二氯乙烯（DDE））、五种全氟烷基物质（PFASs）的浓度，以及头发和脐带血中的汞浓度。我们使用回归分析（单污染物）和结构方程模型（SEMs）（使用OCs、PFASs和汞的潜在结构进行多污染物分析）来估计与GDM和出生体重指标的关联，并考虑GDM的中介作用和/或效应修正。
血清DDE和头发汞浓度与GDM有关（每浓度加倍的调整OR：DDE为1.29；95%CI：0.94，1.77；汞为0.79；95%CI：0.62，0.99），但在多污染物调整的SEMs中，仅OC暴露与GDM之间的正相关仍然显著（每OC浓度加倍时GDM发生几率的变化：0.45；95%CI：0.05，0.86）。PCB和总体OC暴露与头围呈正相关（SEM；每OC浓度加倍的平均变化：0.13cm；95%CI，0.01，0.25）。总体PFAS暴露与出生体重呈负相关（SEM；每PFAS浓度加倍的平均变化：-169g；95%CI：-359，21），对于许多单一PFASs，我们发现男孩中与出生体重和头围呈负相关的模式，而女孩中呈正相关或无关联。没有一种环境污染物与后代身长有关。GDM既没有改变也没有介导与出生体重指标的关联。
我们发现与GDM和后代出生体重的关联特定于环境污染物或污染物组。与出生体重指标的关联似乎独立于GDM的发生。
