Johns Lauren E, Ferguson Kelly K, Cantonwine David E, McElrath Thomas F, Mukherjee Bhramar, Meeker John D
Department of Environmental Health Sciences, University of Michigan School of Public Health , Ann Arbor, Michigan, USA.
Epidemiology Branch, National Institute of Environmental Health Sciences , National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA.
Environ Health Perspect. 2017 Aug 31;125(8):087026. doi: 10.1289/EHP1178.
In addition to its well-established role in maintaining skeletal health, vitamin D has essential regulatory functions in female reproductive and pregnancy outcomes. Phthalates and bisphenol A (BPA) are endocrine disruptors, and previous research has suggested that these chemical agents may disrupt circulating levels of total 25(OH)D in adults.
We investigated the relationships between repeated measures of urinary phthalate metabolites and BPA and circulating total 25(OH)D in a prospective cohort of pregnant women.
The present study population includes participants (n=477) in a nested case-control study of preterm birth drawn from a prospective birth cohort of pregnant women at Brigham and Women's Hospital in Boston, Massachusetts. Urine and blood samples were collected for biomarker measurements at median 10 wk and 26 wk of gestation.
In repeated measures analysis, we observed that an interquartile range (IQR) increase in urinary mono-3-carboxypropyl phthalate (MCPP) was associated with a 4.48% decrease [95% confidence interval (CI): -7.37, -1.58] in total 25(OH)D. We also detected inverse associations for metabolites of di(2-ethylhexyl) phthalate (DEHP) [percent difference (%Δ)=-2.83 to -2.16]. For BPA, we observed a nonsignificant inverse association with total 25(OH)D in the overall population. Our sensitivity analysis revealed that the associations for some metabolites (e.g., MEHP) varied by race/ethnicity, which may reflect potential differences in susceptibility. In agreement with findings from repeated measures analysis, we reported that DEHP metabolites and BPA were significantly associated with an approximate 20% increase in the odds of vitamin D deficiency (≤20 ng/mL) [odds ratio (95% CI): 1.19 (1.06, 1.35) for molar sum of DEHP metabolites and 1.22 (1.01, 1.47) for BPA] at median 10 wk and 26 wk, respectively.
Our results provide suggestive evidence of the potential for environmental exposure to phthalates and/or BPA to disrupt circulating vitamin D levels in pregnancy. https://doi.org/10.1289/EHP1178.
维生素D除了在维持骨骼健康方面具有公认的作用外，在女性生殖和妊娠结局中也具有重要的调节功能。邻苯二甲酸盐和双酚A（BPA）是内分泌干扰物，先前的研究表明，这些化学物质可能会扰乱成年人血液中总25（OH）D的水平。
我们在一个前瞻性孕妇队列中，研究了尿中邻苯二甲酸酯代谢物和双酚A的重复测量值与血液中总25（OH）D之间的关系。
本研究人群包括从马萨诸塞州波士顿布里格姆妇女医院的一个前瞻性孕妇出生队列中选取的477名参与者，这些参与者来自一项早产的巢式病例对照研究。在妊娠第10周和第26周的中位数时间采集尿液和血液样本进行生物标志物测量。
在重复测量分析中，我们观察到尿中邻苯二甲酸单-3-羧丙酯（MCPP）增加一个四分位数间距（IQR）与总25（OH）D降低4.48%相关[95%置信区间（CI）：-7.37，-1.58]。我们还检测到邻苯二甲酸二（2-乙基己基）酯（DEHP）代谢物的负相关关系[差异百分比（%Δ）=-2.83至-2.16]。对于双酚A，我们在总体人群中观察到与总25（OH）D的负相关关系不显著。我们的敏感性分析显示，某些代谢物（如MEHP）的相关性因种族/民族而异，这可能反映了易感性的潜在差异。与重复测量分析的结果一致，我们报告称，在妊娠第10周和第26周的中位数时间，DEHP代谢物和双酚A分别与维生素D缺乏（≤20 ng/mL）几率增加约20%显著相关[比值比（95% CI）：DEHP代谢物摩尔总和为1.19（1.06，1.35），双酚A为1.22（1.01，1.47）]。
我们的结果提供了提示性证据，表明孕期环境暴露于邻苯二甲酸盐和/或双酚A有可能扰乱循环中的维生素D水平。https://doi.org/10.1289/EHP1178
