中国女性尿液双酚 A 浓度与妊娠糖尿病。
Urinary Bisphenol A Concentration and Gestational Diabetes Mellitus in Chinese Women.
机构信息
From the aMOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; bDepartment of Neonatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and cDepartments of Pathology and Bio-Bank, International Peace Maternal and Child Health Hospital, School of medicine, Shanghai Jiao Tong University, Shanghai, China.
出版信息
Epidemiology. 2017 Oct;28 Suppl 1:S41-S47. doi: 10.1097/EDE.0000000000000730.
BACKGROUND
Bisphenol A (BPA) has been associated with variable metabolic effects in animal models. It is unknown whether BPA exposure affects glucose tolerance in pregnancy. We aimed to investigate whether maternal urinary BPA concentration is associated with gestational diabetes mellitus (GDM).
METHODS
This study included 620 pregnant women from Shanghai, China 2012-2013. Maternal urinary BPA concentration was measured by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). GDM (n = 79) was diagnosed according to the criteria of the International Association of Diabetes and Pregnancy Study Groups (IADPSG). Multivariate regressions were used to explore the relationships of urinary BPA with GDM, plasma glucose levels in the 75-g 2-hour oral glucose tolerance test (OGTT), birth weight, and ponder index.
RESULTS
The geometric mean of BPA was 1.32 μg/L. After adjustment for maternal age, education, husband smoking status, prepregnancy body mass index (BMI), and urinary creatinine concentration, plasma glucose at 2 hours in the 75-g OGTT was 0.36 mmol/L lower (95% confidence index [CI] = -0.73, 0.01) for women with urine BPA in the high versus the low tertile. For each unit increase in natural log-transformed BPA, the odds of GDM was reduced by 27% (odds ratio (OR) = 0.73; 95% CI = 0.56, 0.97), the birth weight decreased by 25.70 g (95% CI = -54.48, 3.07), and ponder index was decreased by 0.02 (100 g/cm) (95% CI = -0.03, 0.00).
CONCLUSIONS
Higher maternal urinary BPA concentrations were associated with reduced risk of GDM and marginally lower birth weight and ponder index.
背景
双酚 A（BPA）在动物模型中与多种代谢效应有关。目前尚不清楚 BPA 暴露是否会影响妊娠期间的葡萄糖耐量。我们旨在研究母体尿液中 BPA 浓度是否与妊娠糖尿病（GDM）有关。
方法
本研究纳入了 2012-2013 年来自中国上海的 620 名孕妇。采用高效液相色谱-串联质谱法（HPLC-MS/MS）测定母体尿液中 BPA 浓度。根据国际妊娠糖尿病研究组（IADPSG）的标准诊断 GDM（n = 79）。采用多元回归分析来探讨尿液 BPA 与 GDM、75g 口服葡萄糖耐量试验（OGTT）2 小时后血浆葡萄糖水平、出生体重和体质指数的关系。
结果
BPA 的几何均数为 1.32μg/L。在校正了母亲的年龄、教育程度、丈夫吸烟状况、孕前体重指数（BMI）和尿肌酐浓度后，尿液 BPA 处于高四分位组的女性与低四分位组相比，2 小时 OGTT 时的血浆葡萄糖低 0.36mmol/L（95%置信区间 [CI] = -0.73，0.01）。自然对数转换后的 BPA 每增加一个单位，GDM 的几率降低 27%（比值比 [OR] = 0.73；95% CI = 0.56，0.97），出生体重降低 25.70g（95% CI = -54.48，3.07），体质指数降低 0.02（100g/cm）（95% CI = -0.03，0.00）。
结论
母体尿液中 BPA 浓度较高与 GDM 风险降低以及出生体重和体质指数略有降低有关。
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