Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Environ Res. 2019 Jan;168:389-396. doi: 10.1016/j.envres.2018.10.009. Epub 2018 Oct 14.
A number of endocrine disrupting chemicals (EDC) have been associated with gestational diabetes (GDM) risk factors. However, no human study has investigated the association between pregnancy exposure to parabens, a class of EDCs, and pregnancy glucose levels, a risk factor for GDM. Furthermore, little is known about this association in subfertile women-a group at high risk of GDM.
A total of 241 women from the Environment and Reproductive Health Study had data available on 1st and/or 2nd trimester urinary methylparaben, propylparaben, and butylparaben concentrations, and blood glucose levels after the glucose loading test (GLT), a non-fasting 50 g glucose loading test taken at late 2nd trimester. Trimester-specific associations between specific gravity adjusted methylparaben, butylparaben, and propylparaben with adjusted mean of pregnancy glucose levels were evaluated in linear regression models, using quartiles of each paraben's distribution, and as a paraben mixture, using mutual adjustment and Bayesian kernel machine regression (BKMR), a recently proposed method for investigating chemical mixtures that flexibly models the joint effect of chemicals.
Investigating parabens one at the time did not provide any significant results. When investigating parabens as a chemical mixture with both multiple regression and BKMR, we observed positive associations of butylparaben (e.g comparing the 4th and 1st quartiles) with glucose levels, for both the 1st trimester (adjusted difference=12.5 mg/dL; 95% CI: 0.9, 24.2) and 2nd trimester (adjusted difference=11.2 mg/dL; 95% CI: 0.2, 22.3), and a negative association between 1st trimester propylparaben and glucose (adjusted difference=-22.3 mg/dL; 95% CI: -43.2, -1.4).
We found 1st trimester butylparaben and propylparaben urinary concentrations to be associated with glucose levels in a pregnancy cohort of women at high risk of GDM, even after adjusting for potential confounders. Because exposure to parabens is widespread, these findings may suggest further investigating the effects of this chemical class on pregnancy health.
一些内分泌干扰化学物质（EDC）与妊娠糖尿病（GDM）的危险因素有关。然而，尚无研究调查孕期接触对羟基苯甲酸酯（一种 EDC 类物质）与妊娠血糖水平（GDM 的危险因素）之间的关系。此外，对于受孕困难的女性（GDM 高危人群），人们对这种关联知之甚少。
环境与生殖健康研究中的 241 名女性有可用数据，包括第 1 期和/或第 2 期尿液中甲基对羟基苯甲酸酯、丙基对羟基苯甲酸酯和丁基对羟基苯甲酸酯浓度，以及第 2 孕期晚些时候进行的葡萄糖负荷试验（GLT）后的血糖水平。在线性回归模型中，使用各对羟基苯甲酸酯分布的四分位数评估特定比重调整后的甲基对羟基苯甲酸酯、丁基对羟基苯甲酸酯和丙基对羟基苯甲酸酯与妊娠血糖水平的调整平均值之间的 trimester 特异性关联，以及使用相互调整和贝叶斯核机器回归（BKMR）作为对羟基苯甲酸酯混合物，这是一种最近提出的用于研究灵活建模化学品联合效应的化学混合物的方法。
逐个研究对羟基苯甲酸酯时，没有发现任何显著结果。当使用多回归和 BKMR 作为化学混合物进行研究时，我们观察到丁基对羟基苯甲酸酯与血糖水平呈正相关，无论是在第 1 孕期（调整差异=12.5mg/dL；95%CI：0.9，24.2）还是第 2 孕期（调整差异=11.2mg/dL；95%CI：0.2，22.3），以及第 1 孕期丙基对羟基苯甲酸酯与血糖呈负相关（调整差异=-22.3mg/dL；95%CI：-43.2，-1.4）。
我们发现，在 GDM 高危妊娠队列中，即使在调整了潜在混杂因素后，第 1 孕期的丁基对羟基苯甲酸酯和丙基对羟基苯甲酸酯尿液浓度与血糖水平相关。由于对羟基苯甲酸酯的暴露非常普遍，这些发现可能表明需要进一步研究此类化学物质对妊娠健康的影响。
