State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, China; NHC Key Laboratory of Food Safety Risk Assessment, China National Center for Food Safety Risk Assessment, Beijing, China.
NHC Key Laboratory of Food Safety Risk Assessment, China National Center for Food Safety Risk Assessment, Beijing, China.
Environ Int. 2019 Jun;127:85-93. doi: 10.1016/j.envint.2019.03.035. Epub 2019 Mar 23.
Biomonitoring studies have shown the presence of structurally diverse perfluoroalkyl acids (PFAAs) in humans but only a few studies are available regarding the differential structural effects of PFAAs on human health.
The specific association between different structural PFAAs and both gestational diabetes mellitus (GDM) and glucose homeostasis in pregnant women was investigated.
A prospective nested case-control study including 439 women was conducted during 2013-2015 in Beijing, China. First trimester maternal serum was collected and analyzed for 25 diverse PFAAs with varying carbon chain lengths, linear/branched isomers and carboxylate or sulfonate functional groups. The analyzed PFAAs were grouped into different exposure variables depending on structure characteristics. GDM cases were diagnosed at 24-28 weeks of gestation and individually matched in a 1:2 ratio to controls. Conditional logistic and linear regression was used to evaluate the association between structurally grouped PFAAs and both GDM risk and glucose homeostasis parameters.
Among the 25 PFAAs, 12 perfluoroalkyl carboxylates (PFCAs) and 8 perfluoroalkyl sulfonates (PFSAs) were detected in >55.0% of samples and were respectively grouped into different structural groups. The structural-based effect was observed for PFCAs, where short-chain (C4-C7) PFCAs continuous level was significantly associated with GDM with an estimated odds ratio (OR) of 1.99 (95% CI: 1.29, 3.09), and the multivariable-adjusted ORs (95% CI) of GDM for increasing tertiles of short-chain PFCAs were 1.00 (ref.), 1.82 (0.80, 4.16) and 3.01 (1.31, 6.94), P trend = 0.011. Additionally, increased concentration of short-chain PFCAs was significantly associated with higher postprandial glucose levels (P < 0.05). Non-significant association was observed between structure grouped PFSAs and GDM as well as glucose homeostasis.
This investigation suggests a structure-specific association between short-chain PFCAs exposure and both GDM risk and impaired glucose homeostasis in pregnant women. These findings warrant further investigation with larger samples and a wide range of short-chain PFCAs exposure.
生物监测研究表明，人体中存在结构多样的全氟烷基酸（PFAAs），但关于 PFAAs 对人体健康的不同结构影响的研究较少。
本研究旨在探讨不同结构的 PFAAs 与孕妇妊娠糖尿病（GDM）和葡萄糖稳态之间的特定关联。
2013-2015 年期间，在中国北京进行了一项前瞻性嵌套病例对照研究，共纳入 439 名女性。采集孕妇妊娠早期的血清样本，并使用气相色谱-串联质谱法检测 25 种不同碳链长度、直链/支链异构体以及羧酸根或磺酸根官能团的 PFAAs。根据结构特征，将分析得到的 PFAAs 分为不同的暴露变量。GDM 病例在妊娠 24-28 周时确诊，并以 1:2 的比例与对照组进行个体匹配。采用条件逻辑回归和线性回归评估结构分组 PFAAs 与 GDM 风险和葡萄糖稳态参数之间的关联。
在所检测的 25 种 PFAAs 中，有 12 种全氟烷基羧酸（PFCAs）和 8 种全氟烷基磺酸（PFSAs）在>55.0%的样本中被检出，并分别归入不同的结构组。在 PFCAs 中观察到结构相关的影响，其中短链（C4-C7）PFCAs 的连续水平与 GDM 显著相关，估计比值比（OR）为 1.99（95%置信区间：1.29，3.09），短链 PFCAs 三分位组的多变量校正 OR（95%置信区间）分别为 1.00（参考）、1.82（0.80，4.16）和 3.01（1.31，6.94），P 趋势=0.011。此外，短链 PFCAs 浓度的增加与餐后血糖水平升高显著相关（P<0.05）。结构分组的 PFSAs 与 GDM 以及葡萄糖稳态之间无显著关联。
本研究提示，短链 PFCAs 暴露与孕妇 GDM 风险和葡萄糖稳态受损之间存在结构特异性关联。这些发现需要进一步研究，以扩大样本量并涵盖更广泛的短链 PFCAs 暴露范围。
