Department of Health Statistics, School of Public Health, Weifang Medical University, Weifang, Shandong, China.
Minhang District Maternal and Child Health Hospital, Shanghai, China.
Environ Health. 2020 Aug 17;19(1):88. doi: 10.1186/s12940-020-00640-8.
Evidence on the association between exposure to perfluoroalkyl and polyfluoroalkyl substances (PFASs) and blood glucose concentrations in pregnant women is inconsistent. This study aimed to examine the association between PFAS exposure and the concentrations of fasting plasma glucose (FPG) and one-hour plasma glucose (1 h-PG) after a 50-g oral glucose tolerance test in pregnant women.
The study was based on the Shanghai-Minhang Birth Cohort, in which 1292 pregnant women were recruited. Among them, 981 women provided blood samples (at 12-16 gestational weeks) for PFAS measurement. FPG data collected from 856 women at 12-20 GW and 1 h-PG data collected from 705 women at 20-28 GW were obtained through medical records from the routine prenatal care system. High FPG or 1 h-PG was defined as ≥90th percentile of FPG or 1 h-PG. The analysis of eight PFASs was conducted in this study: perfluorohexane sulfonate (PFHxS), perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUdA), perfluorododecanoic acid (PFDoA), and perfluorotridecanoic acid (PFTrDA). The odds ratios (ORs) and associated 95% confidence intervals (CIs) were estimated to determine the associations of each PFAS compound with high FPG and 1 h-PG from a logistic regression model.
After adjustment for potential confounders, most PFASs were positively associated with high 1 h-PG concentrations. The OR for high 1 h-PG concentrations was 1.87 (95% CI: 1.15-3.05) with a one log unit increase of PFOS; similar associations were observed for PFNA (OR: 2.15, 95% CI: 1.24-3.74), PFDA (OR: 1.61, 95% CI: 1.10-2.44), PFUdA (OR: 1.71, 95% CI: 1.12-2.62), and PFDoA (OR: 1.34, 95% CI: 1.00-1.81). When the PFAS concentrations were categorized into three groups by tertiles, the highest tertiles of PFOS, PFOA, PFNA, PFDA, PFDoA, and PFTrDA had a statistically significant increase in the risk of high 1 h-PG concentrations compared with the lowest tertiles. No statistically significant association was observed between PFAS exposure and high FPG.
PFAS exposure was associated with an increased risk of high 1 h-PG among pregnant women, but no such association was observed for FPG.
关于接触全氟烷基和多氟烷基物质(PFAS)与孕妇血糖浓度之间的关联,目前的证据并不一致。本研究旨在探讨 PFAS 暴露与孕妇空腹血糖(FPG)和口服 50 克葡萄糖耐量试验后 1 小时血糖(1h-PG)浓度之间的关系。
本研究基于上海闵行出生队列,其中招募了 1292 名孕妇。其中,981 名孕妇在 12-16 孕周时提供了血液样本进行 PFAS 测量。通过常规产前保健系统的医疗记录,获得了 856 名孕妇在 12-20 孕周时的 FPG 数据和 705 名孕妇在 20-28 孕周时的 1h-PG 数据。高 FPG 或 1h-PG 定义为 FPG 或 1h-PG 大于等于第 90 百分位数。本研究对 8 种 PFAS 进行了分析:全氟己烷磺酸(PFHxS)、全氟辛烷磺酸(PFOS)、全氟辛酸(PFOA)、全氟壬酸(PFNA)、全氟癸酸(PFDA)、全氟十一烷酸(PFUdA)、全氟十二烷酸(PFDoA)和全氟十三烷酸(PFTrDA)。采用 logistic 回归模型估计每个 PFAS 化合物与高 FPG 和 1h-PG 的比值比(OR)及其相关的 95%置信区间(CI),以确定各 PFAS 化合物与高 FPG 和 1h-PG 的关系。
在调整了潜在混杂因素后,大多数 PFAS 与高 1h-PG 浓度呈正相关。PFOS 每增加一个对数单位,高 1h-PG 浓度的 OR 为 1.87(95%CI:1.15-3.05);PFNA(OR:2.15,95%CI:1.24-3.74)、PFDA(OR:1.61,95%CI:1.10-2.44)、PFUdA(OR:1.71,95%CI:1.12-2.62)和 PFDoA(OR:1.34,95%CI:1.00-1.81)也观察到类似的关联。当根据 tertiles 将 PFAS 浓度分为三组时,与最低 tertiles 相比,PFOS、PFOA、PFNA、PFDA、PFDoA 和 PFTrDA 的最高 tertiles 发生高 1h-PG 浓度的风险显著增加。PFAS 暴露与高 FPG 之间无统计学显著关联。
PFAS 暴露与孕妇高 1h-PG 风险增加相关,但与 FPG 无明显关联。