Zukin Helen, Eskenazi Brenda, Holland Nina, Harley Kim G
Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA.
Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA.
Environ Res. 2021 Mar;194:110712. doi: 10.1016/j.envres.2021.110712. Epub 2021 Jan 15.
Phthalates are a group of endocrine disrupting chemicals that are heavily used throughout industry in flexible plastic and personal-care products. As a result, detectable levels of their metabolites are readily found in humans. Some studies have shown associations of phthalates with diabetes, but associations with gestational diabetes mellitus (GDM) are less clear.
To investigate the association of 11 prenatal urinary phthalate metabolites and development of GDM, impaired glucose tolerance (IGT), continuous plasma glucose level, and excessive gestational weight gain (GWG) in a population of pregnant Latina women (N = 415) enrolled in the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) cohort study.
Phthalate metabolite levels were measured via mass spectrometry from two urine samples collected in the end of the first and second trimester. Maternal plasma glucose levels, prior diabetes diagnosis, GDM diagnosis, and weight gain were abstracted from medical records. Multiple regression was used to evaluate the association between the average of the two urinary phthalate metabolites levels and maternal metabolic outcomes. In our sensitivity analysis, phthalate levels were categorized by level (as quartiles of exposure) and by timing of urine sample collection (as taken in first and second half of pregnancy).
Consistent with findings from a nationally representative sample, all of the individual phthalate metabolites were detected in majority of mothers. Thirty-one mothers (7.5%) were diagnosed with GDM, 49 mothers (14.7%) displayed IGT, and 223 mothers (55.1%) gained an excessive amount of weight during their pregnancy. MEP concentrations were associated with an increased odds of excessive GWG (OR: 1.1, 95% CI: 1.0 to 1.3). We did not find an association between any phthalate metabolite and any maternal glucose outcome.
Contrary to previous studies, our findings do not support an association of prenatal phthalate levels and increased odds for hyperglycemia, IGT, or GDM. But, we did find an increased odds of excessive GWG, a well-known risk factor for GDM.
邻苯二甲酸盐是一类内分泌干扰化学物质，在整个工业中广泛用于柔性塑料和个人护理产品。因此，在人体中很容易检测到其代谢物的水平。一些研究表明邻苯二甲酸盐与糖尿病有关，但与妊娠期糖尿病（GDM）的关联尚不清楚。
在参加萨利纳斯母婴健康评估中心（CHAMACOS）队列研究的拉丁裔孕妇群体（N = 415）中，调查11种产前尿邻苯二甲酸盐代谢物与GDM发生、糖耐量受损（IGT）、连续血糖水平以及孕期体重过度增加（GWG）之间的关联。
通过质谱法测量在孕早期末和孕中期末采集的两份尿液样本中的邻苯二甲酸盐代谢物水平。从医疗记录中提取孕妇血浆葡萄糖水平、既往糖尿病诊断、GDM诊断和体重增加情况。使用多元回归评估两份尿邻苯二甲酸盐代谢物水平的平均值与孕妇代谢结局之间的关联。在我们的敏感性分析中，邻苯二甲酸盐水平按水平（作为暴露四分位数）和尿液样本采集时间（作为孕期前半段和后半段采集）进行分类。
与全国代表性样本的研究结果一致，大多数母亲体内都检测到了所有个体邻苯二甲酸盐代谢物。31名母亲（7.5%）被诊断为GDM，49名母亲（14.7%）表现为IGT，223名母亲（55.1%）在孕期体重增加过多。MEP浓度与GWG过多的几率增加相关（比值比：1.1，95%置信区间：1.0至1.3）。我们未发现任何邻苯二甲酸盐代谢物与任何孕妇血糖结局之间存在关联。
与先前的研究相反，我们的研究结果不支持产前邻苯二甲酸盐水平与高血糖、IGT或GDM几率增加之间存在关联。但是，我们确实发现GWG过多的几率增加，而GWG过多是GDM的一个众所周知的风险因素。
