Choi Hyowon, Kim Nam-Yun, Kim Nalai, Ahn Yeon-Soon
Department of Prevention Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea.
Department of Obstetric and Gynecology, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea.
Toxics. 2024 Nov 22;12(12):841. doi: 10.3390/toxics12120841.
This study aims to investigate the association between exposure to toxic indoor chemicals, specifically polyhexamethylene guanidine (PHMG) and oligo(2-(2-ethoxy) ethoxyethyl guanidinium) chloride (PGH), used in humidifier disinfectants, and gestational diabetes mellitus (GDM). We confirmed pregnancy from 2003 to 2017 and identified GDM by linking a cohort of claimants who reported exposure to PHMG/PGH with National Health Insurance Service data. The GDM incidence was calculated, and PHMG/PGH exposure characteristics-exposure status, the humidifier's distance/location, and exposure duration/hours-were investigated. Logistic regression and mediation analysis were applied using asthma, frequently treated with steroids, as a mediator. Among 521 pregnancies, 38 were identified as GDM, with 2.4% before exposure and 8.9% after exposure. Pregnancies after exposure had a higher odds ratio (OR) for GDM (OR 2.968, 95% CI: 1.004-12.725). A trend of increased GDM risk was observed with longer exposure duration/hours. Additionally, pregnancies after exposure demonstrated total and direct effects on GDM (β = 0.0435, = 0.036, β = 0.0432, = 0.030) independent of the indirect effects by asthma. The incidence of GDM was higher after PHMG/PGH exposure compared to before. PHMG/PGH exposure was associated with GDM, independent of asthma. Further research is warranted to confirm these findings in exposed cohorts and to explore the underlying mechanisms.
本研究旨在调查接触加湿器消毒剂中使用的有毒室内化学物质，特别是聚六亚甲基胍（PHMG）和氯化低聚（2-（2-乙氧基）乙氧基乙基胍）（PGH）与妊娠期糖尿病（GDM）之间的关联。我们确认了2003年至2017年期间的妊娠情况，并通过将一组报告接触过PHMG/PGH的索赔人与国民健康保险服务数据相链接来确定GDM。计算了GDM发病率，并调查了PHMG/PGH暴露特征——暴露状态、加湿器的距离/位置以及暴露持续时间/小时数。使用经常用类固醇治疗的哮喘作为中介变量，应用逻辑回归和中介分析。在521例妊娠中，38例被确定为GDM，暴露前为2.4%，暴露后为8.9%。暴露后的妊娠发生GDM的优势比（OR）更高（OR 2.968，95%CI：1.004 - 12.725）。观察到随着暴露持续时间/小时数增加，GDM风险有上升趋势。此外，暴露后的妊娠对GDM表现出总体和直接影响（β = 0.0435， = 0.036，β = 0.0432， = 0.030），独立于哮喘的间接影响。与暴露前相比，PHMG/PGH暴露后GDM的发病率更高。PHMG/PGH暴露与GDM相关，独立于哮喘。有必要进行进一步研究以在暴露队列中证实这些发现，并探索潜在机制。
