Pregnancy urinary phthalate metabolite concentrations and gestational diabetes risk factors.
Pregnancy urinary phthalate metabolite concentrations and gestational diabetes risk factors.
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DOI：
10.1016/j.envint.2016.09.009
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发表时间：
2016-11
影响因子：
11.8
通讯作者：
Seely EW
中科院分区：
文献类型：
--
作者：
James-Todd TM;Meeker JD;Huang T;Hauser R;Ferguson KK;Rich-Edwards JW;McElrath TF;Seely EW
流行病学研究表明，邻苯二甲酸盐代谢产物浓度与2型糖尿病有关。妊娠期糖尿病是2型糖尿病的重要危险因素。人们对邻苯二甲酸盐和妊娠期糖尿病的危险因素(即妊娠早期体重指数(BMI)、妊娠体重增加(GWG)和妊娠中期血糖水平)知之甚少。共有350名妇女参加了LIFECODES妊娠队列(马萨诸塞州波士顿)，她们在足月分娩，并有妊娠期尿邻苯二甲酸酯代谢产物浓度。对9种比重调整后的尿邻苯二甲酸酯代谢物进行了评估。一般线性回归用于评估邻苯二甲酸酯代谢物的四分位数与连续妊娠早期体重指数和妊娠晚期血糖之间的关系。GWG总量采用线性混合模型。对邻苯二甲酸盐浓度进行多变量Logistic回归，并根据50克葡萄糖负荷试验将GWG和定义为葡萄糖≥140 mg/dL的糖耐量受损分类。针对潜在的混杂因素对模型进行了调整。妊娠早期尿邻苯二甲酸盐代谢产物浓度与妊娠早期体重指数之间没有相关性。妊娠期间邻苯二甲酸单乙酯(MEP)的平均浓度与GWG过多的几率增加2.17(95%CI：0.98，4.79)相关。妊娠中期的MEP与糖耐量受损的几率增加有关(adj.OR：7.18；95%CI：1.97，26.15)。邻苯二甲酸二乙基己酯代谢物浓度与糖耐量受损呈负相关(adj。或：0.25；95%可信区间：0.08，0.85)。暴露于邻苯二甲酸二乙酯(MEP的母体化合物)可能与GWG过多和糖耐量受损有关；邻苯二甲酸二乙基己酯较高与糖耐量受损的几率降低有关。
Epidemiologic studies suggest phthalate metabolite concentrations are associated with type 2 diabetes. GDM is a strong risk factor for type 2 diabetes. Little is known about phthalates and GDM risk factors (i.e. 1st trimester body mass index (BMI), gestational weight gain (GWG), and 2nd trimester glucose levels). A total of 350 women participating in Lifecodes pregnancy cohort (Boston, MA), delivered at term and had pregnancy urinary phthalate metabolite concentrations. Nine specific gravity-adjusted urinary phthalate metabolites were evaluated. General linear regression was used to assess associations between quartiles of phthalate metabolites and continuous 1st trimester BMI and late 2nd trimester blood glucose. Linear mixed models were used for total GWG. Multivariable logistic regression was used for phthalate concentrations and categorized GWG and impaired glucose tolerance defined as glucose ≥ 140mg/dL based on a 50-gram glucose load test. Models were adjusted for potential confounders. There were no associations between 1st trimester urinary phthalate metabolite concentrations and 1st trimester BMI. Mono-ethyl phthalate (MEP) concentrations averaged across pregnancy were associated with a 2.17 increased odds of excessive GWG (95% CI: 0.98, 4.79). Second trimester MEP was associated with an increased odds of impaired glucose tolerance (adj. OR: 7.18; 95% CI: 1.97, 26.15). Di-2-ethylhexyl phthalate metabolite concentrations were inversely associated with impaired glucose tolerance (adj. OR: 0.25; adj. 95% CI: 0.08, 0.85). Higher exposure to di-ethyl phthalate, the parent compound of MEP, may be associated with excessive GWG and impaired glucose tolerance; higher di-2-ethylhexyl phthalate was associated with reduced odds of impaired glucose tolerance.