OBJECTIVE: To investigate the effects of prenatal PAHs &PAEs exposure on the risk of GDM and hyperglycemia in pregnant women.
METHODS: The study population was a total of 725 pregnant women from a prospective birth cohort study conducted from December 2019 to December 2021. Blood glucose levels were collected by the hospital information system. Urinary PAHs & PAEs concentrations were determined by gas chromatography tandem mass spectrometry. The Poisson regression in a generalized linear model (GLM), multiple linear regression, quantile-based g-computation method (qgcomp), and Bayesian kernel machine regression (BKMR) were applied to explore and verify the individual and overall effects of PAHs & PAEs on glucose homeostasis. Potential confounders were adjusted in all statistical models.
RESULTS: A total of 179 (24.69%) women were diagnosed with GDM. The Poisson regression suggested that a ln-unit increment of 4-OHPHE (4-hydroxyphenanthrene) (adjusted Risk Ratio (aRR) = 1.13; 1.02-1.26) was associated with the increased GDM risk. Mixed-exposure models showed similar results. We additionally found that MBZP (mono-benzyl phthalate) (aRR = 1.19; 1.02-1.39) was positively related to GDM risk in qgcomp model. Although neither model demonstrated that 2-OHNAP (2-hydroxynaphthalene) and 9-OHFLU (9-hydroxyfluorene) increased the risk of GDM, 2-OHNAP and 9-OHFLU exposure significantly increased blood glucose levels. BKMR model further confirmed that overall effects of PAHs & PAEs were significantly associated with the gestational hyperglycemia and GDM risk.
CONCLUSIONS: Our study presents that environmental exposure to PAHs & PAEs was positively associated with gestational glucose levels and the risks of developing GDM. In particular, 2-OHNAP, 9-OHFLU, 4-OHPHE and MBZP may serve as important surveillance markers to prevent the development of GDM.
目的:探讨孕妇产前PAHs和PAEs暴露对GDM和高血糖风险的影响。
方法:研究人群为2019年12月至2021年12月进行的前瞻性出生队列研究中的725名孕妇。通过医院信息系统收集血糖水平。通过气相色谱串联质谱法测定尿PAHs和PAEs浓度。广义线性模型(GLM)中的泊松回归,多元线性回归,基于分位数的g计算方法(qgcomp),应用贝叶斯核机回归(BKMR)来探索和验证PAHs和PAEs对血糖稳态的个体和总体影响。在所有统计模型中调整了潜在的混杂因素。
结果:共有179名(24.69%)女性被诊断为GDM。泊松回归表明,4-OHPHE(4-羟基菲)的ln-单位增量(调整后的风险比(aRR)=1.13;1.02-1.26)与GDM风险增加相关。混合暴露模型显示出类似的结果。我们还发现,在qgcomp模型中,MBZP(邻苯二甲酸单苄基酯)(aRR=1.19;1.02-1.39)与GDM风险呈正相关。虽然没有一个模型证明2-OHNAP(2-羟基萘)和9-OHFLU(9-羟基芴)增加GDM的风险,2-OHNAP和9-OHFLU暴露显著增加血糖水平。BKMR模型进一步证实PAHs和PAEs的总体效应与妊娠期高血糖和GDM风险显著相关。
结论:我们的研究表明,环境暴露于PAHs和PAEs与妊娠期葡萄糖水平和发生GDM的风险呈正相关。特别是,2-OHNAP,9-OHFLU,4-OHPHE和MBZP可作为预防GDM发展的重要监测标志物。