毒理学研究表明,暴露于氯化石蜡(CPs)可能会破坏细胞内的葡萄糖和能量代谢。然而,关于人类CP暴露对葡萄糖稳态的影响及其与发生妊娠期糖尿病(GDM)风险增加的潜在关联的信息有限.这里,我们进行了一项采用嵌套病例对照设计的前瞻性研究,以评估妊娠期短链和中链CP(SCCPs和MCCPs)暴露与GDM风险之间的联系.收集杭州地区102例诊断为GDM的孕妇和204例健康对照的血清样本,中国东部。中位数(四分位数间距,GDM组的短链氯化石蜡IQR浓度为161(127,236)ng/mL,而非GDM组的IQR浓度为127(96.9,176)ng/mL(p<0.01)。对于MCCP,GDM组的中位浓度为144(117,174)ng/mL,对照组为114(78.1,162)ng/mL(p<0.01)。与作为参考的最低四分位数相比,在∑SCCP和∑MCCP水平的最高四分位数中,GDM的调整比值比(ORs)分别为7.07(95%CI:2.87,17.40)和3.34(95%CI:1.48,7.53),分别,MCCP与GDM呈倒U型关联。加权分位数和回归评估了所有CP对GDM和葡萄糖稳态的联合作用。在所有CP同源物中,C13H23Cl5和C10H16Cl6是驱动与GDM风险正相关的关键变量。我们的结果表明,孕妇血清中的CP浓度与GDM风险之间存在显着正相关,暴露于短链氯化石蜡和MCCP可能会干扰母体葡萄糖稳态。这些发现有助于更好地了解CP暴露的健康风险以及环境污染物在GDM发病机理中的作用。
Toxicological studies have indicated that exposure to chlorinated paraffins (CPs) may disrupt intracellular glucose and energy metabolism. However, limited information exists regarding the impact of human CP exposure on glucose homeostasis and its potential association with an increased risk of developing gestational diabetes mellitus (GDM). Here, we conducted a prospective study with a nested
case-control design to evaluate the link between short- and medium-chain CP (SCCPs and MCCPs) exposures during pregnancy and the risk of GDM. Serum samples from 102 GDM-diagnosed pregnant women and 204 healthy controls were collected in Hangzhou, Eastern China. The median (interquartile range, IQR) concentration of SCCPs was 161 (127, 236) ng/mL in the GDM group compared to 127 (96.9, 176) ng/mL in the non-GDM group (p < 0.01). For MCCPs, the GDM group had a median concentration of 144 (117, 174) ng/mL, while the control group was 114 (78.1, 162) ng/mL (p < 0.01). Compared to the lowest quartile as the reference, the adjusted odds ratios (ORs) of GDM were 7.07 (95% CI: 2.87, 17.40) and 3.34 (95% CI: 1.48, 7.53) in the highest quartile of ∑SCCP and ∑MCCP levels, respectively, with MCCPs demonstrating an inverted U-shaped association with GDM. Weighted quantile sum regression evaluated the joint effects of all CPs on GDM and glucose homeostasis. Among all CP congeners, C13H23Cl5 and C10H16Cl6 were the crucial variables driving the positive association with the GDM risk. Our results demonstrated a significant positive association between CP concentration in maternal serum and GDM risk, and exposure to SCCPs and MCCPs may disturb maternal glucose homeostasis. These findings contribute to a better understanding of the health risks of CP exposure and the role of environmental contaminants in the pathogenesis of GDM.