nested case–control study

巢式病例对照研究
  • 文章类型: Journal Article
    中链脂肪酸(MCFA)和二十二碳六烯酸(DHA)可影响轻度认知障碍(MCI)的发生。β-羟基丁酸酯(BHB),线粒体DNA拷贝数(mtDNAcn)和线粒体DNA(mtDNA)缺失可能是它们的潜在机制。本研究旨在探讨MCFAs之间的关系,DHA和MCI,以及潜在的机制。
    本研究采用天津市老年人营养与认知(TENC)队列研究数据,在随访期间,120例患者被确定为新发MCI,通过1:1匹配的性别选择了120名没有MCI的个体,年龄,和教育水平作为对照组。采用条件logistic回归分析和中介效应分析探讨二者之间的关系。
    较高的血清辛酸水平(OR:0.633,95%CI:0.520,0.769),血清DHA水平较高(OR:0.962,95%CI:0.942,0.981),更多的mtDNAcn(OR:0.436,95%CI:0.240,0.794)与更低的MCI风险相关,而更多的mtDNA缺失与更高的MCI风险相关(OR:8.833,95%CI:3.909,19.960)。中介分析表明,BHB和mtDNAcn,在系列中,在辛酸和MCI风险之间的关系中具有中介作用,mtDNA缺失在DHA和MCI风险之间的关联中具有中介作用。
    较高的血清辛酸和DHA水平与较低的MCI风险相关。辛酸可以通过BHB影响MCI的发病率,然后线粒体功能,或者通过线粒体功能,或直接。血清DHA水平可通过线粒体功能影响MCI的发生,或直接。
    UNASSIGNED: Medium-chain fatty acids (MCFAs) and docosahexaenoic acid (DHA) could affect the occurrence of mild cognitive impairment (MCI). β-hydroxybutyrate (BHB), mitochondrial DNA copy number (mtDNAcn) and mitochondrial DNA (mtDNA) deletions might be their potential mechanisms. This study aimed to explore the relationship between MCFAs, DHA and MCI, and potential mechanisms.
    UNASSIGNED: This study used data from Tianjin Elderly Nutrition and Cognition (TENC) cohort study, 120 individuals were identified with new onset MCI during follow-up, 120 individuals without MCI were selected by 1:1 matching sex, age, and education levels as the control group from TENC. Conditional logistic regression analysis and mediation effect analysis were used to explore their relationship.
    UNASSIGNED: Higher serum octanoic acid levels (OR: 0.633, 95% CI: 0.520, 0.769), higher serum DHA levels (OR: 0.962, 95% CI: 0.942, 0.981), and more mtDNAcn (OR: 0.436, 95% CI: 0.240, 0.794) were associated with lower MCI risk, while more mtDNA deletions was associated with higher MCI risk (OR: 8.833, 95% CI: 3.909, 19.960). Mediation analysis suggested that BHB and mtDNAcn, in series, have mediation roles in the association between octanoic acid and MCI risk, and mtDNA deletions have mediation roles in the association between DHA and MCI risk.
    UNASSIGNED: Higher serum octanoic acid and DHA levels were associated with lower MCI risk. Octanoic acid could affect the incidence of MCI through BHB, then mitochondria function, or through mitochondria function, or directly. Serum DHA level could affect the incidence of MCI through mitochondria function, or directly.
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  • 文章类型: Journal Article
    尽管人们对他汀类药物的预防作用越来越感兴趣,作为降脂药,偏头痛发作时,缺乏比较他汀类药物使用者和对照组偏头痛可能性的全国性综合研究.我们在韩国国家健康保险服务-健康筛查队列(2002-2019)中的嵌套病例对照研究使用38,957名偏头痛患者和155,828名对照进行了这种关联调查。考虑偏头痛亚型(有/无先兆)和他汀类药物类型(亲脂性与亲水性)。使用倾向得分匹配和对混杂因素的调整,他汀类药物的使用与偏头痛总体可能性降低有关(比值比(OR)0.93),特别是有先兆(OR0.75)和无先兆(OR0.94)的偏头痛。亲脂性他汀类药物对两种亚型均有效,而亲水性他汀类药物主要降低无先兆偏头痛的可能性。亚组分析显示,在不同的人口统计学中具有一致的益处,但是根据体重的不同效果,吸烟,酒精使用,血红蛋白水平,和血脂异常病史。总之,这项全国性的队列研究表明,在不同的人口统计学和临床资料中,使用他汀类药物可能会降低韩国成年人偏头痛的可能性,但基于某些生活方式和合并症因素的不同有效性强调了在评估他汀类药物治疗偏头痛预防的潜在益处时,考虑个体患者特征的重要性.
    Despite growing interest in the preventive effects of statins, as lipid-lowering agents, on migraine attacks, comprehensive nationwide studies comparing migraine likelihood between statin users and controls are lacking. Our nested case-control study within the Korean National Health Insurance Service-Health Screening Cohort (2002-2019) investigated this association using 38,957 migraine patients and 155,828 controls, considering migraine subtypes (with/without aura) and statin types (lipophilic vs. hydrophilic). Using propensity score matching and adjusting for confounders, statin use was linked to reduced migraine likelihood overall (odds ratio (OR) 0.93), particularly for migraines with aura (OR 0.75) and without aura (OR 0.94). Lipophilic statins were effective for both subtypes, while hydrophilic statins mainly reduced the likelihood of migraines without aura. Subgroup analyses showed consistent benefits across demographics, but varied effectiveness based on weight, smoking, alcohol use, hemoglobin levels, and dyslipidemia history. In summary, this nationwide cohort study suggests that statin use may reduce migraine likelihood among Korean adults across diverse demographics and clinical profiles, but varied effectiveness based on certain lifestyle and comorbidity factors underscores the importance of considering individual patient profiles when assessing the potential benefits of statin therapy for migraine prevention.
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  • 文章类型: Journal Article
    我们旨在调查2010-2019年挪威移民与长期处方阿片类药物使用之间的关联。
    嵌套病例对照研究。这些病例都是18岁或以上长期使用阿片类药物的人-也就是说,处方阿片类药物的使用时间超过3个月(N=215,642)。病例与四个对照相匹配,他们填写了至少一个阿片类药物处方,但从未在研究期间(N=862,568)在性别上长期使用阿片类药物,开始长期/短期阿片类药物使用的年龄和年份。移民的定义是在挪威以外出生,有两个外国出生的父母和四个外国出生的祖父母。调整社会经济变量和临床混杂因素,对三个年龄组(18-44岁,45-67岁和68岁)。
    对于最年轻的年龄组,与本地出生的人相比,移民与长期阿片类药物使用呈负相关(调整后比值比0.75;95%置信区间[0.72-0.77]).对于这个年龄段,在非洲出生的人之间的比值比不同(0.56[0.52-0.62]),中美洲或南美洲(0.70[0.62-0.79]),欧盟(EU)以外的欧洲(0.71[0.65-0.77]),亚洲包括土耳其(0.80[0.77-0.84])和欧盟/欧洲经济区(EEA)(0.81[0.77-0.85])。对于中年群体来说,发现移民与本地人(1.05[1.02-1.08])的几率增加,特别是在北美出生的人(1.26[1.13-1.40])和欧盟/欧洲经济区(1.13[1.09-1.18])。在最古老的组中没有关联。
    与本地出生的人相比,移民在年轻人中长期使用阿片类药物的可能性较低,中年人的几率较高,老年人的几率相似。
    UNASSIGNED: We aimed to investigate the association between being an immigrant and long-term prescription opioid use in Norway in 2010-2019.
    UNASSIGNED: Nested case-control study. The cases were all persons 18 years of age or older with long-term opioid use - that is, the use of prescription opioids longer than 3 months (N=215,642). Cases were matched to four controls who filled at least one opioid prescription, but never developed long-term opioid use in the study period (N=862,568) on sex, age and year of starting long-term/short-term opioid use. Being an immigrant was defined as being born outside of Norway to two foreign-born parents and four foreign-born grandparents. Adjusting for socioeconomic variables and clinical confounders, analyses were stratified on three age groups (18-44 years, 45-67 years and ⩾68 years).
    UNASSIGNED: For the youngest age group, being an immigrant was inversely associated with long-term opioid use (adjusted odds ratio 0.75; 95% confidence interval [0.72-0.77]) compared with being native-born people. For this age group, the odds ratio differed between people born in Africa (0.56 [0.52-0.62]), Central or South America (0.70 [0.62-0.79]), Europe outside the European Union (EU) (0.71 [0.65-0.77]), Asia including Turkey (0.80 [0.77-0.84]) and EU/European Economic Area (EEA) (0.81 [0.77-0.85]). For the middle age group, increased odds were found for immigrants versus natives (1.05 [1.02-1.08]) in particular for those born in North America (1.26 [1.13-1.40]) and the EU/EEA (1.13 [1.09-1.18]). There was no association in the oldest group.
    UNASSIGNED: Compared with native-born people, immigrants had lower odds of long-term opioid use among younger adults, higher odds among middle-aged and similar odds among older adults.
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  • 文章类型: Journal Article
    本研究旨在调查广州市男男性行为者(MSM)中性伴侣对HIV感染的影响。中国。在广州市MSM前瞻性队列研究基础上进行巢式病例对照研究。在队列中,接受HIV血清转换的个体被确定为病例组,每个病例与来自非血清转换参与者的4个对照匹配。收集了有关性伴侣在过去6个月中对HIV血清状态的认识的信息。在161名参与者中,36.0%的人知道所有性伴侣的艾滋病毒血清状况。与未知HIV血清状态的伴侣进行无公寓肛交,并且仅意识到某些偶然伴侣的HIV血清状态,这种做法与感染HIV的风险升高呈正相关。相反,充分了解所有性伴侣的艾滋病毒血清状况,包括普通的,与艾滋病毒发病率降低有关。定期与性伴侣就艾滋病毒检测结果进行沟通,诚实地披露自己的艾滋病毒血清状态,拒绝与HIV血清状态未知的伴侣进行性接触可能会降低MSM中感染HIV的风险。
    This study aimed to investigate the impact of sexual partners\' HIV serostatus awareness on the HIV acquisition among men who have sex with men (MSM) in Guangzhou, China. A nested case-control study was conducted based on a prospective cohort of MSM in Guangzhou. Within the cohort, individuals who underwent HIV seroconversion were identified as the case group, and each case was matched with four controls from the non-seroconverted participants. Information regarding the awareness of sexual partners\' HIV serostatus over the preceding 6 months was gathered. Of the 161 participants, 36.0% were aware of the HIV serostatus of all their sexual partners. The practice of engaging in condomless anal sex with partners of unknown HIV serostatus and being aware of the HIV serostatus of only some casual partners were positively correlated with an elevated risk of acquiring HIV. Conversely, being fully aware of the HIV serostatus of all sexual partners, including regular ones, was associated with a diminished risk of HIV incidence. Regular communication with sexual partners regarding HIV testing outcomes, honest disclosure of one\'s own HIV serostatus, and refusal of sexual contact with partners of unknown HIV serostatus can potentially mitigate the risk of acquiring HIV among MSM.
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  • 文章类型: Journal Article
    目的:精神分裂症与自杀风险增加有关。很少有研究调查不同年龄段的自杀风险,可能是由于样本量的限制。
    方法:来自台湾国家健康保险研究数据库,这项研究从2000年1月1日至2019年12月31日确定了195,787名精神分裂症患者.在学习期间,3848例患者死于自杀。我们计算了按年龄分层的自杀的标准化死亡率(SMR)。在这个年龄分层中,巢式病例对照研究,风险集抽样用于按年龄将每个病例与4个生活对照进行匹配,性别,以及首次诊断为精神分裂症的年份。使用条件逻辑回归来估计年龄分层的风险状况。
    结果:SMR在<25岁年龄组中最高(52.8),与年龄呈负相关。在25至34、35至44、45至54和55至64岁年龄组中,失业与自杀风险增加相关。自杀前抑郁和睡眠障碍在精神分裂症自杀病例中比在所有年龄组的对照组中更常见。药物诱导和酒精诱导的精神障碍与自杀显着相关,但仅在54岁以下的年龄组中观察到。心脏病,肺炎,在65岁以下年龄组中,中度或重度肾病是自杀的危险因素.
    结论:自杀的危险因素因年龄而异。这项研究的发现可用于优化预防精神分裂症患者自杀的医疗保健干预措施。
    OBJECTIVE: Schizophrenia is associated with an increased risk of suicide. Few studies have investigated the risk of suicide across different ages, likely due to limitations around sample size.
    METHODS: From the National Health Insurance Research Database in Taiwan, this study identified 195,787 patients with schizophrenia from January 1, 2000, to December 31, 2019. During the study period, 3848 patients died from suicide. We calculated the standardized mortality ratio (SMR) for suicide stratified by age. In this age-stratified, nested case-control study, risk set sampling was used to match each case with 4 living controls by age, sex, and the year of the first diagnosis with schizophrenia. Conditional logistic regression was used for estimating age-stratified risk profiles.
    RESULTS: The SMR was the highest in the <25 years age group (52.8) and inversely correlated with age. Unemployment was associated with an increased risk of suicide in the 25 to 34, 35 to 44, 45 to 54, and 55 to 64 years age groups. Depressive and sleep disorders before suicide were more common among suicide cases with schizophrenia than among controls across all age groups. Drug-induced and alcohol-induced mental disorders were significantly associated with suicide but were observed only in the age group younger than 54. Heart disease, pneumonia, and moderate or severe renal disease were risk factors for suicide in the age groups less than 65.
    CONCLUSIONS: The risk factors for suicide differ by age. This study\'s findings can be used to optimize health-care interventions for preventing suicide in patients with schizophrenia.
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  • 文章类型: Journal Article
    目的:本研究旨在确定妊娠期糖尿病(GDM)与新生儿听力筛查(NHS)结果的相关性。
    方法:在2021年6月至2021年12月出生并接受新生儿听力筛查的新生儿队列中进行了一项巢式病例对照研究。在24-28孕周根据75g2h口服葡萄糖耐量试验(OGTT)诊断为GDM。同一医院共有369名孕妇按产妇年龄(±2岁)以1:2的比例单独匹配,胎龄(±3天)和新生儿性别。卡方检验用于评估GDM与NHS结果之间的关联。
    结果:GDM组的NHS异常结果比非GDM组更常见。当比较两组(GDM病例和对照)时,我们发现它们之间存在显着差异(p<0.05)。而病例组和对照组的分娩方式差异无统计学意义(p>0.05)。
    结论:孕妇GDM病史可能导致NHS的错误率明显升高。
    OBJECTIVE: This study aims to determine the association of gestational diabetes mellitus (GDM) and the results of newborn hearing screening(NHS).
    METHODS: A nested case-control study was conducted in a cohort of newborns who were born between June 2021 to December 2021 and underwent neonatal hearing screening.GDM was diagnosed according to the 75 g 2 h oral glucose tolerance test (OGTT) at 24-28 gestational weeks.A total of 369 pregnant women at the same hospital were individually matched in a 1:2 ratio by maternal age (±2 years), gestational age (±3 days) and sex of newborn.Chi-square test was utilized to evaluate associations between GDM and the results of NHS.
    RESULTS: Abnormal NHS results in the GDM group was more frequent than non-GDM group.When comparing the two groups (GDM case and contol), we found significant differences (p < 0.05) between them.Whereas the difference was not statistically significant (p > 0.05) by delivery modes in both case and control groups.
    CONCLUSIONS: Maternal history of GDM could lead to significantly higher failling rate of NHS.
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  • 文章类型: Journal Article
    肠道菌群可能影响急性胰腺炎(AP)的发展,一种严重的胃肠道疾病,发病率和死亡率高。本研究旨在通过调查肠道微生物群与AP之间的关系来确定因果关系。
    孟德尔随机化(MR)和嵌套病例对照研究用于探索肠道微生物群组成与AP之间的关联。16SrRNA测序,随机森林建模(RF),支持向量机(SVM),和Kaplan-Meier生存分析用于确定AP患者的显著肠道菌群及其与住院时间的相关性。
    双向MR结果证实了特定肠道微生物群与AP之间的因果关系(通过正向和反向MR鉴定出的15和8个微生物类群,分别)。16SrRNA测序分析表明,病例和对照组之间的肠道微生物群组成存在明显差异。值得注意的是,在对RF和SVM的结果进行综合评估后,拟杆菌(B.plebeius)被发现在影响医院状况方面起着重要作用。使用接收器工作特性(ROC)曲线,B.plebeius的预测能力(0.757)。Kaplan-Meier生存分析提供了进一步的见解,即百叶芽孢杆菌丰度升高的患者住院时间延长。
    将MR与嵌套病例对照研究相结合,提供了肠道微生物群与AP之间相互作用的详细表征。B.plebeius被确定为一个重要的贡献者,表明其作为AP动力学的先驱和结果的作用。研究结果强调了AP的多因素性质及其与肠道微生物群的复杂关系。这项研究为未来针对AP治疗中微生物动力学的治疗干预奠定了基础。
    UNASSIGNED: Gut microbiota may influence the development of acute pancreatitis (AP), a serious gastrointestinal disease with high morbidity and mortality. This study aimed to identify a causal link by investigating the relationship between gut microbiota and AP.
    UNASSIGNED: Mendelian randomization (MR) and a nested case-control study were used to explore associations between gut microbiota composition and AP. 16S rRNA sequencing, random forest modelling (RF), support vector machine (SVM), and Kaplan-Meier survival analysis was applied to identify significant gut microbiota and their correlation with hospitalization duration in AP patients.
    UNASSIGNED: Bidirectional MR results confirmed a causal link between specific gut microbiota and AP (15 and 8 microbial taxa identified via forward and reverse MR, respectively). The 16S rRNA sequencing analysis demonstrated a pronounced difference in gut microbiota composition between cases and controls. Notably, after a comprehensive evaluation of the results of RF and SVM, Bacteroides plebeius (B. plebeius) was found to play a significant role in influencing the hospital status. Using a receiver operating characteristic (ROC) curve, the predictive power (0.757) of B. plebeius. Kaplan-Meier survival analysis offered further insight that patients with an elevated abundance of B. plebeius experienced prolonged hospital stays.
    UNASSIGNED: Combining MR with nested case-control studies provided a detailed characterization of interactions between gut microbiota and AP. B. plebeius was identified as a significant contributor, suggesting its role as both a precursor and consequence of AP dynamics. The findings highlight the multifactorial nature of AP and its complex relationship with the gut microbiota. This study lays the groundwork for future therapeutic interventions targeting microbial dynamics in AP treatment.
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  • 文章类型: Journal Article
    背景:膀胱癌(BC)和肾细胞癌(RCC)是男女最常见的泌尿生殖道癌症,每年全球发病率约为50万。BC和RCC都与糖尿病有关。血糖控制不良(低血糖)是糖尿病的严重后果,也是BC和RCC中使用的全身治疗的可能后果。这项研究的目的是调查BC或RCC患者的糖尿病患病率和基于医院的血糖管理。
    方法:这项瑞典基于人群的回顾性登记研究使用国家健康数据登记来获取15年癌症发病率的纵向数据,使用以医院为基础的医疗保健,并填写了门诊药物的处方。研究终点包括BC/RCC个体中糖尿病的共同患病率,由于血糖不良而导致的医疗保健资源利用,使用全身性皮质类固醇,以及合并2型糖尿病患者的糖尿病管理变化。
    结果:我们确定了36,620和15,581名诊断为BC和RCC的个体,分别,2006年至2019年。在BC中,糖尿病患者的比例为24%,在RCC中为23%。发现BC/RCC与血糖控制不良之间存在关联,尽管医院护理中的血糖不良事件数量很少(糖尿病患者和BC/RCC患者中分别有65/59例,至少有1起事件).与2型糖尿病但没有癌症的匹配个体相比,在BC/RCC中观察到更早地转换为基于胰岛素的糖尿病管理。结果还表明类固醇治疗与血糖控制不良之间存在关联,与糖尿病对照组相比,全身性皮质类固醇在BC/RCC患者中更常见。
    结论:在这项大型国家研究中观察到的糖尿病的高患病率和全身性皮质类固醇治疗的增加,突出了对特定临床管理的需求。风险评估,并监测BC/RCC和糖尿病患者。
    BACKGROUND: Bladder cancer (BC) and Renal cell carcinoma (RCC) are the most common urogenital cancers among both sexes, with a yearly global incidence of around 500 000 each. Both BC and RCC have been linked to diabetes. Poor glycemic control (malglycemia) is a serious consequence of diabetes and a possible consequence of systemic treatments used in BC and RCC. The objective of this study was to investigate the prevalence of diabetes and use of hospital-based care for malglycemia in people with BC or RCC.
    METHODS: This Swedish retrospective population-based register study used national health-data registers for longitudinal data on cancer incidence covering 15 years, use of hospital-based health care, and filled prescriptions of outpatient medications. Study endpoints included co-prevalence of diabetes in individuals with BC/RCC, healthcare resource utilization due to malglycemia, use of systemic corticosteroids, and changes in diabetes management for people with concomitant type 2 diabetes.
    RESULTS: We identified 36,620 and 15,581 individuals diagnosed with BC and RCC, respectively, between 2006 and 2019. The proportion of individuals registered with diabetes was 24% in BC and 23% in RCC. An association between BC/RCC and poor glycemic control was found, although the number of malglycemic events in hospital-based care were few (65/59 per 1000 individuals with diabetes and BC/RCC respectively with at least one event). An earlier switch to insulin-based diabetes management was observed in BC/RCC compared to matched individuals with type 2 diabetes but no cancer. The results also indicated an association between steroid treatment and poor glycemic control, and that systemic corticosteroids were more common among people with BC/RCC compared to diabetes controls.
    CONCLUSIONS: The high prevalence of diabetes and increased use of systemic corticosteroid treatment observed in this large national study highlights the need for specific clinical management, risk-assessment, and monitoring of individuals with BC/RCC and diabetes.
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  • 文章类型: Journal Article
    胃癌(GC)幸存者可能更容易发展为骨质疏松症。然而,关于GC与骨质疏松症之间关系的研究很少在大量患者人群中进行。我们旨在通过使用韩国国家健康保险服务-国家样本队列(KNHIS-NSC)将患者与GC和匹配的对照进行比较来确定骨质疏松症的发生率并确定相关因素。这项研究包括9078例GC患者和36,312例对照(1:4倾向评分匹配性别,年龄,residence,和收入)。根据Charlson合并症指数(CCI)评分调整模型(调整后的HR=1.13),GC患者骨质疏松症的风险比(HR)明显高于对照组。Kaplan-Meier分析显示,从索引日期开始的随访期间,GC患者的骨质疏松症累积发生率明显高于对照组(p=0.0087)。在年龄<65岁的人群中,骨质疏松与GC呈正相关。男性,和那些与CCI分数=0。总之,研究结果表明,年龄<65岁的GC男性患骨质疏松症的风险增加。需要研究其他风险因素和最佳干预时机,以预防骨折并最大程度地减少GC幸存者的骨丢失。
    Gastric cancer (GC) survivors may be more likely to develop osteoporosis. However, few studies on the relationship between GC and osteoporosis have been conducted on large patient populations. We aimed to determine the incidence of osteoporosis and identify related factors by comparing patients with GC and matched controls using the Korean National Health Insurance Service-National Sample Cohort (KNHIS-NSC). This study included 9078 patients with GC and 36,312 controls (1:4 propensity score-matched for sex, age, residence, and income). The hazard ratio (HR) for osteoporosis was significantly greater for GC patients than for controls according to Charlson Comorbidity Index (CCI) score-adjusted models (adjusted HR = 1.13). Kaplan-Meier analysis revealed that the cumulative incidence of osteoporosis during the follow-up period commencing from the index date was significantly greater in GC patients than in the controls (p = 0.0087). A positive correlation of osteoporosis with GC was detected for those aged < 65 years, males, and those with CCI scores = 0. In conclusion, the study findings suggest that men with GC aged < 65 years may be at an increased risk for osteoporosis. Research into additional risk factors and the optimal timing of interventions are needed to prevent fractures and minimize bone loss in GC survivors.
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  • 文章类型: Journal Article
    OPFRs是具有生殖和内分泌毒性的新兴环境污染物。本研究旨在研究妊娠早期OPFRs环境暴露与GDM之间的关系。这项巢式病例对照研究基于在妇幼保健医院建立的出生队列,512例孕妇中GDM74例。OPFR,包括TBP,TBEP,TCEP,TDCPP,TMCP,TOCP,使用GC-MS测定妊娠10-14周的TPHP。使用WQS和BKMR模型评估OPFRs和GDM之间的关联。与对照组(90)相比,GDM患者(60)的OPFRs水平显著升高。WQS分析表明,OPFRs的混合物与GDM显着相关(OR1.370,95%CI1.036-1.810,P=0.027),还有TBP,TPHP,和TMCP是混合暴露效应的主要贡献者。在BKMR模型中,个体暴露于TBP,TPHP,和TMCP,TMCP与TBP和TPHP的交互作用与GDM显著相关。OPFRs的环境暴露与GDM呈正相关。这些发现为OPFR暴露对孕妇健康的不利影响提供了证据。
    OPFRs are emerging environmental pollutants with reproductive and endocrine toxicity. This study aimed to examine the association between environmental exposure to OPFRs during early pregnancy and GDM. This nested case-control study was based on a birth cohort that was constructed at a maternal and child health hospital, including 74 cases of GDM among 512 pregnant women. The OPFRs, including TBP, TBEP, TCEP, TDCPP, TMCP, TOCP, and TPHP during 10-14 weeks of pregnancy were determined using GC-MS. The association between the OPFRs and GDM was assessed using WQS and BKMR models. The levels of OPFRs were significantly elevated in GDM patients (60) compared with the controls (90). The WQS analysis showed that mixtures of the OPFRs were significantly associated with GDM (OR 1.370, 95% CI 1.036-1.810, P = 0.027), and TBP, TPHP, and TMCP were the major contributors to the mixed exposure effect. In the BKMR model, individual exposure to TBP, TPHP, and TMCP, and the interaction of TMCP with TBP and TPHP were significantly associated with GDM. Environmental exposure to OPFRs is positively associated with GDM. These findings provide evidence for the adverse effects of OPFR exposure on the health of pregnant women.
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