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Kouiti M, Castillo-Hermoso MÁ, Youlyouz-Marfak I, Khan KS, Thangaratinam S, Olmedo-Requena R, Zamora J, Jiménez-Moléon JJ. Persistent organic pollutant exposure as a risk factor of gestational diabetes mellitus: A systematic review and meta-analysis. BJOG 2024; 131:579-588. [PMID: 38044810 DOI: 10.1111/1471-0528.17725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 11/01/2023] [Accepted: 11/09/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Findings related to the association between persistent organic pollutants (POPs) and gestational diabetes mellitus (GDM) are inconclusive. OBJECTIVES To estimate the strength of the association between POP exposure and GDM in a systematic review with meta-analysis. SEARCH STRATEGY MEDLINE, Scopus and Web of Science were searched until July 2023. SELECTION CRITERIA Cohort and case-control studies analysing the association between POPs and GDM. DATA COLLECTION AND ANALYSIS We assessed the risk of bias using the Quality in Prognosis Studies scale (QUIPS). Standardised mean differences were pooled using random-effect models. MAIN RESULTS Sixteen articles including 12 216 participants were selected. The risk of bias was high in four articles (25%), moderate in 11 (68.75%) and low in one (6.25%). Small mean difference between GDM cases and controls was observed for PFHpA (0.26, 95% confidence interval [CI] 0.1-0.35, I2 = 0.0%), PCB180 (0.37, 95% CI 0.19-0.56; I2 = 25.3%), BDE47 (0.23, 95% CI 0.0-0.45, I2 = 0%), BDE99 (0.36, 95% CI 0.14-0.59; I2 = 0%), BDE100 (0.42, 95% CI 0.19-0.64; I2 = 0%) and HCB (0.22, 95% CI 0.01-0.42, I2 = 39.6%). No considerable difference was observed for the rest of POPs. CONCLUSION Small mean differences between GDM cases and controls were observed for some POPs. However, evidence shows mostly moderate quality and results were heterogeneous. Improved research methodology is needed to assess POPs and GDM risk.
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Affiliation(s)
- Malak Kouiti
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, Granada, Spain
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | | | - Ibtissam Youlyouz-Marfak
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Khalid Saeed Khan
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, Granada, Spain
- Consorcio Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Shakila Thangaratinam
- Institute for Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Birmingham Women's and Children's National Health Service Foundation Trust, Birmingham, UK
| | - Rocío Olmedo-Requena
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, Granada, Spain
- Consorcio Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Javier Zamora
- Consorcio Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Institute for Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Birmingham Women's and Children's National Health Service Foundation Trust, Birmingham, UK
- Clinical Biostatistics Unit, Hospital Ramon y Cajal (IRYCIS), Madrid, Spain
| | - José Juan Jiménez-Moléon
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, Granada, Spain
- Consorcio Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
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Ma J, Li Y, Qian L, Geng S, Yao X, Gao X, Yan Y, Wen J. Serum levels of polychlorinated biphenyls and polybrominated diphenyl ethers in early pregnancy and their associations with gestational diabetes mellitus. CHEMOSPHERE 2023; 339:139640. [PMID: 37499805 DOI: 10.1016/j.chemosphere.2023.139640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/21/2023] [Accepted: 07/22/2023] [Indexed: 07/29/2023]
Abstract
Polychlorinated Biphenyls (PCBs) and Polybrominated Diphenyl Ethers (PBDEs) are extensively present in humans and may disturb glucose metabolism during pregnancy. However, previous reports on the associations between PCBs/PBDEs levels and gestational diabetes mellitus (GDM) have been inconsistent. We performed a nested case-control study to measure the serum levels of 6 PCB and 7 PBDE congeners in early pregnancy, and to assess their associations with GDM risk and blood glucose levels. Totally, 208 serum samples (104 GDM cases and 104 controls) were included based on a prospective cohort which was carried out in Jiangsu province, China, from 2020 to 2022. The results showed that PCB-153 was the major PCB congener, whereas PBDE-47 was the predominant PBDE congener. The continuous concentrations of PCB-153, PBDE-28, and total PCB were significantly related to an increased risk of GDM, with adjusted ORs (95%CI) of 1.25 (1.04-1.50), 1.19 (1.02-1.39), and 1.37 (1.05-1.79), respectively. Potential dose-response relationships were also observed between serum levels of PCB-153 (P = 0.011), PBDE-28 (P = 0.028), total PCB (P = 0.048), and total PCB/PBDE (P = 0.010) and GDM risk. Moreover, PCB-153, PBDE-28 and total PCB levels were positively related to 1-h OGTT blood glucose (adjusted βPCB-153: 0.14, 95%CI: 0.00-0.28; adjusted βPBDE-28: 0.20, 95%CI: 0.08-0.32; adjusted βtotal PCB: 0.30, 95%CI: 0.09-0.50), whereas none of the PCBs/PBDEs were statistically related to fasting blood glucose and 2-h OGTT blood glucose (all P > 0.05). Further meta-analysis also supported the association of PCBs exposure with GDM risk. Our study provides further evidence that PCBs/PBDEs exposure may increase GDM risk during pregnancy.
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Affiliation(s)
- Jinqi Ma
- Department of Obstetrics and Gynecology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, 214023, Jiangsu, China
| | - Ying Li
- Department of Obstetrics and Gynecology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, 214023, Jiangsu, China
| | - Li Qian
- Department of Obstetrics and Gynecology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, 214023, Jiangsu, China
| | - Shijie Geng
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210004, Jiangsu, China
| | - Xiaodie Yao
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210004, Jiangsu, China
| | - Xian Gao
- Department of Obstetrics and Gynecology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, 214023, Jiangsu, China
| | - Yan Yan
- Department of Obstetrics and Gynecology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, 214023, Jiangsu, China
| | - Juan Wen
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210004, Jiangsu, China.
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Yao X, Geng S, Zhu L, Jiang H, Wen J. Environmental pollutants exposure and gestational diabetes mellitus: Evidence from epidemiological and experimental studies. CHEMOSPHERE 2023; 332:138866. [PMID: 37164202 DOI: 10.1016/j.chemosphere.2023.138866] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 04/05/2023] [Accepted: 05/05/2023] [Indexed: 05/12/2023]
Abstract
Except for known sociodemographic factors, long-term exposure to environmental pollutants has been shown to contribute to the development of gestational diabetes mellitus (GDM), but the conclusions remain controversial. To provide a comprehensive overview of the association between environmental pollutants and GDM, we performed a systematic review and meta-analysis. Several electronic databases (PubMed, Embase, Web of Science, Medline and Cochrane) were searched for related epidemiological and experimental studies up to September 2022. For epidemiological studies, a meta-analysis was carried out to appraise the effect of environmental pollutants, including polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs), per- and polyfluoroalkyl substances (PFASs), phenols, phthalates (PAEs), polybrominated diphenyl ethers (PBDEs) and parabens exposure on GDM. Moreover, we also summarized possible biological mechanisms linking pollution exposure and GDM based on the included experimental studies. A total of 80 articles were enrolled, including 38 epidemiological studies and 42 experimental studies. Meta-analysis results showed that exposure to PAEs [OR (95%CI) = 1.07 (1.00, 1.14)], PFASs [OR (95%CI) = 1.10 (1.01, 1.19)], as well as PCBs [OR (95%CI) = 1.18 (1.02, 1.36)] and PBDEs [OR (95%CI) = 1.33 (1.17, 1.50)] significantly increased the risk of GDM, but no significant effects were found for phenols, OCPs, and parabens. In addition, experimental studies suggested that the potential biological mechanisms of environmental pollutants contributing to GDM may involve insulin resistance, β-cell dysfunction, neurohormonal dysfunction, inflammation, oxidative stress, epigenetic modification, and alterations in gut microbiome. In conclusion, long-term environmental pollutants exposure may induce the development of GDM, and there may be a synergistic effect between the homologs. However, studies conducted on the direct biological link between environmental pollutants and GDM were few. More prospective studies and high-quality in vivo and in vitro experiments were needed to investigate the specific effects and mechanisms.
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Affiliation(s)
- Xiaodie Yao
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu, 210004, PR China
| | - Shijie Geng
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu, 210004, PR China
| | - Lijun Zhu
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu, 210004, PR China
| | - Hua Jiang
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu, 210004, PR China.
| | - Juan Wen
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu, 210004, PR China.
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Eberle C, Stichling S. Environmental health influences in pregnancy and risk of gestational diabetes mellitus: a systematic review. BMC Public Health 2022; 22:1572. [PMID: 35982427 PMCID: PMC9389831 DOI: 10.1186/s12889-022-13965-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 06/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications globally. Environmental risk factors may lead to increased glucose levels and GDM, which in turn may affect not only the health of the mother but assuming hypotheses of "fetal programming", also the health of the offspring. In addition to traditional GDM risk factors, the evidence is growing that environmental influences might affect the development of GDM. We conducted a systematic review analyzing the association between several environmental health risk factors in pregnancy, including climate factors, chemicals and metals, and GDM. Methods We performed a systematic literature search in Medline (PubMed), EMBASE, CINAHL, Cochrane Library and Web of Science Core Collection databases for research articles published until March 2021. Epidemiological human and animal model studies that examined GDM as an outcome and / or glycemic outcomes and at least one environmental risk factor for GDM were included. Results Of n = 91 studies, we classified n = 28 air pollution, n = 18 persistent organic pollutants (POP), n = 11 arsenic, n = 9 phthalate n = 8 bisphenol A (BPA), n = 8 seasonality, n = 6 cadmium and n = 5 ambient temperature studies. In total, we identified two animal model studies. Whilst we found clear evidence for an association between GDM and air pollution, ambient temperature, season, cadmium, arsenic, POPs and phthalates, the findings regarding phenols were rather inconsistent. There were clear associations between adverse glycemic outcomes and air pollution, ambient temperature, season, POPs, phenols, and phthalates. Findings regarding cadmium and arsenic were heterogeneous (n = 2 publications in each case). Conclusions Environmental risk factors are important to consider in the management and prevention of GDM. In view of mechanisms of fetal programming, the environmental risk factors investigated may impair the health of mother and offspring in the short and long term. Further research is needed. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13965-5.
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Affiliation(s)
- Claudia Eberle
- Medicine With Specialization in Internal Medicine and General Medicine, Hochschule Fulda, University of Applied Sciences, Leipziger Strasse 123, 36037, Fulda, Germany.
| | - Stefanie Stichling
- Medicine With Specialization in Internal Medicine and General Medicine, Hochschule Fulda, University of Applied Sciences, Leipziger Strasse 123, 36037, Fulda, Germany
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Yan D, Jiao Y, Yan H, Liu T, Yan H, Yuan J. Endocrine-disrupting chemicals and the risk of gestational diabetes mellitus: a systematic review and meta-analysis. Environ Health 2022; 21:53. [PMID: 35578291 PMCID: PMC9109392 DOI: 10.1186/s12940-022-00858-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 04/26/2022] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To conduct a comprehensive systematic review and meta-analysis to estimate the relationship between endocrine-disrupting chemicals (EDCs), including polychlorinated biphenyls (PCBs), poly-brominated diphenyl ethers (PBDEs), phthalates (PAEs), and per- and polyfluoroalkyl substances (PFAS) exposure and risk of gestational diabetes mellitus (GDM). METHODS Relevant studies from their inception to November 2021 were identified by searching EMBASE, PubMed, and Web of Science. The cohort and case-control studies that reported effect size with 95% confidence intervals (CIs) of EDC exposure and GDM were selected. The heterogeneity among the included studies was quantified by I2 statistic. Publication bias was evaluated through the Begg and Egger tests. RESULTS Twenty-five articles with a total of 23,796 participants were found. Results indicated that exposure to PCBs has a significant influence on the incidence of GDM (OR = 1.14; 95% CI = 1.00--1.31; n = 8). The risk of GDM was found to be associated with PBDE exposure (OR = 1.32; 95% CI = 1.15-1.53; n = 4). PAEs and PFASs exposure were also positively associated with the risk of GDM, with summary ORs of 1.10 (95% CI = 1.03-1.16; n = 7 for PAEs) and 1.09 (95% CI = 1.02-1.16; n = 11 for PFASs), respectively. When only cohort studies were considered, the summary OR between PCBs exposure and the risk of GDM was 0.99 (95% CI = 0.91-1.09; n = 5). Meanwhile, the summary ORs from cohort studies for PBDEs, PAEs, and PFASs exposure were 1.12 (95% CI = 1.00-1.26; n = 2), 1.08 (95% CI = 1.02-1.15; n = 5), and 1.06 (95% CI = 1.00-1.12; n = 8), respectively. The Beggs and Egger tests did not show publication bias, and the sensitivity analyses did not change the results in this meta-analysis. CONCLUSION These results support that exposure to certain EDCs, including PCBs, PBDEs, PAEs, and PFAS, increase the risk of GDM. Further large-sample epidemiologic researches and mechanistic studies are needed to verify the potential relationship and biological mechanisms. These results are of public health significance because the daily EDC exposure is expected to increase the risk of GDM development.
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Affiliation(s)
- Dandan Yan
- Department of Pathology, Renmin Hospital of Wuhan University, 238 Jiefang-Road, Wuchang District, Wuhan, 430060, People's Republic of China
| | - Yang Jiao
- Department of Health Toxicology, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong-Road, Wuhan, 430030, People's Republic of China
| | - Honglin Yan
- Department of Pathology, Renmin Hospital of Wuhan University, 238 Jiefang-Road, Wuchang District, Wuhan, 430060, People's Republic of China
| | - Tian Liu
- Department of Pathology, Renmin Hospital of Wuhan University, 238 Jiefang-Road, Wuchang District, Wuhan, 430060, People's Republic of China
| | - Hong Yan
- Department of Health Toxicology, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong-Road, Wuhan, 430030, People's Republic of China
| | - Jingping Yuan
- Department of Pathology, Renmin Hospital of Wuhan University, 238 Jiefang-Road, Wuchang District, Wuhan, 430060, People's Republic of China.
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A low-carbohydrate dietary pattern characterised by high animal fat and protein during the first trimester is associated with an increased risk of gestational diabetes mellitus in Chinese women: a prospective cohort study. Br J Nutr 2021; 126:1872-1880. [PMID: 33597060 DOI: 10.1017/s0007114521000611] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
We aimed to examine the association between low-carbohydrate diet (LCD) scores during the first trimester and gestational diabetes mellitus (GDM) risk in a Chinese population. A total of 1455 women were included in 2017. Dietary information during the first trimester was collected by 24-h dietary recalls for 3 d. The overall, animal and plant LCD scores, which indicated adherence to different low-carbohydrate dietary patterns, were calculated. GDM was diagnosed based on the results of a 75-g, 2-h oral glucose tolerance test at 24-28 weeks gestation. Log-binomial models were used to estimate relative risks (RR) and 95 % CI. The results showed that the multivariable-adjusted RR of GDM from the lowest to the highest quartiles of the overall LCD score were 1·00 (reference), 1·15 (95 % CI 0·92, 1·42), 1·30 (95 % CI 1·06, 1·60) and 1·24 (95 % CI 1·01, 1·52) (P = 0·026 for trend). Multivariable-adjusted RR (95 % CI) of GDM from the lowest to the highest quartiles of the animal LCD score were 1·00 (reference), 1·20 (95 % CI 0·96, 1·50), 1·41 (95 % CI 1·14, 1·73) and 1·29 (95 % CI 1·04, 1·59) (P = 0·002 for trend). After additional adjustment for gestational weight gain before GDM diagnosis, the association of the overall LCD score with GDM risk was non-significant, while the association of animal LCD score with GDM risk remained significant. In conclusion, a low-carbohydrate dietary pattern characterised by high animal fat and protein during the first trimester is associated with an increased risk of GDM in Chinese women.
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Lorigo M, Cairrao E. Fetoplacental vasculature as a model to study human cardiovascular endocrine disruption. Mol Aspects Med 2021; 87:101054. [PMID: 34839931 DOI: 10.1016/j.mam.2021.101054] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 10/15/2021] [Accepted: 11/18/2021] [Indexed: 12/11/2022]
Abstract
Increasing evidence has associated the exposure of endocrine-disrupting chemicals (EDCs) with the cardiovascular (CV) system. This exposure is particularly problematic in a sensitive window of development, pregnancy. Pregnancy exposome can affect the overall health of the pregnancy by dramatic changes in vascular physiology and endocrine activity, increasing maternal susceptibility. Moreover, fetoplacental vascular function is generally altered, increasing the risk of developing pregnancy complications (including cardiovascular diseases, CVD) and predisposing the foetus to adverse health risks later in life. Thus, our review summarizes the existing literature on exposures to EDCs during pregnancy and adverse maternal health outcomes, focusing on the human placenta, vein, and umbilical artery associated with pregnancy complications. The purpose of this review is to highlight the role of fetoplacental vasculature as a model for the study of human cardiovascular endocrine disruption. Therefore, we emphasize that the placenta, together with the umbilical arteries and veins, allows a better characterization of the pregnant woman's exposome. Consequently, it contributes to the protection of the mother and foetus against CV disorders in life.
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Affiliation(s)
- Margarida Lorigo
- CICS-UBI, Health Sciences Research Centre, University of Beira Interior, 6200-506, Covilhã, Portugal; FCS - UBI, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
| | - Elisa Cairrao
- CICS-UBI, Health Sciences Research Centre, University of Beira Interior, 6200-506, Covilhã, Portugal; FCS - UBI, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal.
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Alvarez-Silvares E, Fernández-Cruz T, Domínguez-Vigo P, Rubio-Cid P, Seoane-Pillado T, Martínez-Carballo E. Association between placenta concentrations polybrominated and polychlorinated biphenyls and gestational diabetes mellitus: a case-control study in northwestern Spain. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:10292-10301. [PMID: 33462692 DOI: 10.1007/s11356-021-12377-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 01/04/2021] [Indexed: 06/12/2023]
Abstract
Exposure to persistent organic pollutants begins in uterine life. The study was conducted to evaluate associations between gestational diabetes mellitus and the presence of persistent organic pollutants in placenta samples. They were derived from a birth cohort study in Ourense (NW Spain). Selective pressurized liquid extraction methodologies were used to determine targeted persistent organic pollutants in placenta samples. Cleanup of extracts was performed by solid-phase extraction using EZ-POP cartridges and detection by gas chromatography coupled to tandem mass spectrometry. Statistical calculations were performed by comparing the values obtained in the case and control groups. Statistical significance was considered as p < 0.050. Results: The concentrations of several congeners of polybrominated diphenyl ethers (PBDE) and polychlorinated biphenyls (PCB) presented lower levels in the placentas of expectant mothers with gestational diabetes mellitus when comparing them to the control cohort. This difference was statistically significant. It was revealed that this association was independent of obesity, age, parity, amenorrhoea at birth, or a family history of diabetes mellitus. To the best of our knowledge, this paper reported an inverse relationship between PBDE and PCB levels in placenta and gestational diabetes mellitus for the first time. We believe this may open a door to future studies in this field.
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Affiliation(s)
- Esther Alvarez-Silvares
- Obstetrics and Gynaecology Department, Complexo Hospitalario Universitario de Ourense, C/ Ramón Puga 54, 32005, Ourense, Spain.
| | - Tania Fernández-Cruz
- Nutrition and Bromatology Group, Analytical and Food Chemistry Department, Agri-Food Research and Transfer Cluster (CITACA), Campus da Auga, Faculty of Sciences of the University of Vigo, 32004, Ourense, Spain
| | - Paula Domínguez-Vigo
- Obstetrics and Gynaecology Department, Complexo Hospitalario Universitario de Ourense, C/ Ramón Puga 54, 32005, Ourense, Spain
| | - Paula Rubio-Cid
- Obstetrics and Gynaecology Department, Complexo Hospitalario Universitario de Ourense, C/ Ramón Puga 54, 32005, Ourense, Spain
| | | | - Elena Martínez-Carballo
- Nutrition and Bromatology Group, Analytical and Food Chemistry Department, Agri-Food Research and Transfer Cluster (CITACA), Campus da Auga, Faculty of Sciences of the University of Vigo, 32004, Ourense, Spain
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Mehta SS, James-Todd T, Applebaum KM, Bellavia A, Coleman-Phox K, Adler N, Laraia B, Epel E, Parry E, Wang M, Park JS, Zota AR. Persistent organic pollutants and maternal glycemic outcomes in a diverse pregnancy cohort of overweight women. ENVIRONMENTAL RESEARCH 2021; 193:110551. [PMID: 33278474 PMCID: PMC7855882 DOI: 10.1016/j.envres.2020.110551] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/11/2020] [Accepted: 11/24/2020] [Indexed: 05/15/2023]
Abstract
BACKGROUND Animal and human studies suggest certain persistent organic pollutants (POPs) may impact glucose metabolism; however, few epidemiologic studies have examined environmental determinants of glycemic outcomes during pregnancy. Our objective is to evaluate associations between exposures to individual and mixture of POPs and measures of prenatal fasting glucose, insulin, and insulin resistance during pregnancy in overweight women. METHODS A cohort of overweight and obese pregnant women (N = 95) was recruited from California. Blood samples were collected during late first or second trimester (median = 16 weeks' gestation; range = 10-24 weeks). Exposures included serum concentrations of polybrominated diphenyl ethers (PBDEs) and hydroxylated metabolites (OH-PBDEs), polychlorinated biphenyls (PCBs), and poly- and perfluoroalkyl substances (PFASs). Outcomes included serum concentrations of fasting plasma glucose, fasting plasma insulin, and calculated homeostatic model assessment of insulin resistance (HOMA-IR). Generalized linear models were used to evaluate cross-sectional associations between individual and aggregate POPs and mean percent difference in fasting glucose, fasting insulin, and HOMA-IR. Bayesian kernel machine regression (BKMR) was used to assess the relative importance of each exposure to the association with our outcomes, using conditional and group posterior inclusion probabilities (PIPs). RESULTS Study participants were racially/ethnically diverse and nearly half were below the federal poverty level. Across PBDEs and OH-PBDEs, the direction of associations with fasting glucose, fasting insulin and HOMA-IR were varied. A doubling of PCB-138, PCB-153, PCB-180, and ∑PCBs concentrations was associated with a 2.10% mmol/L (95%CI: 0.49%, 3.74%), 2.10% mmol/L (95%CI: -0.14%, 4.39%), 2.10% mmol/L (95%CI: 0.12%, 4.12%), and 2.81% mmol/L (95%CI: 0.38%, 5.31%) increase in fasting glucose, respectively. Exposure to individual PCBs was positively associated with both fasting insulin and HOMA-IR. All PFAS were inversely associated with fasting glucose, fasting insulin, and HOMA-IR. In BKMR models of fasting glucose, all four chemical classes were important contributors to the overall mixture, with PFASs identified as the most important contributor. DISCUSSION Prenatal PCB exposure was positively associated while certain PBDE and PFAS analytes were inversely associated with fasting glucose concentrations in overweight women. Further examination of the relationship between POPs exposure and glycemic functioning in a larger study population of women during pregnancy is warranted.
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Affiliation(s)
- Suril S Mehta
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
| | - Tamarra James-Todd
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA; Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Katie M Applebaum
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Andrea Bellavia
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Kimberly Coleman-Phox
- Center for Health and Community, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Nancy Adler
- Department of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Barbara Laraia
- Division of Community Health and Human Development, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Elissa Epel
- Department of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Emily Parry
- Environmental Chemistry Laboratory, California Department of Toxic Substances Control, Berkeley, CA, USA
| | - Miaomiao Wang
- Environmental Chemistry Laboratory, California Department of Toxic Substances Control, Berkeley, CA, USA
| | - June-Soo Park
- Environmental Chemistry Laboratory, California Department of Toxic Substances Control, Berkeley, CA, USA
| | - Ami R Zota
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
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10
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Female mice exposed to low doses of dioxin during pregnancy and lactation have increased susceptibility to diet-induced obesity and diabetes. Mol Metab 2020; 42:101104. [PMID: 33075544 PMCID: PMC7683344 DOI: 10.1016/j.molmet.2020.101104] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/05/2020] [Accepted: 10/13/2020] [Indexed: 12/30/2022] Open
Abstract
Objective Exposure to persistent organic pollutants is consistently associated with increased diabetes risk in humans. We investigated the short- and long-term impact of transient low-dose dioxin (2,3,7,8-tetrachlorodibenzo-p-dioxin, TCDD) exposure during pregnancy and lactation on glucose homeostasis and beta cell function in female mice, including their response to a metabolic stressor later in life. Methods Female mice were injected with either corn oil (CO; vehicle control) or 20 ng/kg/d TCDD 2x/week throughout mating, pregnancy and lactation, and then tracked for 6–10 weeks after chemical exposure stopped. A subset of CO- and TCDD-exposed dams was then transferred to a 45% high-fat diet (HFD) or remained on a standard chow diet for an additional 11 weeks to assess the long-term effects of TCDD on adaptability to a metabolic stressor. To summarize, female mice were transiently exposed to TCDD and then subsequently tracked beyond when TCDD had been excreted to identify lasting metabolic effects of TCDD exposure. Results TCDD-exposed dams were hypoglycemic at birth but otherwise had normal glucose homeostasis during and post-TCDD exposure. However, TCDD-exposed dams on a chow diet were modestly heavier than controls starting 5 weeks after the last TCDD injection, and their weight gain accelerated after transitioning to a HFD. TCDD-exposed dams also had an accelerated onset of hyperglycemia, impaired glucose-induced plasma insulin levels, reduced islet size, increased MAFA-ve beta cells, and increased proinsulin accumulation following HFD feeding compared to controls. Overall, our study demonstrates that low-dose TCDD exposure during pregnancy has minimal effects on metabolism during the period of active exposure, but has detrimental long-term effects on metabolic adaptability to HFD feeding. Conclusions Our study suggests that transient low-dose TCDD exposure in female mice impairs metabolic adaptability to HFD feeding, demonstrating that dioxin exposure may be a contributing factor to obesity and diabetes pathogenesis in females. Female mice exposed to TCDD during pregnancy are hypoglycemic at birth. TCDD exposure promotes weight gain long after exposure ceases. TCDD-exposed dams fed a high-fat diet have accelerated onset of glucose intolerance. TCDDHFD dams have defects in islet morphology and beta cell function.
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11
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Varshavsky J, Smith A, Wang A, Hom E, Izano M, Huang H, Padula A, Woodruff TJ. Heightened susceptibility: A review of how pregnancy and chemical exposures influence maternal health. Reprod Toxicol 2020; 92:14-56. [PMID: 31055053 PMCID: PMC6824944 DOI: 10.1016/j.reprotox.2019.04.004] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 03/12/2019] [Accepted: 04/22/2019] [Indexed: 12/19/2022]
Abstract
Pregnancy is a unique period when biological changes can increase sensitivity to chemical exposures. Pregnant women are exposed to multiple environmental chemicals via air, food, water, and consumer products, including flame retardants, plasticizers, and pesticides. Lead exposure increases risk of pregnancy-induced hypertensive disorders, although women's health risks are poorly characterized for most chemicals. Research on prenatal exposures has focused on fetal outcomes and less on maternal outcomes. We reviewed epidemiologic literature on chemical exposures during pregnancy and three maternal outcomes: preeclampsia, gestational diabetes, and breast cancer. We found that pregnancy can heighten susceptibility to environmental chemicals and women's health risks, although variations in study design and exposure assessment limited study comparability. Future research should include pregnancy as a critical period for women's health. Incorporating biomarkers of exposure and effect, deliberate timing and method of measurement, and consistent adjustment of potential confounders would strengthen research on the exposome and women's health.
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Affiliation(s)
- Julia Varshavsky
- University of California, San Francisco, Program on Reproductive Health and the Environment, San Francisco, CA, USA.
| | - Anna Smith
- University of California, Berkeley, School of Public Health, Berkeley, CA, USA
| | - Aolin Wang
- University of California, San Francisco, Program on Reproductive Health and the Environment, San Francisco, CA, USA; University of California, San Francisco, Bakar Computational Health Sciences Institute, San Francisco, CA, USA
| | - Elizabeth Hom
- University of California, San Francisco, Program on Reproductive Health and the Environment, San Francisco, CA, USA
| | - Monika Izano
- University of California, San Francisco, Program on Reproductive Health and the Environment, San Francisco, CA, USA
| | - Hongtai Huang
- University of California, San Francisco, Program on Reproductive Health and the Environment, San Francisco, CA, USA; University of California, San Francisco, Bakar Computational Health Sciences Institute, San Francisco, CA, USA
| | - Amy Padula
- University of California, San Francisco, Program on Reproductive Health and the Environment, San Francisco, CA, USA
| | - Tracey J Woodruff
- University of California, San Francisco, Program on Reproductive Health and the Environment, San Francisco, CA, USA
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12
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Examining Reproductive Health Outcomes in Females Exposed to Polychlorinated Biphenyl and Polybrominated Biphenyl. Sci Rep 2020; 10:3314. [PMID: 32094419 PMCID: PMC7039953 DOI: 10.1038/s41598-020-60234-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/25/2019] [Indexed: 12/02/2022] Open
Abstract
In 1973, accidental contamination of Michigan livestock with polybrominated biphenyls (PBBs) led to the establishment of a registry of exposed individuals that have been followed for > 40 years. Besides being exposed to PBBs, this cohort has also been exposed to polychlorinated biphenyls (PCBs), a structurally similar class of environmental pollutants, at levels similar to average US exposure. In this study, we examined the association between current serum PCB and PBB levels and various female reproductive health outcomes to build upon previous work and inconsistencies. Participation in this cross-sectional study required a blood draw and completion of a detailed health questionnaire. Analysis included only female participants who had participated between 2012 and 2015 (N = 254). Multivariate linear and logistic regression models were used to identify associations between serum PCB and PBB levels with each gynecological and infertility outcome. Additionally, a generalized estimating equation (GEE) model was used to evaluate each pregnancy and birth outcome in order to account for multiple pregnancies per woman. We controlled for age, body mass index, and total lipid levels in all analyses. A p-value of <0.05 was used for statistical significance. Among the women who reported ever being pregnant, there was a significant negative association with higher total PCB levels associating with fewer lifetime pregnancies ( β = −0.11, 95% CI = −0.21 to −0.005, p = 0.04). There were no correlations between serum PCB levels and the self-reported gynecological outcomes (pelvic inflammatory disease, endometriosis, polycystic ovarian syndrome, or uterine fibroids). No associations were identified between serum PCB levels and the prevalence of female infertility in women reporting ever having sexual intercourse with a male partner. There were no associations identified between serum PCB levels and pregnancy outcomes (singleton live births or miscarriages) or birth outcomes (preterm birth, birth weight, birth defects, hypertensive disorders of pregnancy, or gestational diabetes). PBB was not associated with any outcome. Further research is needed to determine if and how PCB may reduce pregnancy number.
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13
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Bocato MZ, Bianchi Ximenez JP, Hoffmann C, Barbosa F. An overview of the current progress, challenges, and prospects of human biomonitoring and exposome studies. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2019; 22:131-156. [PMID: 31543064 DOI: 10.1080/10937404.2019.1661588] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Human Biomonitoring (HB), the process for determining whether and to what extent chemical substances penetrated our bodies, serves as a useful tool to quantify human exposure to pollutants. In cases of nutrition and physiologic status, HB plays a critical role in the identification of excess or deficiency of essential nutrients. In pollutant HB studies, levels of substances measured in body fluids (blood, urine, and breast milk) or tissues (hair, nails or teeth) aid in the identification of potential health risks or associated adverse effects. However, even as a widespread practice in several countries, most HB studies reflect exposure to a single compound or mixtures which are measured at a single time point in lifecycle. On the other hand, throughout an individual's lifespan, the contact with different physical, chemical, and social stressors occurs at varying intensities, differing times and durations. Further, the interaction between stressors and body receptors leads to dynamic responses of the entire biological system including proteome, metabolome, transcriptome, and adductome. Bearing this in mind, a relatively new vision in exposure science, defined as the exposome, is postulated to expand the traditional practice of measuring a single exposure to one or few chemicals at one-time point to an approach that addresses measures of exposure to multiple stressors throughout the lifespan. With the exposome concept, the science of exposure advances to an Environment-Wide Association Perspective, which might exhibit a stronger relationship with good health or disease conditions for an individual (phenotype). Thus, this critical review focused on the current progress of HB and exposome investigations, anticipating some challenges, strategies, and future needs to be taken into account for designing future surveys.
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Affiliation(s)
- Mariana Zuccherato Bocato
- Laboratório de Toxicologia Analítica e de Sistemas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo , Ribeirão Preto , Brazil
| | - João Paulo Bianchi Ximenez
- Laboratório de Toxicologia Analítica e de Sistemas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo , Ribeirão Preto , Brazil
| | - Christian Hoffmann
- Departmento de Alimentos e Nutrição Experimental Faculdade de Ciências Farmacêuticas, Universidade de São Paulo , São Paulo , Brazil
| | - Fernando Barbosa
- Laboratório de Toxicologia Analítica e de Sistemas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo , Ribeirão Preto , Brazil
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14
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Rahman ML, Zhang C, Smarr MM, Lee S, Honda M, Kannan K, Tekola-Ayele F, Buck Louis GM. Persistent organic pollutants and gestational diabetes: A multi-center prospective cohort study of healthy US women. ENVIRONMENT INTERNATIONAL 2019; 124:249-258. [PMID: 30660025 DOI: 10.1016/j.envint.2019.01.027] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 11/05/2018] [Accepted: 01/10/2019] [Indexed: 05/21/2023]
Abstract
BACKGROUND Persistent organic pollutants (POPs) are linked with insulin resistance and type-2 diabetes (T2D) in the general population. However, their associations with gestational diabetes (GDM) are inconsistent. OBJECTIVE We prospectively evaluated the associations of POPs measured in early pregnancy with GDM risk. We also assessed whether pre-pregnancy BMI (ppBMI) and family history of T2D modify this risk. METHODS In NICHD Fetal Growth Study, Singletons, we measured plasma concentration of 76 POPs, including 11 organochlorine pesticides (OCPs), 9 polybrominated diphenylethers (PBDEs), 44 polychlorinated biphenyls (PCBs), and 11 per-and polyfluoroalkyl substances (PFAS) among 2334 healthy non-obese women at 8-13 weeks of gestation. GDM was diagnosed by Carpenter and Coustan criteria. We constructed chemical networks using a weighted-correlation algorithm and examined the associations of individual chemical and chemical networks with GDM using multivariate Poisson regression with robust variance. RESULTS Higher concentrations of PCBs with six or more chlorine atoms were associated with increased risk of GDM in the overall cohort (risk ratios [RRs] range: 1.08-1.13 per 1-standard deviation [SD] increment) and among women with a family history of T2D (RRs range: 1.08-1.48 per 1-SD increment) or normal ppBMI (RRs range: 1.08-1.22 per 1-SD increment). Similar associations were observed for the chemical network comprised of PCBs with ≥6 chlorine atoms and the summary measure of total PCBs and non-dioxin like PCBs (138, 153, 170, 180). Furthermore, four PFAS congeners - perfluorononanoic acid (PFNA), perfluorooctanoic acid (PFOA), perfluoroheptanoic acid (PFHpA), and perfluorododecanoic acid (PFDoDA) - showed significant positive associations with GDM among women with a family history of T2D (RRs range:1.22-3.18 per 1-SD increment), whereas BDE47 and BDE153 showed significant positive associations among women without a family history of T2D. CONCLUSIONS Environmentally relevant levels of heavily chlorinated PCBs and some PFAS and PBDEs were positively associated with GDM with suggestive effect modifications by family history of T2D and body adiposity status.
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Affiliation(s)
- Mohammad L Rahman
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
| | - Cuilin Zhang
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Melissa M Smarr
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Sunmi Lee
- Wadsworth Center, New York State Department of Health, Department of Environmental Health Sciences; School of Public Health, State University of New York at Albany, NY, USA
| | - Masato Honda
- Wadsworth Center, New York State Department of Health, Department of Environmental Health Sciences; School of Public Health, State University of New York at Albany, NY, USA
| | - Kurunthachalam Kannan
- Wadsworth Center, New York State Department of Health, Department of Environmental Health Sciences; School of Public Health, State University of New York at Albany, NY, USA
| | - Fasil Tekola-Ayele
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Germaine M Buck Louis
- Dean's Office, College of Health and Human Services, George Mason University, Fairfax, VA, USA
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15
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Chung MK, Kannan K, Louis GM, Patel CJ. Toward Capturing the Exposome: Exposure Biomarker Variability and Coexposure Patterns in the Shared Environment. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2018; 52:8801-8810. [PMID: 29972023 PMCID: PMC6085725 DOI: 10.1021/acs.est.8b01467] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/20/2018] [Accepted: 07/04/2018] [Indexed: 05/24/2023]
Abstract
Many factors affect the variation in the exposome. We examined the influence of shared household and partner's sex in relation to the variation in 128 endocrine disrupting chemical (EDC) exposures among couples. In a cohort comprising of 501 couples trying for pregnancy, we measured 128 (13 chemical classes) persistent and nonpersistent EDCs and estimated 1) sex-specific differences; 2) variance explained by shared household; and 3) Spearman's rank correlation coefficients ( rs) for females, males, and couples' exposures. Sex was correlated with 8 EDCs including per- and polyfluoroalkyl substances (PFASs) ( p < 0.05). Shared household explained 43% and 41% of the total variance for PFASs and blood metals, respectively, but less than 20% for the remaining 11 EDC classes. Coexposure patterns of the exposome were similar between females and males, with within-class rs higher for persistent than for nonpersistent chemicals. Median rss of polybrominated compounds and urine metalloids were 0.45 and 0.09, respectively, for females (0.41 and 0.08 for males; 0.21 and 0.04 for couples). Our findings suggest that individual, rather than shared environment, could be a major factor influencing the covariation of the exposome. Understanding the correlations of exposures has important analytical and sampling implications for exposomics research.
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Affiliation(s)
- Ming Kei Chung
- Department
of Biomedical Informatics, Harvard Medical School, Harvard University, 10 Shattuck Street, Boston, Massachusetts 02115, United States
| | - Kurunthachalam Kannan
- Division
of Environmental Health Sciences Wadsworth Center, New York State
Department of Health, and Department of Environmental Health Sciences, The University at Albany, Albany, New York 12201, United States
| | - Germaine M. Louis
- Office
of the Director, Division of Intramural Population Health Research,
Eunice Kennedy Shriver National Institute for Child Health and Human
Development, The National Institutes of
Health, 6710b Rockledge
Drive, Bethesda, Maryland 20892, United States
| | - Chirag J. Patel
- Department
of Biomedical Informatics, Harvard Medical School, Harvard University, 10 Shattuck Street, Boston, Massachusetts 02115, United States
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16
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Zhang L, Liu X, Meng G, Chi M, Li J, Yin S, Zhao Y, Wu Y. Non-dioxin-like polychlorinated biphenyls in early pregnancy and risk of gestational diabetes mellitus. ENVIRONMENT INTERNATIONAL 2018; 115:127-132. [PMID: 29558635 DOI: 10.1016/j.envint.2018.03.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 03/09/2018] [Accepted: 03/09/2018] [Indexed: 05/12/2023]
Abstract
Several studies support a plausible association of human exposure to polychlorinated biphenyls (PCBs) with type 2 diabetes mellitus. However, little is known about the potential link between circulating PCBs levels in early pregnancy and development of gestational diabetes mellitus (GDM). Here, we conducted a prospective study with a nested case-control design to determine the association of PCB exposure in early pregnancy with GDM risk. Concentrations of selected so-called 'indicator PCBs' were determined in sera of women in the first trimester of pregnancy via gas chromatography - high resolution mass spectrometry. Pregnant women were screened for GDM at 24-28 weeks of gestation using the oral glucose test (OGTT). GDM was defined based on the diagnostic criteria set by China Ministry of Health. Conditional logistic and linear regression models were employed to evaluate the association of PCB exposure with GDM risk and OGTT values, respectively. The odds ratios (OR) of PCB-28, PCB-52, and PCB-101 for GDM were 1.86 (95% CI: 1.05-3.27), 1.90 (95% CI: 1.28-2.82) and 1.85 (95% CI: 1.22-2.82), respectively. No statistical association was evident for other PCBs. However, after adjusting for confounders including some PCB congeners, only PCB-52 remained significantly associated with GDM with OR of 1.97 (95% CI: 1.27-3.07). Moreover, PCB-52 was positively associated with all blood glucose values of OGTT (p < 0.05). Our findings collectively suggest that serum levels of specific non-dioxin-like PCBs in early pregnancy disturb the glucose metabolism and increase the risk of GDM.
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Affiliation(s)
- Lei Zhang
- The Key Laboratory of Food Safety Risk Assessment, Ministry of Health (CFSA) and China National Center for Food Safety Risk Assessment, Beijing, China
| | - Xin Liu
- The Key Laboratory of Food Safety Risk Assessment, Ministry of Health (CFSA) and China National Center for Food Safety Risk Assessment, Beijing, China; State Key Lab of Food Science and Technology, School of Food Science and Technology, Nanchang University, Nanchang, China
| | - Guimin Meng
- Department of Obstetrics and Gynecology, Beijing Fengtai Hospital, Beijing, China
| | - Min Chi
- The Key Laboratory of Food Safety Risk Assessment, Ministry of Health (CFSA) and China National Center for Food Safety Risk Assessment, Beijing, China
| | - Jingguang Li
- The Key Laboratory of Food Safety Risk Assessment, Ministry of Health (CFSA) and China National Center for Food Safety Risk Assessment, Beijing, China.
| | - Shuaixing Yin
- The Key Laboratory of Food Safety Risk Assessment, Ministry of Health (CFSA) and China National Center for Food Safety Risk Assessment, Beijing, China
| | - Yunfeng Zhao
- The Key Laboratory of Food Safety Risk Assessment, Ministry of Health (CFSA) and China National Center for Food Safety Risk Assessment, Beijing, China
| | - Yongning Wu
- The Key Laboratory of Food Safety Risk Assessment, Ministry of Health (CFSA) and China National Center for Food Safety Risk Assessment, Beijing, China
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Abstract
BACKGROUND Self-report is often used in identifying gestational diabetes events in epidemiologic studies; however, validity data are limited, with little to no data on self-reported severity or treatment. METHODS We aimed to assess the validity of self-reported gestational diabetes diagnosis and evaluate the accuracy of glucose diagnosis results and gestational diabetes treatment self-reported at 6-week postpartum. Data were from 82 and 83 women with and without gestational diabetes, respectively, within the prospective National Institute Child Health and Human Development Fetal Growth Studies-Singletons (2009-2013). Medical record data were considered the gold standard. RESULTS Sensitivity was 95% (95% confidence interval [CI] = 88, 98), and specificity was 100% (95% CI = 96, 100); four women with gestational diabetes incorrectly reported not having the disease, and none of the women without gestational diabetes reported having gestational diabetes. Sensitivity did not vary substantially across maternal characteristics including race/ethnicity. For women who attempted to recall their values (84/159 women), self-reported glucose challenge test results did not differ from the medical records (median difference: 0; interquartile range: 0-0 mg/dl). Medical records indicated that 42 (54%) of 78 women with confirmed gestational diabetes were treated by diet only and 33 (42%) were treated by medication. All 42 women with diet-treated gestational diabetes correctly reported having had diet and lifestyle modification, and 28 (85%) of 33 women with medication-treated gestational diabetes indicated postpartum that they had medication treatment. CONCLUSIONS At 6-week postpartum, regardless of race/ethnicity or socioeconomic status, women accurately recalled whether they had gestational diabetes and, as applicable, their treatment method.
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18
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Valvi D, Oulhote Y, Weihe P, Dalgård C, Bjerve KS, Steuerwald U, Grandjean P. Gestational diabetes and offspring birth size at elevated environmental pollutant exposures. ENVIRONMENT INTERNATIONAL 2017; 107:205-215. [PMID: 28753482 PMCID: PMC5584560 DOI: 10.1016/j.envint.2017.07.016] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 07/17/2017] [Accepted: 07/18/2017] [Indexed: 05/17/2023]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is associated with increased availability of glucose and macronutrients in fetal circulation and macrosomia. Therefore, the role of GDM in the association between metabolism-disrupting chemicals and birth size deserves attention. OBJECTIVE We examined whether GDM may mediate or modify the associations between maternal environmental pollutant exposures and offspring birth size measures. METHODS We analyzed 604 Faroese pregnant women and their offsprings born in 1997-2000. Maternal pregnancy serum concentrations of organochlorine compounds (OCs: polychlorinated biphenyl (PCB) congeners and dichlorodiphenyldichloroethylene (DDE)), and five perfluoroalkyl substances (PFASs), and hair and cord blood mercury concentrations were measured. We used regression (single-pollutants) and structural equation models (SEMs) (multiple-pollutant analyses using latent constructs of OCs, PFASs and mercury) to estimate the associations with GDM and birth size measures, accounting for mediation and/or effect modification by GDM. RESULTS Serum-DDE and hair-mercury concentrations were associated with GDM (adjusted OR per concentration doubling: 1.29; 95% CI: 0.94, 1.77 for DDE, and 0.79; 95% CI: 0.62, 0.99 for mercury), but in multiple pollutant-adjusted SEMs only a positive association between OC exposure and GDM remained significant (change in GDM odds per OC doubling: 0.45; 95% CI: 0.05, 0.86). PCB and overall OC exposure were positively associated with head circumference (SEM; mean change per OC doubling: 0.13cm; 95% CI, 0.01. 0.25). Overall PFAS exposure was inversely associated with birth weight (SEM; mean change per PFAS doubling: -169g; 95% CI: -359, 21), and for many single-PFASs we found a pattern of inverse associations with birth weight and head circumference in boys, and positive or null associations in girls. None of the environmental pollutants was associated with offspring length. GDM neither modified nor mediated the associations with birth size measures. CONCLUSIONS We found associations with GDM and offspring birth size to be specific to the environmental pollutant or pollutant group. Associations with birth size measures appear to be independent of GDM occurrence.
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Affiliation(s)
- Damaskini Valvi
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
| | - Youssef Oulhote
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Pal Weihe
- Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark; Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands
| | - Christine Dalgård
- Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Kristian S Bjerve
- Department of Medical Biochemistry, St. Olays Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Laboratory Medicine, Children's and Women's Health, NTNU, Trondheim, Norway
| | - Ulrike Steuerwald
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands
| | - Philippe Grandjean
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark
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Independent Maternal and Fetal Genetic Effects on Midgestational Circulating Levels of Environmental Pollutants. G3-GENES GENOMES GENETICS 2017; 7:1287-1299. [PMID: 28235828 PMCID: PMC5386877 DOI: 10.1534/g3.117.039784] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Maternal exposure to environmental pollutants could affect fetal brain development and increase autism spectrum disorder (ASD) risk in conjunction with differential genetic susceptibility. Organohalogen congeners measured in maternal midpregnancy blood samples have recently shown significant, but negative associations with offspring ASD outcome. We report the first large-scale maternal and fetal genetic study of the midpregnancy serum levels of a set of 21 organohalogens in a subset of 790 genotyped women and 764 children collected in California by the Early Markers for Autism (EMA) Project. Levels of PCB (polychlorinated biphenyl) and PBDE (polybrominated diphenyl ether) congeners showed high maternal and fetal estimated SNP-based heritability (h2g) accounting for 39–99% of the total variance. Genome-wide association analyses identified significant maternal loci for p,p′-DDE (P = 7.8 × 10−11) in the CYP2B6 gene and for BDE-28 (P = 3.2 × 10−8) near the SH3GL2 gene, both involved in xenobiotic and lipid metabolism. Fetal genetic loci contributed to the levels of BDE-100 (P = 4.6 × 10−8) and PCB187 (P = 2.8 × 10−8), near the potential metabolic genes LOXHD1 and PTPRD, previously implicated in neurodevelopment. Negative associations were observed for BDE-100, BDE153, and the sum of PBDEs with ASD, partly explained by genome-wide additive genetic effects that predicted PBDE levels. Our results support genetic control of midgestational biomarkers for environmental exposures by nonoverlapping maternal and fetal genetic determinants, suggesting that future studies of environmental risk factors should take genetic variation into consideration. The independent influence of fetal genetics supports previous hypotheses that fetal genotypes expressed in placenta can influence maternal physiology and the transplacental transfer of organohalogens.
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20
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Vafeiadi M, Roumeliotaki T, Chalkiadaki G, Rantakokko P, Kiviranta H, Fthenou E, Kyrtopoulos SA, Kogevinas M, Chatzi L. Persistent organic pollutants in early pregnancy and risk of gestational diabetes mellitus. ENVIRONMENT INTERNATIONAL 2017; 98:89-95. [PMID: 27743729 DOI: 10.1016/j.envint.2016.10.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 09/30/2016] [Accepted: 10/06/2016] [Indexed: 05/28/2023]
Abstract
BACKGROUND Persistent organic pollutants (POPs) are a group of diverse substances, including polychlorinated biphenyls (PCBs) and organochlorine pesticides that are resistant to biodegradation and ubiquitously present in our environment. Exposure to endocrine disrupting chemicals such as POPs has been linked to type 2 diabetes and metabolic disturbances in epidemiological and animal studies, but little is known about POPs exposure during pregnancy and the development of gestational diabetes mellitus (GDM). The purpose of this study was to determine the extent to which exposure to current low levels of different POPs in the first trimester of pregnancy is associated with GDM risk in 939 women from the "Rhea" pregnancy cohort in Crete, Greece. METHODS Concentrations of several PCBs, dichlorodiphenyldichloroethene (DDE), and hexachlorobenzene (HCB) were determined in first trimester maternal serum by triple quadrupole mass spectrometry. We defined total PCBs as the sum of all congeners, nondioxin-like PCBs as the sum of PCB 153, 138, 170 and 180, and dioxin-like PCBs as the sum of PCB 118 and 156. Pregnant women were screened for gestational diabetes mellitus (GDM) between 24 and 28weeks of gestation, and GDM was defined by the criteria proposed by Carpenter and Coustan. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression models. RESULTS Of the 939 women, 68 (7%) developed GDM. Serum concentrations of POPs were higher in women with GDM. Women in the medium and high tertiles of PCBs had 3.90 (95% CI: 1.37, 11.06) and 3.60 (95% CI: 1.14, 11.39) fold respectively higher odds of developing GDM compared to women in the lowest tertile of PCB exposure after adjusting for pre-pregnancy BMI and several other confounders. Odds of GDM for women in the medium and high tertiles of dioxin-like PCBs was 5.63 (95% CI: 1.81, 17.51) and 4.71 (95% CI: 1.38, 16.01) and for nondioxin-like PCBs 2.36 (95% CI: 0.89, 6.23) and 2.26 (95% CI: 0.77, 6.68) respectively. Prenatal DDE and HCB exposure were not significantly associated GDM risk. CONCLUSIONS These findings suggest that women with high PCBs levels in early pregnancy had higher risk for GDM. Further studies are needed to replicate these results and to evaluate potential biological mechanisms underlying the observed associations.
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Affiliation(s)
- Marina Vafeiadi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.
| | - Theano Roumeliotaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Georgia Chalkiadaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Panu Rantakokko
- Department of Environmental Health, National Institute for Health and Welfare, Chemicals and Health Unit, Kuopio, Finland
| | - Hannu Kiviranta
- Department of Environmental Health, National Institute for Health and Welfare, Chemicals and Health Unit, Kuopio, Finland
| | - Eleni Fthenou
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Soterios A Kyrtopoulos
- National Hellenic Research Foundation, Institute of Biology, Medicinal Chemistry and Biotechnology, Athens, Greece
| | - Manolis Kogevinas
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Hospital del Mar Research Institute (IMIM), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Leda Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
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Eslami B, Naddafi K, Rastkari N, Rashidi BH, Djazayeri A, Malekafzali H. Association between serum concentrations of persistent organic pollutants and gestational diabetes mellitus in primiparous women. ENVIRONMENTAL RESEARCH 2016; 151:706-712. [PMID: 27640070 DOI: 10.1016/j.envres.2016.09.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 08/28/2016] [Accepted: 09/05/2016] [Indexed: 05/20/2023]
Abstract
BACKGROUND There is growing evidence that persistent organic pollutants (POPs) may play an important role in increasing the risk of gestational diabetes mellitus (GDM). OBJECTIVES The aim of this study was to examine the association between polychlorinated biphenyls (PCBs, 10 congeners) and polybrominated diphenyl ethers (PBDEs, 8 congeners) and GDM in primiparous women with no family history of diabetes in first-degree relatives during the third trimester of pregnancy. METHODS This case-control study was performed among the three university hospitals of Tehran University of Medical Sciences. Serum samples were collected from cases (n=70) that were diagnosed with GDM and from controls (n=70) with a normal pregnancy that attended the same hospital for a routine prenatal visit. Pollutant levels were analyzed by Gas Chromatography Mass Spectrometry (GC/MS). RESULTS Logistic regression analyses manifested the positive association between total POPs (sum of total PCBs and PBDEs) (Odds ratio (OR)=1.61, 95% CI: 1.31-1.97, p-value <0.0001) and total PCBs (OR=1.75, 95% CI: 1.35-2.27, p-value<0.0001) and GDM considering confounding variables (age, gestational age, pre-pregnancy body mass index (BMI), and total maternal serum lipid). In addition, we found a positive association between total PBDEs and GDM (OR =2.21; 95% CI: 1.48-3.30, p-value <0.0001). Finally, we found a positive association between Ln PCB 187, 118 and Ln PBDE 99, 28 with GDM. Meanwhile a negative association between Ln PCB 28 and GDM was established. CONCLUSION Our data suggest that exposure to certain POPs (PCBs and PBDEs) could be a potential modifying risk factor for GDM.
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Affiliation(s)
- Bita Eslami
- Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Naddafi
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Noushin Rastkari
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Batool Hossein Rashidi
- Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abolghasem Djazayeri
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Malekafzali
- Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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