A cohort study on association between the first trimester phthalates exposure and fasting blood glucose level in the third trimester / 中华流行病学杂志

ABSTRACT

Objective To examine the association between the phthalate exposure in the first trimester and fasting blood glucose level or gestational diabetes mellitus (GDM) in the third trimester in pregnant women.Methods A total of 3 474 pregnant women,receiving their prenatal examination in Ma'anshan Maternal and Child Health-Care Hospital of Anhui province,were selected from May 2013 to September 2014.Questionnaires were used to collect the information about their sociodemographic characteristics,clinical characteristics and GDM diagnostic results in the first,second and third trimesters.Urine samples and fasting venous blood samples were collected.Concentrations of 7 kinds of phthalate metabolites in urine samples were detected by solid phase extraction-high performance liquid chromatography-tandem mass spectrometry (SPE-HPLC-MS/MS),and multiple linear regression model was used for statistical analyses.Logistic regression analysis on the risk of the first trimester phthalate exposure for GDM in the third trimester was conducted.Results The prevalence of GDM in this study was 12.8％,monomethyl phthalate (MMP),monoethyl phthalate (MEP),mono-n-butyl phthalate (MBP),monobenzyl phthalate (MBzP) and mono-(2-ethyl-5-oxohexyl) phthalate (MEHHP) exposure levels were positively correlated with the fasting blood glucose level in the third trimester (P＜0.05),but mono-(2-ethylhexyl) phthalate (MEHP) and mono-(2-ethyl-5-hydroxylhexyl) phthalate (MEOHP) exposure levels were negatively correlated with the fasting blood glucose level in the third trimester (P＜0.05).Stratified analysis showed a positive correlation between MEHHP exposure and the third trimester fasting blood glucose level in both normal group and GDM group.However,MMP,MEP,MBP,MBzP,MEHP and MEOHP exposure levels had influences on the third trimester fasting blood glucose level in normal group but not in GDM group.MMP and MBP exposure might increase the risk of GDM,but MEOHP exposure might reduce the risk of GDM.Conclusion The phthalate exposure in the first trimester might be associated with the fasting blood glucose level in the third trimester,MMP,MEP,MBP,MBzP and MEHHP concentrations were positively associated with the third trimester blood glucose level,MEHP and MEOHP concentrations were negatively associated with the third trimester blood glucose level.Moreover,the effects of different kinds of phthalates might be different.