孕妇血清邻苯二甲酸酯浓度与妊娠期糖尿病之间的关系

Relationship between serum concentrations of phthalic acid esters and gestational diabetes mellitus in pregnant women

邻苯二甲酸酯(PAEs)广泛暴露于人体,对孕妇有许多不利影响.迄今为止,已发表了许多关于PAE对妊娠期糖尿病(GDM)风险影响的研究,但这些研究的结果存在争议.本研究共采集了2011年至2012年158例孕妇血清样本(包括104名GDM孕妇和54名未患GDM孕妇),利用气相色谱-质谱(GC-MS)测量了血清中16种PAEs的浓度,并研究了血清中PAEs浓度与孕妇患GDM风险和血糖水平之间的关系.结果表明,邻苯二甲酸二(2-乙基)己酯(DEHP,平均值为32.95 ng·mL^(-1))是孕妇血清中浓度最高的PAEs,其次是邻苯二甲酸二丁酯(DBP,平均值为20.55 ng·mL^(-1))和邻苯二甲酸丁基苄基酯(BBP,平均值为9.89 ng·mL^(-1)).Logistic回归分析结果指出,孕妇血清中的邻苯二甲酸二甲酯(DMP,odds ratio(OR)=2.39,95%置信区间(CI):1.14,3.85),DBP(OR=3.54,95%CI:1.25,5.70),邻苯二甲酸二异丁酯(DIBP,OR=2.32,95%CI:1.78,4.14)和DEHP(OR=4.19,95%CI:2.89,5.99)浓度与GDM发病率呈显著正相关.此外,孕妇的血清中DBP、DIBP和DEHP浓度与2 h血糖呈正相关(未调整模型:β_(DBP)=0.13,95%CI:0.09,0.42,P<0.05;β_(DIBP)=0.19,95%CI:0.04,0.65,P<0.05;β_(DEHP)=0.32,95%CI:0.10,0.53,P<0.05.调整后模型:β_(DBP)=0.12,95%CI:0.07,0.38,P<0.05;β_(DIBP)=0.25,95%CI:0.10,0.69,P<;0.05;β_(DEHP)=0.38,95%CI:0.15,0.58,P<0.05).总结而言,暴露于DBP、DIBP、DMP和DEHP可能会增加孕妇患GDM的风险.

Phthalic acid esters(PAEs)are widely present in humans and can have many adverse effects on pregnant women.To date,many studies on the effects of PAEs on the risk of gestational diabetes mellitus(GDM)have been published,but the findings of these studies are controversial.In this study,158 serum samples(including 104 pregnant women with GDM and 54 pregnant women non-GDM)were collected between 2011 and 2012.The concentrations of 16 PAEs in serum were measured by Gas Chromatography-Mass Spectrometer(GC-MS),and the association between PAEs concentrations in serum and GDM risk and blood glucose level of pregnant women was studied.The results showed that di(2-ethyl)hexyl phthalate(DEHP;mean=32.95 ng·mL^(-1))was the abundant PAEs in serum,followed by dibutyl phthalate(DBP;mean=20.55 ng·mL^(-1))and butyl benzyl phthalate(BBP;mean=9.89 ng·mL^(-1)).Logistic regression analysis indicated that dimethyl phthalate(DMP;odd ratio(OR)=2.39,95%confidence interval(CI):1.14,3.85),DBP(OR=3.54,95%CI:1.25,5.70),di-isobutyl phthalate(DIBP;OR=2.32,95%CI:1.78,4.14),and DEHP(OR=4.19,95%CI:2.89,5.99)concentrations in serum were significant positively associated with GDM.In addition,the concentrations of DBP,DIBP,and DEHP in serum of pregnant women were positively associated with 2-hour blood glucose(Crude Model:β_(DBP)=0.13,95%CI:0.09,0.42,P<0.05;β_(DIBP)=0.19,95%CI:0.04,0.65,P<0.05;β_(DEHP)=0.32,95%CI:0.10,0.53,P<0.05.Adjusted Model:β_(DBP)=0.12,95%CI:0.07,0.38,P<0.05;β_(DIBP)=0.25,95%CI:0.10,0.69,P<0.05;β_(DEHP)=0.38,95%CI:0.15,0.58,P<0.05).Overall,the results showed that exposure to DBP,DIBP,DMP,and DEHP may increase the risk of GDM in pregnant women.