PMID- 33984575 OWN - NLM STAT- MEDLINE DCOM- 20210902 LR - 20210902 IS - 1873-6750 (Electronic) IS - 0160-4120 (Linking) VI - 156 DP - 2021 Nov TI - Environmental exposure to perfluoroalkyl substances in early pregnancy, maternal glucose homeostasis and the risk of gestational diabetes: A prospective cohort study. PG - 106621 LID - S0160-4120(21)00246-4 [pii] LID - 10.1016/j.envint.2021.106621 [doi] AB - BACKGROUND: Humans are widely exposed to environmental perfluoroalkyl substances (PFAS), which may affect glucose homeostasis. However, research linking PFAS exposure to glucose homeostasis during pregnancy is limited and the results were inconsistent. We aimed to investigate the association between PFAS exposure and glucose homeostasis in pregnancy in a large prospective cohort. METHODS: A total of 2747 pregnant women who participated in the Shanghai Birth Cohort, had blood samples in early pregnancy and completed a 75 g oral glucose tolerance test (OGTT) at 24-28 gestational weeks were included. 10 PFAS were determined by high-performance liquid chromatography/tandem mass spectrometry (HPLC/MS-MS) in the plasma samples in early pregnancy. Logistic regression was used to explore the associations between PFAS concentrations and gestational diabetes mellitus (GDM), while multiple linear regression was used to model the associations between PFAS and OGTT fasting, 1-h and 2-h glucose levels. Potential confounders were adjusted. Bayesian kernel machine regression (BKMR) and a quantile-based g-computation approach (qgcomp) were employed to explore the joint and independent effects of PFAS on glucose homeostasis. RESULTS: The incidence of GDM was 11.8%. One log-unit increment in plasma concentrations in early pregnancy was associated with an increased risk of GDM for perfluorobutane sulfonate (PFBS) (adjusted odd ratio (aOR) = 1.23, 95% confidence interval (95% CI): 1.05, 1.44) and perfluoroheptanoic acid (PFHpA) (aOR = 1.25, 95% CI: 1.07, 1.46). Perfluorooctane sulfonic acid (PFOS), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluorohexanesulfonate (PFHxS) and PFHpA were positively correlated with 1-h and 2-h glucose levels. Results of the mixed exposure model showed that the joint effects of PFAS were significantly associated with abnormal glucose homeostasis; In the BKMR model, PFAS mixture exposure was positively associated with the GDM incidence, 1-h and 2-h glucose levels and negatively correlated with FBG level. A similar trend could be observed in qgcomp and the positive correlation between PFAS and 2-h glucose level was significant (beta = 0.12, 95% CI: 0.04, 0.20). PFOS, PFNA and PFHpA may be the main contributors after controlling for other PFAS congeners. PFOS was significantly correlated with GDM incidence and 2-h glucose level, and PFHpA was significantly associated with FBG and 2-h glucose levels. The above associations were more prominent among women with a normal prepregnant BMI. CONCLUSIONS: Environmental exposure to PFAS may affect glucose homeostasis in pregnancy and increase the risk of GDM, especially in normal weight women. CI - Copyright (c) 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved. FAU - Yu, Guoqi AU - Yu G AD - Ministry of Education -Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Jin, Minfei AU - Jin M AD - Department of Obstetrics and Gynecology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Huang, Ying AU - Huang Y AD - Xinhua Hospital Chongming Branch, Shanghai Jiao Tong University School of Medicine, China. FAU - Aimuzi, Ruxianguli AU - Aimuzi R AD - Shanghai Jiao Tong University School of Public Health, Shanghai, China. FAU - Zheng, Tao AU - Zheng T AD - Department of Obstetrics and Gynecology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Nian, Min AU - Nian M AD - Shanghai Jiao Tong University School of Public Health, Shanghai, China. FAU - Tian, Ying AU - Tian Y AD - Ministry of Education -Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Jiao Tong University School of Public Health, Shanghai, China. FAU - Wang, Weiye AU - Wang W AD - Ministry of Education -Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Luo, Zhongcheng AU - Luo Z AD - Ministry of Education -Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Obstetrics and Gynecology, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Canada. FAU - Shen, Lisong AU - Shen L AD - Department of Laboratory Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Wang, Xipeng AU - Wang X AD - Department of Obstetrics and Gynecology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Du, Qing AU - Du Q AD - Xinhua Hospital Chongming Branch, Shanghai Jiao Tong University School of Medicine, China; Department of Rehabilitation Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: duqing@xinuamed.com.cn. FAU - Xu, Weiping AU - Xu W AD - Xinhua Hospital Chongming Branch, Shanghai Jiao Tong University School of Medicine, China; Department of Cardiovascular, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: xuweiping@xinhuamed.com.cn. FAU - Zhang, Jun AU - Zhang J AD - Ministry of Education -Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Jiao Tong University School of Public Health, Shanghai, China. Electronic address: junjimzhang@sina.com. CN - Shanghai Birth Cohort Study LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20210511 PL - Netherlands TA - Environ Int JT - Environment international JID - 7807270 RN - 0 (Alkanesulfonic Acids) RN - 0 (Environmental Pollutants) RN - 0 (Fluorocarbons) RN - IY9XDZ35W2 (Glucose) SB - IM MH - *Alkanesulfonic Acids/toxicity MH - Bayes Theorem MH - China/epidemiology MH - Cohort Studies MH - *Diabetes, Gestational/chemically induced/epidemiology MH - Environmental Exposure/adverse effects MH - *Environmental Pollutants/toxicity MH - Female MH - *Fluorocarbons/toxicity MH - Glucose MH - Homeostasis MH - Humans MH - Pregnancy MH - Prospective Studies OTO - NOTNLM OT - Gestational diabetes mellitus OT - Glucose homeostasis OT - Obese status OT - Perfluoroalkyl substances EDAT- 2021/05/14 06:00 MHDA- 2021/09/03 06:00 CRDT- 2021/05/13 20:16 PHST- 2020/12/04 00:00 [received] PHST- 2021/04/15 00:00 [revised] PHST- 2021/04/30 00:00 [accepted] PHST- 2021/05/14 06:00 [pubmed] PHST- 2021/09/03 06:00 [medline] PHST- 2021/05/13 20:16 [entrez] AID - S0160-4120(21)00246-4 [pii] AID - 10.1016/j.envint.2021.106621 [doi] PST - ppublish SO - Environ Int. 2021 Nov;156:106621. doi: 10.1016/j.envint.2021.106621. Epub 2021 May 11.