PMID- 35691348
OWN - NLM
STAT- MEDLINE
DCOM- 20220628
LR  - 20220628
IS  - 1879-1026 (Electronic)
IS  - 0048-9697 (Linking)
VI  - 838
IP  - Pt 4
DP  - 2022 Sep 10
TI  - Exposure to per- and polyfluoroalkyl substances as a risk factor for gestational 
      diabetes mellitus through interference with glucose homeostasis.
PG  - 156561
LID - S0048-9697(22)03658-0 [pii]
LID - 10.1016/j.scitotenv.2022.156561 [doi]
AB  - Per- and polyfluoroalkyl substances (PFASs) are hypothesized to trigger 
      gestational diabetes mellitus (GDM) through modulation of glucose metabolism. 
      However, studies investigating links between joint PFASs to GDM are limited and 
      led to discrepant conclusions. This study included 171 women with GDM development 
      in pregnancy and 169 healthy controls from Hangzhou, China between October 2020 
      and September 2021. By using the solid-phase extraction (SPE)-ultra performance 
      liquid chromatography-tandem-mass-spectrometry (UPLC/MS-MS), 15 PFASs were 
      detected to be widely distributed in maternal serum, with highest median 
      concentrations of 7.43, 4.23, and 3.64 ng/mL for perfluorooctanoic acid (PFOA), 
      perfluorooctane sulfonic acid (PFOS), and 6:2 chlorinated polyfluorinated ether 
      sulfonates (6:2 Cl-PFESA). Multivariable logistic regressions suggested that the 
      adjusted odds ratios (ORs) with 95% confidence intervals (CI) of GDM for second 
      and highest tertiles of PFOA were 2.57 (1.24, 4.86), p = 0.001 and 1.98 (1.06, 
      3.65), p = 0.023. Compared with the reference tertile, the ORs of GDM were also 
      significantly increased at the highest tertile of perfluoroundecanoic acid 
      (PFUnDA), perfluorododecanoic acid (PFDoA), PFOS and 6:2Cl-PFESA. Multiple linear 
      regressions further indicated that exposure to these PFASs congeners were 
      positively associated with continuous glycemic outcomes of fasting blood glucose 
      (FBG), 1-h, and 2-h glucose after 75 g oral glucose tolerance (OGTT) test as well 
      as glycohemoglobin (HbA1c). Nevertheless, perfluorohexane sulfonic acid (PFHxS), 
      4:2 fluorotelomer sulfonates (FTSs), and 3H-perfluoro-3-[(3-methoxy-propoxy) 
      propanoic acid] (ADONA) exhibited protective effects on some of these glycemic 
      outcomes. When assessing the PFASs as mixtures by conducting the Bayesian kernel 
      machine regression (BKMR), the risks of GDM and values of glycemic outcomes 
      increased significantly as the concentrations of the PFASs mixture increased, 
      with PFOA being the largest contributor. We therefore propose that although the 
      effects on glucose homeostasis varied between different PFAS congeners, the 
      elevated combined exposures to PFASs may be associated with substantially 
      increased GDM risks by altering glucose metabolism.
CI  - Copyright (c) 2022 Elsevier B.V. All rights reserved.
FAU - Xu, Chenye
AU  - Xu C
AD  - College of Environmental Science and Engineering, Donghua University, Shanghai 
      201620, China.
FAU - Zhang, Long
AU  - Zhang L
AD  - Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 
      310006, China.
FAU - Zhou, Quan
AU  - Zhou Q
AD  - College of Environmental Science and Engineering, Donghua University, Shanghai 
      201620, China.
FAU - Ding, Jiaxin
AU  - Ding J
AD  - College of Environmental Science and Engineering, Donghua University, Shanghai 
      201620, China.
FAU - Yin, Shanshan
AU  - Yin S
AD  - Interdisciplinary Research Academy (IRA), Zhejiang Shuren University, Hangzhou 
      310015, China.
FAU - Shang, Xuejun
AU  - Shang X
AD  - Department of Andrology, Jinling Hospital, School of Medicine, Nanjing 
      University, Nanjing, Jiangsu, 210002, China.
FAU - Tian, Yonghong
AU  - Tian Y
AD  - Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 
      310006, China. Electronic address: tianyh@zju.edu.cn.
LA  - eng
PT  - Journal Article
DEP - 20220609
PL  - Netherlands
TA  - Sci Total Environ
JT  - The Science of the total environment
JID - 0330500
RN  - 0 (Alkanesulfonates)
RN  - 0 (Alkanesulfonic Acids)
RN  - 0 (Blood Glucose)
RN  - 0 (Environmental Pollutants)
RN  - 0 (Fluorocarbons)
RN  - IY9XDZ35W2 (Glucose)
SB  - IM
MH  - Alkanesulfonates/analysis
MH  - *Alkanesulfonic Acids/analysis
MH  - Bayes Theorem
MH  - Blood Glucose/analysis
MH  - China
MH  - *Diabetes, Gestational/chemically induced/epidemiology
MH  - *Environmental Pollutants/analysis
MH  - Female
MH  - *Fluorocarbons/analysis
MH  - Glucose
MH  - Homeostasis
MH  - Humans
MH  - Pregnancy
MH  - Risk Factors
OTO - NOTNLM
OT  - Bayesian kernel machine regression (BKMR)
OT  - Continuous glycemic outcomes
OT  - Gestational diabetes mellitus (GDM)
OT  - Per- and polyfluoroalkyl substances (PFAS)
COIS- Declaration of competing interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2022/06/13 06:00
MHDA- 2022/06/29 06:00
CRDT- 2022/06/12 19:23
PHST- 2022/03/13 00:00 [received]
PHST- 2022/06/03 00:00 [revised]
PHST- 2022/06/05 00:00 [accepted]
PHST- 2022/06/13 06:00 [pubmed]
PHST- 2022/06/29 06:00 [medline]
PHST- 2022/06/12 19:23 [entrez]
AID - S0048-9697(22)03658-0 [pii]
AID - 10.1016/j.scitotenv.2022.156561 [doi]
PST - ppublish
SO  - Sci Total Environ. 2022 Sep 10;838(Pt 4):156561. doi: 
      10.1016/j.scitotenv.2022.156561. Epub 2022 Jun 9.