PMID- 36965679 OWN - NLM STAT- MEDLINE DCOM- 20230418 LR - 20230418 IS - 1873-6424 (Electronic) IS - 0269-7491 (Linking) VI - 326 DP - 2023 Jun 1 TI - Exposure to per- and polyfluoroalkyl substances in early pregnancy, risk of gestational diabetes mellitus, potential pathways, and influencing factors in pregnant women: A nested case-control study. PG - 121504 LID - S0269-7491(23)00506-7 [pii] LID - 10.1016/j.envpol.2023.121504 [doi] AB - Although previous studies have reported an association between maternal serum perfluoroalkyl substance (PFAS) exposure and gestational diabetes mellitus (GDM) risk, results have been inconsistent. Few studies have focused on the combined effects of emerging and legacy PFASs on glucose homeostasis while humans are always exposed to multiple PFASs simultaneously. Moreover, the potential pathways by which PFAS exposure induces GDM are unclear. A total of 295 GDM cases and 295 controls were enrolled from a prospective cohort of 2700 pregnant women in Shanghai, China. In total, 16 PFASs were determined in maternal spot serum samples in early pregnancy. We used conditional logistic regression, multiple linear regression, and Bayesian kernel machine regression (BKMR) to examine individual and joint effects of PFAS exposure on GDM risk and oral glucose tolerance test outcomes. The mediating effects of maternal serum biochemical parameters, including thyroid and liver function were further assessed. Maternal perfluorooctanoic acid (PFOA) exposure was associated with an increased risk of GDM (odds ratio (OR) = 1.68; 95% confidence interval (95% CI): 1.10, 2.57), consistent with higher concentrations in GDM cases than controls. Based on mediation analysis, an increase in the free triiodothyronine to free thyroxine ratio partially explained the effect of this association. For continuous glycemic outcomes, positive associations were observed between several PFASs and 1-h and 2-h glucose levels. In BKMR, PFAS mixture exposure showed a positive trend with GDM incidence, although the CIs were wide. These associations were more pronounced among women with normal pre-pregnancy body mass index (BMI). Mixed PFAS congeners may affect glucose homeostasis by increasing 1-h glucose levels, with perfluorononanoic acid found to be a main contributor. Exposure to PFASs was associated with increased risk of GDM and disturbance in glucose homeostasis, especially in normal weight women. The PFAS-associated disruption of maternal thyroid function may alter glucose homeostasis. CI - Copyright (c) 2023 Elsevier Ltd. All rights reserved. FAU - Zang, Lu AU - Zang L AD - Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China; University of Chinese Academy of Sciences, Beijing, 100049, China; State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai, 200240, China. FAU - Liu, Xiaorui AU - Liu X AD - The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China. FAU - Xie, Xianjing AU - Xie X AD - The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China. FAU - Zhou, Xuming AU - Zhou X AD - Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China. FAU - Pan, Yitao AU - Pan Y AD - State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai, 200240, China. FAU - Dai, Jiayin AU - Dai J AD - State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai, 200240, China. Electronic address: daijy65@sjtu.edu.cn. LA - eng PT - Journal Article DEP - 20230324 PL - England TA - Environ Pollut JT - Environmental pollution (Barking, Essex : 1987) JID - 8804476 RN - 0 (Fluorocarbons) RN - IY9XDZ35W2 (Glucose) RN - 0 (Environmental Pollutants) RN - 0 (Alkanesulfonic Acids) SB - IM MH - Humans MH - Pregnancy MH - Female MH - *Diabetes, Gestational/chemically induced/epidemiology MH - Pregnant Women MH - Prospective Studies MH - Case-Control Studies MH - Bayes Theorem MH - China/epidemiology MH - *Fluorocarbons/toxicity MH - Glucose MH - *Environmental Pollutants MH - *Alkanesulfonic Acids/toxicity 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- 2023/03/26 06:00 MHDA- 2023/04/18 06:42 CRDT- 2023/03/25 20:30 PHST- 2023/01/02 00:00 [received] PHST- 2023/02/27 00:00 [revised] PHST- 2023/03/22 00:00 [accepted] PHST- 2023/04/18 06:42 [medline] PHST- 2023/03/26 06:00 [pubmed] PHST- 2023/03/25 20:30 [entrez] AID - S0269-7491(23)00506-7 [pii] AID - 10.1016/j.envpol.2023.121504 [doi] PST - ppublish SO - Environ Pollut. 2023 Jun 1;326:121504. doi: 10.1016/j.envpol.2023.121504. Epub 2023 Mar 24.