Background

Animal and human studies suggest certain persistent organic pollutants (POPs) may impact glucose metabolism; however, few epidemiologic studies have examined environmental determinants of glycemic outcomes during pregnancy. Our objective is to evaluate associations between exposures to individual and mixture of POPs and measures of prenatal fasting glucose, insulin, and insulin resistance during pregnancy in overweight women. Methods: A cohort of overweight and obese pregnant women (N=95) was recruited from California. Blood samples were collected during late first or second trimester (median = 16 weeks’ gestation; range = 10-24 weeks). Exposures included serum concentrations of polybrominated diphenyl ethers (PBDEs) and hydroxylated metabolites (OH-PBDEs), polychlorinated biphenyls (PCBs), and poly- and perfluoroalkyl substances (PFASs),. Outcomes included serum concentrations of fasting plasma glucose, fasting plasma insulin, and calculated homeostatic model assessment of insulin resistance (HOMA-IR). Generalized linear models were used to evaluate cross-sectional associations between individual and aggregate POPs and mean percent difference in fasting glucose, fasting insulin, and HOMA-IR. Bayesian kernel machine regression (BKMR) was used to assess the relative importance of each exposure to the association with our outcomes, using conditional and group posterior inclusion probabilities (PIPs). Results: Study participants were racially/ethnically diverse and nearly half were below the federal poverty level. Across PBDEs and OH-PBDEs, the direction of associations with fasting glucose, fasting insulin and HOMA-IR were varied. A doubling of PCB-138, PCB-153, PCB-180, and ∑PCBs concentrations was associated with a 2.10% mmol/L (95%CI: 0.49%, 3.74%), 2.10% mmol/L (95%CI: -0.14%, 4.39%), 2.10% mmol/L (95%CI: 0.12%, 4.12%), and 2.81% mmol/L (95%CI: 0.38%, 5.31%) increase in fasting glucose, respectively. Exposure to individual PCBs was positively associated with both fasting insulin and HOMA-IR. All PFAS were inversely associated with fasting glucose, fasting insulin, and HOMA-IR. In BKMR models of fasting glucose, all four chemical classes were important contributors to the overall mixture, with PFASs identified as the most important contributor. Discussion: Prenatal PCB exposure was positively associated while certain PBDE and PFAS analytes were inversely associated with fasting glucose concentrations in overweight women. Further examination of the relationship between POPs exposure and glycemic functioning in a larger study population of women during pregnancy is warranted.

中文翻译：

---

超重女性的不同妊娠队列中的持久性有机污染物和孕产妇血糖结果

背景

动物和人类研究表明，某些持久性有机污染物 (POPs) 可能会影响葡萄糖代谢；然而，很少有流行病学研究检查怀孕期间血糖结果的环境决定因素。我们的目标是评估超重女性在怀孕期间暴露于个体和持久性有机污染物混合物与产前空腹血糖、胰岛素和胰岛素抵抗测量之间的关联。方法：从加利福尼亚招募了一组超重和肥胖的孕妇（N=95）。在妊娠晚期或妊娠中期（中位 = 16 周妊娠；范围 = 10-24 周）收集血样。暴露包括多溴二苯醚 (PBDEs) 和羟基化代谢物 (OH-PBDEs)、多氯联苯 (PCBs) 以及多和全氟烷基物质 (PFAS) 的血清浓度。结果包括空腹血浆葡萄糖的血清浓度、空腹血浆胰岛素和计算的胰岛素抵抗稳态模型评估（HOMA-IR）。广义线性模型用于评估个体和总体 POPs 之间的横截面关联以及空腹血糖、空腹胰岛素和 HOMA-IR 的平均百分比差异。结果：研究参与者具有种族/民族多样性，近一半低于联邦贫困线。在 PBDEs 和 OH-PBDEs 中，与空腹血糖、空腹胰岛素和 HOMA-IR 的关联方向各不相同。PCB-138、PCB-153、PCB-180 和 ∑PCBs 浓度翻倍与 2.10% mmol/L (95%CI: 0.49%, 3.74%)、2.10% mmol/L (95%CI: -0.14%、4.39%)、2.10% mmol/L (95%CI: 0.12%, 4.12%) 和 2.81% mmol/L (95%CI: 0.38%, 5.31%) 分别增加空腹血糖。暴露于单个 PCB 与空腹胰岛素和 HOMA-IR 呈正相关。所有 PFAS 均与空腹血糖、空腹胰岛素和 HOMA-IR 呈负相关。在空腹血糖的 BKMR 模型中，所有四种化学类别都是整体混合物的重要贡献者，PFAS 被确定为最重要的贡献者。讨论：产前 PCB 暴露呈正相关，而某些 PBDE 和 PFAS 分析物与超重女性的空腹血糖浓度呈负相关。有必要在更大的妊娠期女性研究人群中进一步检查 POPs 暴露与血糖功能之间的关系。