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Environ Int. 2016 Nov;96:118-126. doi: 10.1016/j.envint.2016.09.009. Epub 2016 Sep 17.

Pregnancy urinary phthalate metabolite concentrations and gestational diabetes risk factors.

Author information

1
Departments of Environmental Health and Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA; Division of Women's Health, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02120, USA. Electronic address: tjtodd@hsph.harvard.edu.
2
Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
3
Division of Women's Health, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02120, USA; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
4
Departments of Environmental Health and Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
5
Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709, USA.
6
Division of Women's Health, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02120, USA.
7
Division of Maternal Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
8
Division of Endocrine, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.

Abstract

BACKGROUND:

Epidemiologic studies suggest phthalate metabolite concentrations are associated with type 2 diabetes. GDM is a strong risk factor for type 2 diabetes. Little is known about phthalates and GDM risk factors (i.e. 1st trimester body mass index (BMI), gestational weight gain (GWG), and 2nd trimester glucose levels).

METHODS:

A total of 350 women participating in Lifecodes pregnancy cohort (Boston, MA), delivered at term and had pregnancy urinary phthalate metabolite concentrations. Nine specific gravity-adjusted urinary phthalate metabolites were evaluated. General linear regression was used to assess associations between quartiles of phthalate metabolites and continuous 1st trimester BMI and late 2nd trimester blood glucose. Linear mixed models were used for total GWG. Multivariable logistic regression was used for phthalate concentrations and categorized GWG and impaired glucose tolerance defined as glucose‚Č•140mg/dL based on a 50-gram glucose load test. Models were adjusted for potential confounders.

RESULTS:

There were no associations between 1st trimester urinary phthalate metabolite concentrations and 1st trimester BMI. Mono-ethyl phthalate concentrations averaged across pregnancy were associated with a 2.17 increased odds of excessive GWG (95% CI: 0.98, 4.79). Second trimester mono-ethyl phthalate was associated with increased odds of impaired glucose tolerance (adj. OR: 7.18; 95% CI: 1.97, 26.15). A summary measure of di-2-ethylhexyl phthalate metabolite concentrations were inversely associated with impaired glucose tolerance (adj. OR: 0.25; adj. 95% CI: 0.08, 0.85).

CONCLUSIONS:

Higher exposure to mono-ethyl phthalate, a metabolite of the parent compound of di-ethyl phthalate, may be associated with excessive GWG and impaired glucose tolerance; higher di-2-ethylhexyl phthalate was associated with reduced odds of impaired glucose tolerance.

KEYWORDS:

Body mass index; Gestational diabetes; Gestational weight gain; Impaired glucose tolerance; Phthalates; Pregnancy

PMID:
27649471
PMCID:
PMC5304919
DOI:
10.1016/j.envint.2016.09.009
[Indexed for MEDLINE]
Free PMC Article

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