Associations of bisphenol exposure with the risk of gestational diabetes mellitus: a nested case–control study in Guangxi, China

Abstract

A growing number of epidemiologic studies have estimated the associations between endocrine-disrupting chemicals and gestational diabetes mellitus (GDM). However, reports on the association between bisphenol A (BPA) substitutes and GDM are limited. This investigation aimed to explore the associations of maternal serum BPA, bisphenol B (BPB), bisphenol F (BPF), bisphenol S (BPS), and tetrabromobisphenol A (TBBPA) with the risk of GDM. A nested case-control study was performed among 500 pregnant women. Associations between the serum bisphenol levels and the risk of GDM were assessed by conditional logistic regression analysis and two-mixture modeling approaches (Bayesian kernel machine regression [BKMR] and quantile gcomputation). BPA and TBBPA were negatively associated with the risk of GDM in the adjusted models, respectively. Intermediate BPS levels were associated with increased odds (OR: 1.84; 95% CI: 1.04, 3.27) of GDM compared with the low concentration groups only based on the single-bisphenol models. Associations between BPA, BPS, and TBBPA with the risk of GDM were also found in the BKMR analysis. The quantile gcomputation (OR: 0.55; 95% CI: 0.43, 0.69) and BKMR models revealed a statistically signi cant and negative joint effect of the ve bisphenols on the risk of GDM. This study demonstrates the association between exposure to BPS with the increased risk of GDM. In addition, exposure to BPA and TBBPA were associated with the reduced risk of GDM. Moreover, exposure to the mixture of the ve bisphenols was negatively associated with the risk of GDM.

New environmental factors related to diabetes risk in humans: Emerging bisphenols used in synthesis of plastics

“…In 2021 five articles relevant to the analysis were published: van der Meer et al [ 38 ], Tang et al [ 39 ], Lee et al [ 40 ], Duan et al [ 41 ] and An et al [ 42 ]. van der Meer et al [ 38 ] analyzed the presence of endocrine-disrupting metabolites in the urine of subjects with impaired fasting glucose levels (6.1–7.0 mmol/L).…”

“…BPS was detected only in 18% of the samples, so it was excluded from subsequent analysis. Tang et al [ 39 ] performed a case–control study in pregnant women with and without GDM. Multinomial logistic regression models performed with serum BPS and BPF, corrected for pregnancy BMI, area of residence, passive smoking during pregnancy, gravity, parity, and exercise regularly, showed positive but nonsignificant results, with OR (95%CI) of 1.68 (0.95–2.99) for highest levels of BPS, and 1.18 (0.68–2.05) for BPF.…”

“…For the BPS meta-analysis, the works of Duan et al [ 34 ], Zhang et al [ 35 ], Tang et al [ 39 ], Zhu et al [ 44 ] and Moreno-Gómez-Toledano et al [ 43 ] were used. For the combined analysis, binomial and multinomial logistic regression analyses of the different population groups were selected, including a total of eight elements in the meta-analysis.…”

“…Articles with relevant data for qualitative analysis were Zhang et al [ 35 ], Tang et al [ 39 ], Moreno-Gómez-Toledano et al [ 43 ] and Li et al [ 33 ]. The same subgroups used in the quantitative analysis of the BPS were included, in addition to the multinomial logistic regression performed in the case–control study by Li et al [ 33 ].…”

Bisphenol A (BPA) and Cardiovascular or Cardiometabolic Diseases

“…In 620 pregnant women, high maternal urinary BPA concentrations led to a reduced risk of gestational diabetes mellitus (GDM) and slightly reduced birth weight and ponderal index [9]. Maternal serum BPA levels were also negatively associated with the risk of developing GDM [27]. In another study, serum BPA levels showed a positive relationship with blood glucose and insulin levels and HOMA-insulin resistance in the middle term of pregnancy; an increased BPA concentration tended to increase the risk ratio of GDM, although this was not statistically significant [28].…”