Exposure to endocrine disrupting chemicals (EDCs) and cardiometabolic indices during pregnancy: The HOME Study

Abstract

Background: Toxicology studies have identified pregnancy as a window of susceptibility for endocrine disrupting chemicals (EDCs) and cardiometabolic indices in women. No study in humans, however, has examined EDC mixtures and cardiometabolic indices during pregnancy. Methods: We used the Health Outcomes and Measures of the Environment (HOME) Study to examine whether bisphenol A (BPA), polybrominated diphenyl ethers (PBDEs), per- and polyfluoroalkyl substances (PFAS), and phthalates are associated with blood pressure, glucose, and lipids in 388 pregnant women. We measured PBDEs and PFAS in serum at 16 weeks gestation, while BPA and phthalate metabolites were quantified in urine at 16 and 26 weeks gestation. We used linear regression and Bayesian Kernel Machine Regression (BKMR) to estimate covariate-adjusted associations of individual EDCs and their mixtures with cardiometabolic indices during pregnancy. Results: A 10-fold increase in BDE-28 was associated with a 13.1 mg/dL increase in glucose (95% Confidence Interval [CI] 2.9, 23.2) in linear regression. The BKMR model also identified BDE-28 as having a positive association with glucose. BDE-28, BDE-47, and BDE-99 were positively associated with total cholesterol in both single- and multi-pollutant models, whereas a suggestive negative association was noted with BDE-153. Mono-n-butyl phthalate (MBP) (β = −7.9 mg/dL, 95% CI −12.9, −3.0) and monobenzyl phthalate (MBzP) (β = −6.3 mg/dL, 95% CI −10.6, −2.0) were both associated with significant decreases in cholesterol in linear regression, but only MBzP was identified as an important contributor in the BKMR model. Conclusion: Overall, we observed positive associations between PBDEs with glucose and cholesterol levels during pregnancy, while negative associations were found between some phthalate biomarkers and cholesterol. No relationship was noted for BPA or PFAS with cardiometabolic indices during pregnancy across both models.

Association of Urinary Phthalate and Phthalate Replacement Metabolite Concentrations with Serum Lipid Biomarker Levels among Pregnant Women Attending a Fertility Center

“…To the best of our acknowledge, only one epidemiologic study has assessed the relationship between urinary phthalate metabolites and circulating lipid biomarker levels during pregnancy [37]. In a cross-sectional analysis in which both urine and blood samples were collected at approximately 16 weeks of gestation, Vuong et al reported that urinary MBzP was negatively associated with total cholesterol levels, and it was also an important contributor in the mixture models examining circulating triglycerides among 388 pregnant women participating in the Health Outcomes and Measures of the Environment (HOME) Study [37]. In a different study on pregnancy exposures in relation to post-natal lipids, Wu et al prospectively investigated pregnancy urinary phthalate metabolite concentrations in relation to 4-8 years post-delivery lipid biomarker levels in 618 Mexican women [51].…”

“…Pregnant women represent a vulnerable study population to endocrine-disrupting chemical exposure, including phthalates, with potential consequences not only for maternal health but also to offspring health [36]. Yet, to the best of our knowledge, only one study has examined the association between urinary concentrations of phthalate metabolites and circulating lipid biomarker levels in pregnant women from the general population [37]. This study showed that concentrations of some phthalate metabolites were positively associated with circulating tryglicerides and total cholesterol during pregnancy.…”

Update of the risk assessment of polybrominated diphenyl ethers (PBDEs) in food

“…All analysed subjects had detectable BDE-47 levels and 279 subjects were tested for the remaining PBDEs. As also discussed above, Vuong et al (2021) focused on blood pressure, glucose, and lipids in the pregnant women. Mean maternal serum concentrations of BDE-28 and -47 were 1.1 and 20.7 ng/g lipid, respectively.…”

“…All analysed subjects had detectable BDE-47 levels and 279 subjects were tested for the remaining PBDEs. Vuong et al (2021) focused on blood pressure, glucose, and lipids in the pregnant women. Non-fasting glucose levels were measured at 1-h after drinking 50 g glucose load (n = 234), with the average assessment completed at ~ 27.6 ± 1.4 weeks gestation.…”

“…As also discussed above, Vuong et al. ( 2021 ) focused on blood pressure, glucose, and lipids in the pregnant women. Mean maternal serum concentrations of BDE‐28 and ‐47 were 1.1 and 20.7 ng/g lipid, respectively.…”