Exposure to phthalates, bisphenol A and metals in pregnancy and the association with impaired glucose tolerance and gestational diabetes mellitus: The MIREC study

Shapiro, Gabriel D.; Dodds, Linda; Arbuckle, Tye E.; Ashley‐Martin, Jillian; Fraser, William D.; Fisher, Mandy; Taback, Shayne; Keely, Erin; Bouchard, Maryse F.; Monnier, Patricia; Dallaire, Renée; Morisset, Anne‐Sophie; Ettinger, Adrienne S.

doi:10.1016/j.envint.2015.05.016

Cited by 172 publications

(121 citation statements)

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“…These results were similar to our observation of an association between toenail As and GDM. In a large longitudinal study of 1274 Canadian women, Shapiro et al observed a positive relationship between the highest quartile of first trimester blood As and GDM (OR: 3.7, 95 % CI: 1.4, 9.6), as well as with combined GDM and glucose intolerance (OR: 1.9, 95 % CI: 1.1, 3.5) [22]. A nested case–control study within pregnancy cohort of Chinese women compared metals, including As, in meconium samples from infants born to healthy mothers ( n = 190) or mothers with GDM ( n = 137).…”

Section: Discussionmentioning

confidence: 99%

Maternal arsenic exposure and gestational diabetes and glucose intolerance in the New Hampshire birth cohort study

et al. 2016

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BackgroundGestational diabetes mellitus (GDM) is a major pregnancy complication with detrimental effects for both mothers and their children. Accumulating evidence has suggested a potential role for arsenic (As) exposure in the development of GDM, but current studies have not assessed As exposure from water, urine or toenail samples.MethodsWe investigated the association between As exposure and risk of glucose intolerance and GDM among 1151 women enrolled in the New Hampshire Birth Cohort Study. Arsenic was measured in home well water and via biomarkers (i.e., maternal urine collected ~24–28 weeks gestation and toenail clippings collected 2 weeks postpartum).ResultsA total of 105 (9.1 %) of women were diagnosed with glucose intolerance and 14 (1.2 %) of women were diagnosed with GDM. A total of 10.3 % of women had water As levels above 10 μg/L, with a mean As level of 4.2. Each 5 μg/L increase in As concentration in home well water was associated with a ~10 % increased odds of GDM (OR: 1.1, 95 % CI 1.0, 1.2). A positive and statistically significant association also was observed between toenail As and GDM (OR: 4.5, 95 % CI 1.2, 16.6), but not urinary arsenic (OR: 0.8, 95 % CI 0.3, 2.4). In a stratified analysis, the association between water As and GDM and glucose intolerance was largely limited to obese women (OR: 1.7, 95 % CI 1.0, 2.8).ConclusionsOur findings support the role of As exposure via water from private wells in the incidence of GDM and that this association may be modified by body composition.Electronic supplementary materialThe online version of this article (doi:10.1186/s12940-016-0194-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Maternal arsenic exposure and gestational diabetes and glucose intolerance in the New Hampshire birth cohort study

et al. 2016

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“…It is associated with insulin resistance at second trimester (Lacroix et al 2014). Growing evidence suggests a role of environmental chemicals, as arsenic, phthalates, bisphenol A, metals NOx, SO 2, and O 3, in the development of GDM (Robledo et al 2015;Shapiro et al 2015). By contrast, moderate coff ee and tea intake may have a protective eff ect (Hinkle et al 2015).…”

Section: Risk Factorsmentioning

confidence: 99%

Gestational diabetes: An overview with attention for developing countries

Schiavone

Putoto

et al. 2016

Endocrine Regulations

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Gestational diabetes mellitus (GDM) is defi ned as a glucose intolerance that occurs for the fi rst time or it is fi rst identifi ed during pregnancy. Th e GDM etiology is multifactorial. It has not completely been established yet and several known risk factors may contribute to its onset. To date, there are no shared guidelines on the management and follow-up, especially regarding the lowincome countries. In this paper, we describe the state of art about epidemiology, physiopathology, diagnosis, and management of GDM. Moreover, we focus on the current state in low income countries trying to outline basis for further research.

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“…[25] However, this study only assessed the exposure to phthalates, a non-persistent chemical, at one time-point. Also, they evaluated the association between urinary phthalate metabolites and overt GDM, without assessing risk factors related to GDM or actual glucose levels to determine whether these chemicals had an effect on GDM risk factors or elevated glucose levels in pregnancy.…”

Section: Introductionmentioning

confidence: 99%

“…Also, they evaluated the association between urinary phthalate metabolites and overt GDM, without assessing risk factors related to GDM or actual glucose levels to determine whether these chemicals had an effect on GDM risk factors or elevated glucose levels in pregnancy. [25] Evaluating the relationship of these risk factors with urinary phthalate metabolites is important, given that pre-pregnancy obesity confers a 2- to 3-fold increased risk of GDM, while excessive GWG in early pregnancy is associated with an ~70% increased risk of GDM. [26, 27]…”

Section: Introductionmentioning

confidence: 99%

Pregnancy urinary phthalate metabolite concentrations and gestational diabetes risk factors

James‐Todd

Meeker

Huang

et al. 2016

Environment International

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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 ≥ 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 (MEP) concentrations averaged across pregnancy were associated with a 2.17 increased odds of excessive GWG (95% CI: 0.98, 4.79). Second trimester MEP was associated with an increased odds of impaired glucose tolerance (adj. OR: 7.18; 95% CI: 1.97, 26.15). 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 di-ethyl phthalate, the parent compound of MEP, may be associated with excessive GWG and impaired glucose tolerance; higher di-2-ethylhexyl phthalate was associated with reduced odds of impaired glucose tolerance.

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Exposure to phthalates, bisphenol A and metals in pregnancy and the association with impaired glucose tolerance and gestational diabetes mellitus: The MIREC study

Abstract: Our findings add to the growing body of evidence supporting the role of maternal arsenic exposure as a risk factor for gestational diabetes.

Cited by 172 publications

References 73 publications

Maternal arsenic exposure and gestational diabetes and glucose intolerance in the New Hampshire birth cohort study

Maternal arsenic exposure and gestational diabetes and glucose intolerance in the New Hampshire birth cohort study

Gestational diabetes: An overview with attention for developing countries

Pregnancy urinary phthalate metabolite concentrations and gestational diabetes risk factors

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