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

Peng Tang,Mengrui Lin,Xiaoyun Zeng,Xiaoqiang Qiu,Xiaojing Guo,Shun Liu,Dongping Huang,Jun Liang,Bincai Wei,Bihu Liu,Qian Liao,Huishen Huang

doi:10.1007/s11356-021-17794-8

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. In conditional logistic regression models, the OR for BPS was significantly increased in the medium exposure groups (OR = 1.77; 95% CI: 1.01, 3.13) compared with the reference group, while BPA (OR: 0.38, 95%CI: 0.29, 0.50) and TBBPA (OR: 0.67, 95%CI: 0.54, 0.85) were negatively associated with the risk of GDM. In the Bayesian kernel machine regression (BKMR) analysis, the joint effect of bisphenols was positively associated with the risk of GDM. BPS showed positively relationship, while BPA and TBBPA showed negatively relationship, respectively. The quantile g-computation revealed a statistically significant and negative joint effect of the five bisphenols on the risk of GDM (OR: 0.57; 95% CI: 0.46, 0.72) with BPA (70.2%), TBBPA (21.3%), and BPB (8.5%) had positive contribution to the overall effect. These findings suggested that BPS had a positive effect on the risk of GDM, while BPA and TBBPA had negative effect on the risk of GDM. Moreover, exposure to the mixture of the five bisphenols was negatively associated with the risk of GDM.

Highlights

Gestational diabetes mellitus (GDM), which is a common complication during pregnancy, is any degree of glucose intolerance with onset or first recognition during pregnancy (American-Diabetes-Association 2013)
bisphenol A (BPA) and tetrabromobisphenol A (TBBPA) were associated with a decreased risk of GDM, while bisphenol S (BPS) increased the risk of GDM
To the best of our knowledge, this study is the first report on the exploration of the associations of bisphenol B (BPB) and TBBPA with the risk of GDM

Summary

Introduction

Gestational diabetes mellitus (GDM), which is a common complication during pregnancy, is any degree of glucose intolerance with onset or first recognition during pregnancy (American-Diabetes-Association 2013). In addition to the traditional risk factors, such as maternal age, obesity, ethnicity, family history of diabetes, and high-carbohydrate diets (Ehrlich et al 2016, Farahvar et al 2019), some recent studies have shown that endocrine-disrupting chemicals (EDCs) may play an important role in the incidence and development of GDM (Ehrlich et al 2016, Filardi et al 2020, Liu et al 2018b, Xu et al 2020). The effects of BPA on human health have been extensively studied, with its estrogenic activity as one of its best-known outcomes. Previous epidemiological studies have determined a strong association between BPA and type 2 diabetes mellitus (T2DM) (Rancière et al 2019, Sun et al 2014). Results on the relationship between BPA and GDM were inconsistent (Fisher et al 2018, Hou et al 2021, Robledo et al 2013, Shapiro et al 2015, Wang et al 2017, Yang et al 2021, Zhang et al 2019)

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