Maternal urinary triclosan level, gestational diabetes mellitus and birth weight in Chinese women

Fengxiu Ouyang,Ning Tang,Hui-Juan Zhang,Xia Wang,Shasha Zhao,Weiye Wang,Jun Zhang,Weiwei Cheng

doi:10.1016/j.scitotenv.2018.01.102

Fengxiu Ouyang, Ning Tang + Show 6 more

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https://doi.org/10.1016/j.scitotenv.2018.01.102

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Abstract

Triclosan (TCS) is an antibacterial chemical widely used in personal-care products and an endocrine disruptor. While TCS exposure is associated with insulin resistance and metabolic disorders in animals, few studies have assessed its effect on the risk of gestational diabetes mellitus (GDM) in humans. This study aimed to explore whether maternal urinary TCS level is associated with the risk of GDM and infant birthweight. We examined 620 pregnant women from Shanghai, China in 2012–2013. Urinary TCS level was measured with high-performance liquid chromatography–tandem mass spectrometry (HPLC–MS/MS), and categorized into high, medium and low in tertiles. GDM was defined based on recommendation of International Association of Diabetes and Pregnancy Study Groups (IADPSG). The GDM rate was 12.7%. TCS was detectable (≥0.1 ng/mL) in 97.9% women (median 2.7 ng/mL). There was a positive, but statistically non-significant association between urinary TCS levels and GDM (adjusted odds ratio 1.17; 95%CI: 0.99, 1.39, with each unit increase of log (TCS) ng/mL) with adjustment for urinary creatinine, maternal age, education, passive smoking, parity and prepregnancy BMI categories. 48.1% of infants were females. Birthweight was 122.8 g higher (95% CI: 13.9, 231.6 g) for female infants of women in high TCS (median 13.3 ng/mL) versus low TCS (median 0.77 ng/mL), with adjustment for urinary creatinine, prepregnancy BMI, GDM and other confounders. No association was found between maternal TCS and birthweight in male infants. These results suggested the potential for TCS to be associated with increased risk of GDM and a gender-specific association with higher birthweight among female infants in a population with widespread but moderate exposure to TCS.

Highlights

Triclosan (TCS), a broad-spectrum antimicrobial chemical, has been widely used in personal-care products, clothing and plastics for N40 years (Jones et al, 2000)
No association was found between maternal TCS and birthweight in male infants. These results suggested the potential for TCS to be associated with increased risk of gestational diabetes mellitus (GDM) and a gender-specific association with higher birthweight among female infants in a population with widespread but moderate exposure to TCS
We detected TCS in 97.9% of women. 14.6% of women had a BMI of 23–24.9 kg/m2, and 10.4% was overweight with BMI ≥ 25 kg/m2. 12.7% had diagnosed GDM

Summary

Introduction

Triclosan (TCS), a broad-spectrum antimicrobial chemical, has been widely used in personal-care products (toothpaste, mouthwash, antibacterial soap, hand sanitizer and cosmetics), clothing and plastics for N40 years (Jones et al, 2000). 98.2% of urine samples had detectable TCS (≥0.1 ng/mL) (Wang et al, 2017). TCS is an endocrine disruptor chemical (EDC) with estrogenic/androgenic and thyroid hormone properties (Stoker et al, 2010; Gee et al, 2008). Animal studies show that TCS exposure induced insulin resistance and metabolic disorder (Regnault et al, 2016). Maternal triclosan exposure was associated with increased plasma glucose, cholesterol, and triglycerides (Rabaglino et al, 2016). There are increasing concerns of EDCs being risk factors for gestational diabetes mellitus (GDM), due to biological plausibility (Ehrlich et al, 2016). TCS was found to be associated with decreased free thyroxine (FT4) levels in women (Geens et al, 2015). No previous study examined the effect of maternal TCS exposure on GDM (Ehrlich et al, 2016)

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