Urinary phenols exposure in early to mid-pregnancy and gestational diabetes mellitus

Abstract

TPS 743: Health effects in pregnancy, Exhibition Hall, Ground floor, August 26, 2019, 3:00 PM - 4:30 PM Background/Aim: Certain phenols as endocrine disruptors have been linked to type 2 diabetes among non-pregnant populations, but their roles in gestational diabetes (GDM) remain elusive due to scarce data. We investigated the associations of urinary phenols during early-to-mid pregnancy with GDM risk. Methods: Within the prospective Pregnancy Environment and Lifestyle Study, we conducted a nested case-control study of 111 GDM cases at gestational weeks (GW) 24-28 and 222 non-GDM controls, matched on age, GW at urine collection, and race/ethnicity (Asian/non-Asian, given high proportion of Asian cases). Urinary bisphenols A, F, S (BPA, BPF, BPS), benzophenone-3, and triclosan were assessed at GW 10-13 and 16-19. Conditional logistic regression estimated adjusted odds ratios (aOR) of GDM in relation to phenols, adjusting for pre-pregnancy body mass index, urinary creatinine, and race/ethnicity (White/Black/Hispanic/Asian). Results: Women with versus without GDM had higher levels of BPF and BPS at GW 10-13 and triclosan at GW 10-13 and 16-19 (all P <0.05). BPS in the middle and highest tertiles versus lowest tertile at GW 10-13 had a 2.10-fold (95% CI 1.08-4.10) and 1.96-fold (0.96-4.03) increased risk of GDM, respectively, after adjusting for covariates, with no association at GW 16-19; no associations were observed for other phenols. Effect modification by race/ethnicity was observed for BPA, BPS, and TCS (all P-for-interaction <0.10). We observed only among non-Asians associations of GDM with BPA in the highest tertile at GW 10-13 (aOR 2.69; 95% CI 1.00-7.19) and in the middle tertile at GW 16-19 (4.71; 1.31-17.0), BPS in the highest tertile at GW 10-13 (3.90; 1.41-10.8), and triclosan in the highest tertile at GW 10-13 (3.26; 1.27-8.35). Conclusions: Elevated urinary BPA, BPS, and triclosan levels, as early as in the first trimester, were associated with increased risk of GDM, only among non-Asians. Further investigations are needed to understand these racial/ethnic differences.