TY - JOUR
T1 - The associations of phthalate biomarkers during pregnancy with later glycemia and lipid profiles
AU - Wu, Haotian
AU - Just, Allan C.
AU - Colicino, Elena
AU - Calafat, Antonia M.
AU - Oken, Emily
AU - Braun, Joseph M.
AU - McRae, Nia
AU - Cantoral, Alejandra
AU - Pantic, Ivan
AU - Pizano-Zárate, María Luisa
AU - Tolentino, Mary Cruz
AU - Wright, Robert O.
AU - Téllez-Rojo, Martha M.
AU - Baccarelli, Andrea A.
AU - Deierlein, Andrea L.
N1 - Funding Information:
This work was supported by grants from the National Institute of Environmental Health Sciences (R00 ES023474 to ALD, R01 ES021357 and P30 ES009089 to AAB, R01 ES024381 to JMB, P30 ES023515, R01 ES013744, R01ES014930, and R24 ES028522 to ROW, and P30ES023515 and R00ES023450 to ACJ). The funding source did not have any role in the interpretation of the study results, writing of the manuscript, or decision to submit for publication.
Funding Information:
We gratefully acknowledge all members of the PROGRESS team for their tireless efforts in maintain the cohort. In addition, we would like to thank the American British Cowdray Hospital for providing research facilities for the PROGRESS study. Lastly, we would also like to thank the study participants and PROGRESS staff, without whom none of this would have been possible. This work was supported by grants from the National Institute of Environmental Health Sciences (R00 ES023474 to ALD, R01 ES021357 and P30 ES009089 to AAB, R01 ES024381 to JMB, P30 ES023515, R01 ES013744, R01ES014930, and R24 ES028522 to ROW, and P30ES023515 and R00ES023450 to ACJ). The funding source did not have any role in the interpretation of the study results, writing of the manuscript, or decision to submit for publication. The findings in this article are the opinions of the authors and do not necessarily reflect the official opinion of the Centers for Disease Control and Prevention. Use of trade names is for identification only and does not imply endorsement by the CDC, the Public Health Service, or the US Department of Health and Human Services.
Publisher Copyright:
© 2021 The Author(s)
PY - 2021/10
Y1 - 2021/10
N2 - Background: Pregnancy induces numerous cardiovascular and metabolic changes. Alterations in these sensitive processes may precipitate long-term post-delivery health consequences. Studies have reported associations between phthalates and metabolic complications of pregnancy, but no study has investigated metabolic outcomes beyond pregnancy. Objectives: To examine associations of exposure to phthalates during pregnancy with post-delivery metabolic health. Design: We quantified 15 urinary phthalate biomarker concentrations during the second and third trimesters among 618 pregnant women from Mexico City. Maternal metabolic health biomarkers included fasting blood measures of glycemia [glucose, insulin, Homeostatic Model Assessment of Insulin Resistance [HOMA-IR], % hemoglobin A1c (HbA1c%)] and lipids (total, high-density lipoprotein (HDL), low-density lipoprotein (LDL) cholesterol, triglycerides), at 4–5 and 6–8 years post-delivery. To estimate the influence of the phthalates mixture, we used Bayesian weighted quantile sum regression and Bayesian kernel machine regression; for individual biomarkers, we used linear mixed models. Results: As a mixture, higher urinary phthalate biomarker concentrations during pregnancy were associated with post-delivery concentrations of plasma glucose (interquartile range [IQR] difference: 0.13 SD, 95%CrI: 0.05, 0.20), plasma insulin (IQR difference: 0.06 SD, 95%CrI: −0.02, 0.14), HOMA-IR (IQR difference: 0.08 SD, 95% CrI: 0.01, 0.16), and HbA1c% (IQR difference: 0.15 SD, 95%CrI: 0.05, 0.24). Associations were primarily driven by mono-2-ethyl-5-carboxypentyl terephthalate (MECPTP) and the sum of dibutyl phthalate biomarkers (∑DBP). The phthalates mixture was associated with lower HDL (IQR difference: −0.08 SD, 95%CrI: −0.16, −0.01), driven by ∑DBP and monoethyl phthalate (MEP), and higher triglyceride levels (IQR difference: 0.15 SD, 95%CrI: 0.08, 0.22), driven by MECPTP and MEP. The overall mixture was not associated with total cholesterol and LDL. However, ∑DBP and MEP were associated with lower and higher total cholesterol, respectively, and MECPTP and ∑DBP were associated with lower LDL. Conclusions: Phthalate exposure during pregnancy is associated with adverse long-term changes in maternal metabolic health. A better understanding of timing of the exact biological changes and their implications on metabolic disease risk is needed.
AB - Background: Pregnancy induces numerous cardiovascular and metabolic changes. Alterations in these sensitive processes may precipitate long-term post-delivery health consequences. Studies have reported associations between phthalates and metabolic complications of pregnancy, but no study has investigated metabolic outcomes beyond pregnancy. Objectives: To examine associations of exposure to phthalates during pregnancy with post-delivery metabolic health. Design: We quantified 15 urinary phthalate biomarker concentrations during the second and third trimesters among 618 pregnant women from Mexico City. Maternal metabolic health biomarkers included fasting blood measures of glycemia [glucose, insulin, Homeostatic Model Assessment of Insulin Resistance [HOMA-IR], % hemoglobin A1c (HbA1c%)] and lipids (total, high-density lipoprotein (HDL), low-density lipoprotein (LDL) cholesterol, triglycerides), at 4–5 and 6–8 years post-delivery. To estimate the influence of the phthalates mixture, we used Bayesian weighted quantile sum regression and Bayesian kernel machine regression; for individual biomarkers, we used linear mixed models. Results: As a mixture, higher urinary phthalate biomarker concentrations during pregnancy were associated with post-delivery concentrations of plasma glucose (interquartile range [IQR] difference: 0.13 SD, 95%CrI: 0.05, 0.20), plasma insulin (IQR difference: 0.06 SD, 95%CrI: −0.02, 0.14), HOMA-IR (IQR difference: 0.08 SD, 95% CrI: 0.01, 0.16), and HbA1c% (IQR difference: 0.15 SD, 95%CrI: 0.05, 0.24). Associations were primarily driven by mono-2-ethyl-5-carboxypentyl terephthalate (MECPTP) and the sum of dibutyl phthalate biomarkers (∑DBP). The phthalates mixture was associated with lower HDL (IQR difference: −0.08 SD, 95%CrI: −0.16, −0.01), driven by ∑DBP and monoethyl phthalate (MEP), and higher triglyceride levels (IQR difference: 0.15 SD, 95%CrI: 0.08, 0.22), driven by MECPTP and MEP. The overall mixture was not associated with total cholesterol and LDL. However, ∑DBP and MEP were associated with lower and higher total cholesterol, respectively, and MECPTP and ∑DBP were associated with lower LDL. Conclusions: Phthalate exposure during pregnancy is associated with adverse long-term changes in maternal metabolic health. A better understanding of timing of the exact biological changes and their implications on metabolic disease risk is needed.
KW - Diabetes
KW - Gestation
KW - Metabolic
KW - Phthalates
KW - Postpartum
KW - Pregnancy
UR - http://www.scopus.com/inward/record.url?scp=85105338211&partnerID=8YFLogxK
U2 - 10.1016/j.envint.2021.106612
DO - 10.1016/j.envint.2021.106612
M3 - Article
C2 - 33965768
AN - SCOPUS:85105338211
SN - 0160-4120
VL - 155
JO - Environment international
JF - Environment international
M1 - 106612
ER -