妊娠早期有机氯农药暴露与妊娠期糖尿病的关联研究

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摘要目的研究妊娠早期血浆有机氯农药(OCPs)暴露与妊娠期糖尿病(GDM)发病的关联。方法采用基于出生队列的巢式病例对照设计,从北京市通州区妇幼保健院自2018年6月开始建立的前瞻性队列(PKUBC-T 出生队列)中随机抽取200名GDM孕妇(GDM组),以年龄和口服糖耐量试验孕周为匹配条件1:1匹配200名健康孕妇(对照组)。孕妇基本信息从首次产检的调查问卷中获得,采集孕妇妊娠早期静脉血,采用气相色谱-质谱联用仪定量血浆中20种OCPs浓度,采用条件Logistic回归比较两组OCPs浓度的差异。结果 20种OCPs中有5种被检出,4,4-二氯二苯二氯乙烯(p,p′-DDE)的检出率最高为100.0%,灭蚁灵(Mirex)最低为51.3%。5种被检出的OCPs中浓度最高的是异狄氏剂(END),GDM组和对照组的中位数分别为232.4 ng/g血脂和201.1 ng/g血脂,其次是p,p′-DDE,GDM组和对照组的中位数分别为63.9 ng/g血脂和56.2 ng/g血脂。在校正协变量后发现,与最低暴露组相比,END最高暴露组与GDM的关联具有统计学意义(OR=1.84, 95% CI:1.01~3.34),并存在剂量-效应关系。结论北京地区妇女妊娠早期检出的五种OCPs中END高暴露是GDM发病的危险因素,未发现其余四种OCPs暴露与GDM发病存在关联。

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	杨向明
	韩娜
	包鹤龄
	金楚瑶
	周双
	徐金辉
	王斌
	王海俊
	安琳

关键词 ：有机氯农药, 血浆, 妊娠期糖尿病

Abstract：Objective To explore the association between exposure to organochlorine pesticides (OCPs) during early pregnancy and gestational diabetes (GDM).Methods We conducted a nested case-control study based on a birth cohort. From June 2018, 200 GDM pregnant women (i.e., the case group) were randomly selected from a prospective cohort (PKUBC-T birth cohort) established in the Maternal and Child Health Hospital of Tongzhou District, Beijing City. The GDM women were 1:1 matched with 200 healthy pregnant women (i.e., the control group), according to the gestational age and time of OGTT. The basic information of pregnant women was collected by questionnaires during the first visit of prenatal care. Samples of venous blood was collected from the pregnant women during their first trimester, and 20 OCPs concentrations in plasma were quantified by gas chromatography-mass spectrometry. We utilized conditional logistic regression to examine whether the OCPs concentrations in the control group were different from those in the GDM cases.Results Five out of twenty OCPs were detected. The highest detection rate (100.00%) was reported for 2,2-bis(4-chlorophenyl)-1,1-dichloroethene (p,p′-DDE). Among the five detected OCPs, the highest was the concentration of Endrin (END), the median of which was 232.4 ng/g lipid and 201.1 ng/g lipid for the GDM cases and the controls, respectively; the second was p,p′-DDE, the median of which was 63.9 ng/g lipid and 56.2 ng/g lipid for the GDM cases and the controls, respectively. After adjustment for multiple covariates, the association between END and GDM was statistically significant (OR=1.84, 95%CI:1.01-3.34; for the high-exposure group, referring to the low-exposure group). We also found a dose-response relationship between END and GDM.Conclusion Among the 5 OCPs detected in the early-pregnant women in Beijing, we found that the exposure to END was a risk factor for the development of GDM. We didn′t find significant correlation between GDM the other four OCPs.

Key words： Organochlorine pesticide Plasma Gestational diabetes mellitus

收稿日期: 2020-12-14

ZTFLH:	R17
	R71

基金资助:国家自然科学基金项目(81973053, 41771527)

通讯作者: 安琳(anlin@bjmu.edu.cn )

引用本文:

杨向明, 韩娜, 包鹤龄, 金楚瑶, 周双, 徐金辉, 王斌, 王海俊, 安琳. 妊娠早期有机氯农药暴露与妊娠期糖尿病的关联研究[J]. 中国生育健康杂志, 2022, 33(3): 201-205. YANG Xiangming, HAN Na, BAO Heling, JIN Chuyao, ZHOU Shuang, XU Jinhui, WANG Bin, WANG Haijun, AN Lin. The association between organochlorine pesticide exposure in early pregnancy and gestational diabetes. Chinese Journal of Reproductive Health, 2022, 33(3): 201-205.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2022/V33/I3/201

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