Endocrine-disrupting chemicals elevate risk for gestational diabetes
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Exposure to certain endocrine-disrupting chemicals, including polychlorinated biphenyls and polybrominated diphenyl ethers, heightened the risk for gestational diabetes in a recent study.
Jingping Yuan, MD, PhD, of the department of pathology at Renmin Hospital of Wuhan University in China, and colleagues conducted the analysis to determine the relationship between risk for gestational diabetes and exposure to endocrine-disrupting chemicals (EDCs), including polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), phthalate acid esters (PAEs) and per- and polyfluoroalkyl substances (PFAS).
The researchers used Embase, PubMed and Web of Science databases to select relevant studies from their inception to November 2021 and chose cohort and case-control studies that reported effect size with 95% CIs of EDC exposure and gestational diabetes.
In all, the comprehensive systematic review and meta-analysis included 25 articles and 23,796 participants. Of the articles, 16 were cohort studies, seven were case-control studies and two were cross-sectional studies.
Data suggested that PCB (OR = 1.14; 95% CI, 1-1.31; n = 8) and PBDE (OR = 1.32; 95% CI, 1.15-1.53; n = 4) exposure significantly increased the incidence of gestational diabetes. Similarly, exposure to both PAEs (OR = 1.1; 95% CI, 1.03-1.16; n = 7) and PFAS (OR = 1.09; 95% CI, 1.02-1.16; n = 11) was also associated with gestational diabetes risk.
After excluding all but cohort studies, the researchers found that the summary OR between PCB exposure and gestational diabetes risk was 0.99 (95% CI, 0.91-1.09; n = 5), whereas it was 1.12 for PBDEs (95% CI, 1-1.26; n = 2), 1.08 (95% CI, 1.02-1.15; n = 5) for PAEs and 1.06 (95% CI, 1-1.12; n = 8) for PFAS.
Furthermore, the researchers noted that Begg’s and Egger’s tests did not reveal publication bias, and that the sensitivity analyses did not affect the findings.
“The results of our present meta-analysis indicated that PCB, PBDE, PAE and PFAS exposure have significant effects on the risk of gestational diabetes,” the researchers concluded. “These results provide strong evidence to a certain extent, supporting the hypothesis that [with] certain EDCs (especially the PCBs, PBDEs, PAEs, and PFASs) exposure is related to an increased risk of gestational diabetes. Further large-sample and high-quality epidemiologic studies with improved methods for documenting cases of gestational diabetes and in vivo and in vitro studies are needed to verify the potential relationship and biological mechanisms.”
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