Prenatal exposure to EDCs may increase metabolic syndrome risk for children
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Key takeaways:
- Children exposed to higher prenatal levels of EDCs had higher metabolic syndrome risk scores.
- The findings could be used to develop interventions to mitigate metabolic syndrome risk.
Children exposed in utero to higher levels of some types of endocrine-disrupting chemicals have a higher risk for developing metabolic syndrome, according to findings published in JAMA Network Open.
Using data from a population-based birth cohort, researchers assessed associations between prenatal exposure to mixtures of endocrine-disrupting chemicals (EDCs) and metabolic syndrome risk score, which was calculated based on waist circumference, HDL cholesterol, triglycerides, insulin, systolic blood pressure and diastolic BP. Exposure to higher levels of prenatal metals, organochlorine pesticides, polybrominated diphenyl ethers (PBDEs) and perfluoroalkyl and polyfluoroalkyl substances (PFAS) were all tied to increased metabolic syndrome risk score.
“These EDC mixtures were also linked to elevated levels of pro-inflammatory proteins, amino acids and altered glycerophospholipid levels in childhood, further contributing to the risk of metabolic syndrome,” Nuria Güil-Oumrait, MSc, a predoctoral researcher at Barcelona Institute for Global Health in Spain, told Healio. “These results underscore the importance of reducing exposure to EDC mixtures during pregnancy to safeguard children’s metabolic health and address the increasing prevalence of metabolic syndrome across the life course.”
Güil-Oumrait and colleagues obtained data from the Human Early Life Exposome (HELIX) project, which included data from six European longitudinal population-based cohort studies. Pregnant women were recruited from April 2003 to January 2009. EDCs were measured through maternal serum, plasma, whole blood and urine samples during pregnancy. Researchers followed up with children at age 6 to 11 years from December 2013 to Feb. 26, 2016. Metabolic syndrome risk score was calculated using data collected from children at follow-up. Metabolite and protein level were measured through child urine and blood samples.
The study included 1,134 mother-child pairs. Of the children, 30.1% had a metabolic syndrome score that classified them as high risk.
In mixture analyses, each one-quartile increase in prenatal exposure to metals (beta = 0.44; 95% credible interval [CrI], 0.3-0.59), organochlorine pesticides (beta = 0.22; 95% CrI, 0.15-0.29), PBDEs (beta = 0.17; 95% CrI, 0.06-0.27) and PFAS (beta = 0.19; 95% CrI, 0.14-0.24) was associated with a higher metabolic syndrome risk score. Each one-quartile increase in exposure to high-molecular-weight phthalate metabolites (beta = –0.07; 95% CrI, –0.1 to –0.04) and low-molecular-weight phthalate metabolites (beta = –0.13; 95% CrI, –0.18 to –0.08) was tied to a lower metabolic syndrome risk score.
Sex-specific differences
In sex-stratified analysis, each one-quartile increase in exposure to polychlorinated biphenyls was associated with a higher metabolic syndrome risk score for girls (beta = 0.11; 95% CrI, 0.03-0.19) but a lower metabolic syndrome risk score for boys (beta = –0.17; 95% CrI, –0.21 to –0.12). PFAS and high-molecular-weight phthalates were also tied to a higher metabolic syndrome risk score among girls, but not boys.
“Recognizing the sex-specific susceptibility to EDC exposure is essential for tailored clinical management,” Güil-Oumrait said. “Girls may be more vulnerable to certain EDCs like PFAS and polychlorinated biphenyls due to their interference with sex steroid hormone pathways. Health care professionals should consider sex-specific differences when assessing metabolic health risks in children.”
EDCs tied to higher protein levels
In cross-sectional analysis, exposure to all prenatal mixtures of EDCs were associated with higher levels of C-reactive protein and elevated levels of at least two of interleukin-1 beta, IL-6, IL-1 receptor agonist and leptin. Metals and persistent chemicals were associated with higher levels of alpha-aminoadipic acid leucine, isoleucine and valine, as well as altered levels of diacyl chain phosphatidylcholine. Metals and persistent chemicals with the exception of PBDEs were linked to higher urine levels of 4-deoxyerythronic acid and 3-hydroxisobutyrate. All of the elevated protein and metabolite levels were associated with higher metabolic syndrome risk scores among children.
Metals and PFAS were associated with lower levels of acylcarnitine, which was associated with a lower metabolic syndrome risk score. All mixtures except for low-molecular-weight phthalate metabolites were linked to lower urine hippurate among children, which was associated with a lower metabolic syndrome risk score.
Interventions, research needed
Güil-Oumrait said the findings offer insights into how the health care community can potentially reduce the burden of metabolic syndrome. She suggested using an aggregate metabolic syndrome risk score to identify at-risk people early in life. Additionally, diet interventions focused on enhancing gut microbiome diversity and reducing inflammation could help improve metabolic health outcomes for children exposed to elevated prenatal levels of EDCs.
“Future studies should focus on incorporating repeated urine samples during pregnancy to comprehensively assess EDC exposure,” Güil-Oumrait said. “Additionally, the development of novel statistical tools that can integrate mixture analysis with mediation and interaction analysis will be essential for gaining a deeper understanding of the metabolic effects of EDCs. These approaches will allow researchers to explore the temporal dynamics of EDC exposure and its impact on metabolic health outcomes, ultimately leading to more effective prevention and intervention strategies.”
For more information:
Nuria Güil-Oumrait, MSc, can be reached at nuria.guil@isglobal.org.
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