Exposure to contaminants of emerging concern and gestational diabetes mellitus subtypes: An exploratory nested case-control study

作者：Boya Wang, Yiwen Qiu, Nuo Xu, Shuhui Wang, Xialidan Alifu, Haoyue Cheng, Hui Liu, Lina Yu, Zi Lin, Danqing Chen, Liqiong Guo, Yunxian Yu · 发表于：Journal of Hazardous Materials · 年份：2025 · DOI：10.1016/j.jhazmat.2025.140487 · 被引用次数：2 · 研究领域：Skin Protection and Aging、Gestational Diabetes Research and Management、Per- and polyfluoroalkyl substances research

The association of combined exposure to contaminants of emerging concern (CECs), including ultraviolet stabilizers (UVs), with gestational diabetes mellitus (GDM) remains unreported. To address this gap, the present study quantified plasma concentrations of 99 CECs, aiming to estimate associations of early pregnancy CEC exposure with GDM and its subtypes, and identify key contributors. This nested case-control study enrolled 120 participants from the Zhoushan cohort: 90 GDM cases (30 each of isolated fasting hyperglycemia [IFH], isolated postprandial hyperglycemia [IPH], combined hyperglycemia [CH]) and 30 normal glucose tolerance (NGT) controls. Conditional logistic regression evaluated single-pollutant effects on GDM. Combined exposure was assessed via adaptive elastic net (AENET), Bayesian kernel machine regression (BKMR), and quantile g-computation (qgcomp). Among valid detected chemicals, 12 CECs showed significantly higher levels in GDM (UV-P [2.66 vs. 1.40 ng/mL in NGT controls]). Conditional logistic regression showed positive associations of PAHs, PAEs, UVs, synthetic antioxidants with GDM. Three statistical approaches identified positive correlations between combined CEC exposure and risks of GDM, IFH, CH. qgcomp showed combined exposure associated with GDM [1.39 (95 %CI=1.15-1.67)], IFH [1.94 (95 %CI=1.39-2.70)], CH [1.96 (95 %CI=1.32-2.89)]. BKMR identified UV-P and DEP as key contributors. These findings warrant validation in large prospective studies with mechan...