妊娠早期血清尿三氯生水平与妊娠28周血糖稳态的关系  

Relationship between serum triclosan levels in early pregnancy and plasma glucose homeostasis at 28 weeks of pregnancy

作　　者：乔金凤[1] 刘江华[1] 马李娜 QIAO Jin-feng;LIU Jiang-hua;MA Li-na(Department of Obstetrics,Baoding Second Central Hospital Baoding 072750,Hebei,China)

机构地区：[1]保定市第二中心医院产科,河北保定072750

出　　处：《广东医学》2024年第3期335-339,共5页Guangdong Medical Journal

基　　金：河北省卫生健康委员会科研项目(20200732)。

摘　　要：目的探讨妊娠早期尿三氯生(TCS)水平与妊娠28周时血糖稳态之间的关系。方法招募2019年1月至2020年6月期间在保定市第二中心医院接受产前检查的241例孕妇。研究的主要结局是在中位妊娠28周通过1 h非禁食、50 g葡萄糖负荷试验(GLT)筛查妊娠期糖尿病(GDM)。在早期妊娠和中期妊娠收集尿液样本以测量尿比重(Sg),并通过在线固相萃取结合同位素稀释-高效液相色谱-串联质谱法对酚类混合物(双酚A、二苯甲酮-3和TCS)进行定量分析。结果根据GLT测试结果,199例GLT正常,其余42例异常。与GLT正常女性相比,GLT异常女性的BMI较高,总运动时间较低(P<0.05)。在早期妊娠和中期妊娠观察到TCS与妊娠血糖水平之间呈正相关(分别比较第2、第3和第4个四分位数与第1个四分位数的TCS:adj.OR=0.41,95%CI:-0.19~1.05;adj.OR=0.43,95%CI:-0.17~1.02;adj.OR=0.45,95%CI:-0.14~1.05)和中期妊娠(adj.OR=0.76,95%CI:0.19~1.32;adj.OR=0.66,95%CI:0.94~1.22;adj.OR=0.56,95%CI:0.04~1.12)。贝叶斯核机器回归(BKMR)的结果显示,早期妊娠和中期妊娠TCS与血糖水平呈正相关(P<0.05)。结论妊娠期尿TCS浓度与妊娠晚期GDM筛查试验中的血糖水平呈正相关。Objective To investigate the correlation between urinary triclosan(TCS)levels in early pregnancy and glucose homeostasis at 28 weeks of gestation.Methods A total of 241 pregnant women undergoing prenatal exami-nations at the Second Central Hospital of Baoding from January 2019 to June 2020 were recruited.The primary outcome was gestational diabetes mellitus(GDM)screened by a 1-hour non-fasting,50 g glucose load test(GLT)at a median of 28 weeks of pregnancy.Urine samples were collected in early and mid-pregnancy to measure urine specific gravity(Sg)and quantify phenolic compounds(bisphenol A,benzophenone-3,and TCS)using online solid-phase extraction combined with isotope dilution-high-performance liquid chromatography-tandem mass spectrometry.Results Ac-cording to GLT results,199 women had normal GLT,while the remaining 42 had abnormal results.Women with abnormal GLT had higher BMI and lower total exercise time compared to those with normal GLT(P<0.05).Positive associations between TCS levels and gestational glucose levels were observed in early pregnancy and mid-pregnancy(comparing the 2nd,3rd,and 4th quartiles with the 1st quartile of TCS:adj.OR=0.41,95%Cl:-0.19-1.05;adj.OR=0.43,95%CI:-0.17-1.02;adj.0R=0.45,95%Cl:-0.14-1.05)and mid-pregnancy(adj.OR=0.76,95%Cl:0.19-1.32;adj.OR=0.66,95%CI:0.94-1.22;adj.OR=0.56,95%CI:0.04-1.12).Bayesian kermnel ma-chine regression(BKMR)results indicated a positive association between TCS and glucose levels in both early and mid-pregnancy(P<0.05).Conclusion n Urinary TCS concentration during pregnancy is positively correlated with glucose levels in late pregnancy GDM screening tests.

关 键 词：妊娠早期 三氯生 血糖 尿 

分 类 号：R714.2[医药卫生—妇产科学] R574.4[医药卫生—临床医学]