Association of non-phthalate plasticizer exposure during early pregnancy with gestational diabetes mellitus: The potential mediation effect of plasma lipidome

Given the well-documented endocrine-disrupting effects of phthalate plasticizers (PAEs) on human health, their use has been subjected to stringent regulatory restrictions, prompting a global shift toward non-phthalate plasticizers (non-PAEs) as alternatives. While epidemiological evidence has establ...

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Main Authors: Yingying Mao, Shuqin Tang, Huan Liu, Qing Huang, Da Chen, Yuanyuan Li, Fengjiang Sun, Wei Huang
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Ecotoxicology and Environmental Safety
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Online Access:http://www.sciencedirect.com/science/article/pii/S0147651325007419
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author Yingying Mao
Shuqin Tang
Huan Liu
Qing Huang
Da Chen
Yuanyuan Li
Fengjiang Sun
Wei Huang
author_facet Yingying Mao
Shuqin Tang
Huan Liu
Qing Huang
Da Chen
Yuanyuan Li
Fengjiang Sun
Wei Huang
author_sort Yingying Mao
collection DOAJ
description Given the well-documented endocrine-disrupting effects of phthalate plasticizers (PAEs) on human health, their use has been subjected to stringent regulatory restrictions, prompting a global shift toward non-phthalate plasticizers (non-PAEs) as alternatives. While epidemiological evidence has established significant associations between PAE exposure and gestational diabetes mellitus (GDM), the potential role of non-PAEs in GDM pathogenesis represents a critical knowledge gap in environmental epidemiology. To address this, we conducted a case-control study nested within a well-established prospective birth cohort in Wuhan, China, comprising 286 GDM cases and 286 matched healthy controls. Plasma concentrations of 10 non-PAEs were quantified with high detection frequencies (≥ 70 % for six species). Using multivariable conditional logistic regression and restricted cubic spline regression models adjusted for maternal age, pre-pregnancy body mass index, and other covariates, we identified significant positive associations between gestational exposure to dimethyl azelate (DMAZ), trihexyl trimellitate, di(2-ethylhexyl) maleate, and dibutyl fumarate and elevated GDM risk. In addition, the Bayesian kernel machine regression (BKMR) model further revealed a joint effect of the non-PAE mixture exposure on GDM risk, and DMAZ and diisobutyl adipate/dibutyl adipate (DiBA/DnBA) were identified as key contributors to the joint effect. Our results also demonstrated significant mediation effects of selected lipid molecules (especially phosphatidylcholine and lysophosphatidylcholine) on the associations of DMAZ and DiBA/DnBA with GDM risk. These findings contribute to a deeper understanding of the environmental stressors associated with the development of GDM, as well as the underlying biological mechanisms involving lipid metabolism.
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spelling doaj-art-10b2a5e4354742ab90b9b8ebcbec9fa12025-08-20T03:07:50ZengElsevierEcotoxicology and Environmental Safety0147-65132025-07-0129911840510.1016/j.ecoenv.2025.118405Association of non-phthalate plasticizer exposure during early pregnancy with gestational diabetes mellitus: The potential mediation effect of plasma lipidomeYingying Mao0Shuqin Tang1Huan Liu2Qing Huang3Da Chen4Yuanyuan Li5Fengjiang Sun6Wei Huang7College of Environment and Climate, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou, Guangdong 510632, ChinaCollege of Environment and Climate, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou, Guangdong 510632, ChinaCollege of Environment and Climate, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou, Guangdong 510632, ChinaCollege of Environment and Climate, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou, Guangdong 510632, ChinaCollege of Environment and Climate, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou, Guangdong 510632, ChinaKey Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Corresponding authors.College of Environment and Climate, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou, Guangdong 510632, China; Corresponding authors.College of Environment and Climate, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou, Guangdong 510632, China; Corresponding authors.Given the well-documented endocrine-disrupting effects of phthalate plasticizers (PAEs) on human health, their use has been subjected to stringent regulatory restrictions, prompting a global shift toward non-phthalate plasticizers (non-PAEs) as alternatives. While epidemiological evidence has established significant associations between PAE exposure and gestational diabetes mellitus (GDM), the potential role of non-PAEs in GDM pathogenesis represents a critical knowledge gap in environmental epidemiology. To address this, we conducted a case-control study nested within a well-established prospective birth cohort in Wuhan, China, comprising 286 GDM cases and 286 matched healthy controls. Plasma concentrations of 10 non-PAEs were quantified with high detection frequencies (≥ 70 % for six species). Using multivariable conditional logistic regression and restricted cubic spline regression models adjusted for maternal age, pre-pregnancy body mass index, and other covariates, we identified significant positive associations between gestational exposure to dimethyl azelate (DMAZ), trihexyl trimellitate, di(2-ethylhexyl) maleate, and dibutyl fumarate and elevated GDM risk. In addition, the Bayesian kernel machine regression (BKMR) model further revealed a joint effect of the non-PAE mixture exposure on GDM risk, and DMAZ and diisobutyl adipate/dibutyl adipate (DiBA/DnBA) were identified as key contributors to the joint effect. Our results also demonstrated significant mediation effects of selected lipid molecules (especially phosphatidylcholine and lysophosphatidylcholine) on the associations of DMAZ and DiBA/DnBA with GDM risk. These findings contribute to a deeper understanding of the environmental stressors associated with the development of GDM, as well as the underlying biological mechanisms involving lipid metabolism.http://www.sciencedirect.com/science/article/pii/S0147651325007419Non-phthalate plasticizersGestational diabetes mellitusMixture effectPlasma lipidomeMediation analysis
spellingShingle Yingying Mao
Shuqin Tang
Huan Liu
Qing Huang
Da Chen
Yuanyuan Li
Fengjiang Sun
Wei Huang
Association of non-phthalate plasticizer exposure during early pregnancy with gestational diabetes mellitus: The potential mediation effect of plasma lipidome
Ecotoxicology and Environmental Safety
Non-phthalate plasticizers
Gestational diabetes mellitus
Mixture effect
Plasma lipidome
Mediation analysis
title Association of non-phthalate plasticizer exposure during early pregnancy with gestational diabetes mellitus: The potential mediation effect of plasma lipidome
title_full Association of non-phthalate plasticizer exposure during early pregnancy with gestational diabetes mellitus: The potential mediation effect of plasma lipidome
title_fullStr Association of non-phthalate plasticizer exposure during early pregnancy with gestational diabetes mellitus: The potential mediation effect of plasma lipidome
title_full_unstemmed Association of non-phthalate plasticizer exposure during early pregnancy with gestational diabetes mellitus: The potential mediation effect of plasma lipidome
title_short Association of non-phthalate plasticizer exposure during early pregnancy with gestational diabetes mellitus: The potential mediation effect of plasma lipidome
title_sort association of non phthalate plasticizer exposure during early pregnancy with gestational diabetes mellitus the potential mediation effect of plasma lipidome
topic Non-phthalate plasticizers
Gestational diabetes mellitus
Mixture effect
Plasma lipidome
Mediation analysis
url http://www.sciencedirect.com/science/article/pii/S0147651325007419
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