Urinary metabolites of multiple volatile organic compounds, oxidative stress biomarkers, and gestational diabetes mellitus: Association analyses

Volatile organic compounds are ubiquitous in the environment, which may cause various adverse health effects. The objectives of this study were to investigate associations of single and mixture of urinary metabolites of volatile organic compounds (mVOCs) with gestational diabetes mellitus (GDM) risk, and examine the possible role of oxidative stress in the associations. This nested case-control study included 454 GDM cases and 454 healthy controls matched by maternal age and infant sex. Urinary concentrations of twenty-one mVOCs and three oxidative stress biomarkers (including 8-OHdG, 8-OHG, and HNEMA), in early pregnancy were measured. Analyses using logistic regression model showed that an interquartile range increase in urinary concentrations of six individual mVOCs (ATCA, BPMA, CEMA, 3HPMA, MU, and TGA) were significantly associated with increased odds of GDM by 19-27%. Weighted quantile sum regression analyses showed that in each quartile increment of the mixture of mVOCs, the odds of GDM increased by 39% (95% CI: 16%, 67%), with 2-aminothiazoline-4-carboxylic acid weighted the most in the associations (weight: 25%). Furthermore, significant associations of the oxidative stress biomarkers with both GDM and certain mVOCs were observed. These results suggested that certain urinary mVOCs (correspondingly, the parent VOCs such as 1-bromopropane, cyanide, and benzene should be concerned as priority ones for regulation and policy making) in early pregnancy were significantly associated with elevated GDM incidence, and the associations were potentially related with oxidative stress biomarkers.