1
|
Liang W, Zhu H, Xu J, Zhao Z, Zhou L, Zhu Q, Cai J, Ji L. Ambient air pollution and gestational diabetes mellitus: An updated systematic review and meta-analysis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 255:114802. [PMID: 36934545 DOI: 10.1016/j.ecoenv.2023.114802] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/23/2023] [Accepted: 03/15/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE We aimed to evaluate the relationship between the composition of particulate matter (PM) and gestational diabetes mellitus (GDM) by a comprehensively review of epidemiological studies. METHODS We systematically identified cohort studies related to air pollution and GDM risk before February 8, 2023 from six databases (PubMed, Embase, Web of Science Core Collection, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform and Chongqing VIP Chinese Science and Technology Periodical databases). We calculated the relative risk (RR) and its 95% confidence intervals (CIs) to assess the overall effect by using a random effects model. RESULTS This meta-analysis of 31 eligible cohort studies showed that exposure to PM2.5, PM10, SO2, and NO2 was associated with a significantly increased risk of GDM, especially in preconception and first trimester. Analysis of the components of PM2.5 found that the risk of GDM was strongly linked to black carbon (BC) and nitrates (NO3-). Specifically, BC exposure in the second trimester and NO3- exposure in the first trimester elevated the risk of GDM, with the RR of 1.128 (1.032-1.231) and 1.128 (1.032-1.231), respectively. The stratified analysis showed stronger correlations of GDM risk with higher levels of pollutants in Asia, except for PM2.5 and BC, which suggested that the specific composition of particulate pollutants had a greater effect on the exposure-outcome association than the concentration. CONCLUSIONS Our study found that ambient air pollutant is a critical factor for GDM and further studies on specific particulate matter components should be considered in the future.
Collapse
Affiliation(s)
- Weiqi Liang
- Department of Preventive Medicine, School of Medicine, Ningbo University, Ningbo, China
| | - Hui Zhu
- Department of Internal Medicine, School of Medicine, Ningbo University, Ningbo, China
| | - Jin Xu
- Department of Preventive Medicine, School of Medicine, Ningbo University, Ningbo, China; Zhejiang Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, China
| | - Zhijia Zhao
- Department of Preventive Medicine, School of Medicine, Ningbo University, Ningbo, China
| | - Liming Zhou
- Center for Reproductive Medicine, Ningbo Women and Children's Hospital, Ningbo, China
| | - Qiong Zhu
- Department of Pediatrics, Affiliated People's Hospital of Ningbo University, Ningbo, China
| | - Jie Cai
- Center for Reproductive Medicine, Ningbo Women and Children's Hospital, Ningbo, China.
| | - Lindan Ji
- Zhejiang Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, China; Department of Biochemistry, School of Medicine, Ningbo University, Ningbo, China.
| |
Collapse
|
2
|
Laine MK, Kautiainen H, Anttila P, Gissler M, Pennanen P, Eriksson JG. Early pregnancy particulate matter exposure, pre-pregnancy adiposity and risk of gestational diabetes mellitus in Finnish primiparous women: An observational cohort study. Prim Care Diabetes 2023; 17:79-84. [PMID: 36464621 DOI: 10.1016/j.pcd.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 11/23/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022]
Abstract
AIMS To evaluate the association between the exposure of particulate matter with an aerodynamic diameter of ≤ 2.5μm (PM2.5) and with an aerodynamic diameter of ≤ 10μm (PM10) over the first trimester and the risk of gestational diabetes mellitus (GDM), and to assess whether maternal pre-pregnancy body mass index (BMI) modified the GDM risk. METHODS All Finnish primiparous women without previously diagnosed diabetes who delivered between 2009 and 2015 in the city of Vantaa, Finland, composed the study cohort (N = 6189). Diagnosis of GDM was based on a standard 75 g 2-hour oral glucose tolerance test. The average daily concentration of PM2.5 and PM10 over the first trimester was calculated individually for each woman. The relationship between exposure of PM2.5 and PM10 and GDM was analyzed with logistic models. RESULTS No association was observed between the average daily concentrations of PM2.5 and PM10 over the first trimester and the GDM risk. When simultaneously taking BMI and PM10 into account both mean daily PM10 concentration (p = 0.047) and pre-pregnancy BMI (p = 0.016) increased GDM risk independently and an interaction (p = 0.013) was observed between PM10 concentration and pre-pregnancy BMI. CONCLUSIONS Even globally low PM10 exposure level together with elevated maternal pre-pregnancy BMI seems to increase the GDM risk.
Collapse
Affiliation(s)
- Merja K Laine
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland.
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland; Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland.
| | - Pia Anttila
- Finnish Meteorological Institute, Helsinki, Finland.
| | - Mika Gissler
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland; Karolinska Institute, Stockholm, Sweden.
| | | | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland; National University Singapore, Yong Loo Lin School of Medicine, Department of Obstetrics and Gynecology, Singapore, Singapore; Singapore Institute for Clinical Sciences (SCIS), Agency for Science, Technology and Research (A⁎STAR), Singapore.
| |
Collapse
|
3
|
Liu W, Zhang Q, Liu W, Qiu C. Association between air pollution exposure and gestational diabetes mellitus in pregnant women: a retrospective cohort study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:2891-2903. [PMID: 35941503 DOI: 10.1007/s11356-022-22379-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/31/2022] [Indexed: 06/15/2023]
Abstract
The global prevalence of gestational diabetes mellitus (GDM) is increasing annually, and previous research reports on the relationship between exposure to air pollutants and GDM are not completely consistent. We investigated the association between air pollutant exposure and GDM in pregnant women in a retrospective cohort study in Guangzhou. We found that in the first trimester, exposure to PM2.5 and CO showed a significant association with GDM. In the second trimester, exposure to PM10 was significantly associated with GDM. In the third trimester, exposure to PM2.5, PM10, NO2, SO2, and CO at IQR4 (odds ratio [OR] = 1.271, 95% confidence interval [CI]: 1.179-1.370; OR = 1.283, 95% CI: 1.191-1.383; OR = 1.230, 95% CI: 1.145-1.322; OR = 1.408, 95% CI: 1.303-1.522; OR = 1.150, 95% CI: 1.067-1.240, respectively) compared with IQR1 was positively associated with GDM. However, exposure to NO2 was negatively associated with GDM in the first and second trimesters, and O3 was negatively associated with GDM in the second and third trimesters. We found that the correlation between air pollutants and GDM in different trimesters of pregnancy was not completely consistent in this retrospective cohort study. During pregnancy, there may be an interaction between air pollutant exposure and other factors, such as pregnant women's age, occupation, anemia status, pregnancy-induced hypertension status, and pregnancy season.
Collapse
Affiliation(s)
- Weiqi Liu
- Department of Clinical Laboratory, The Maternal and Children Health Care Hospital (Huzhong Hospital) of Huadu, Guangzhou, Guangdong, 510800, People's Republic of China.
| | - Qingui Zhang
- Department of Clinical Laboratory, Foshan Fosun Chancheng Hospital, Foshan, Guangdong, 528000, People's Republic of China
| | - Weiling Liu
- Department of Clinical Laboratory, Foshan Fosun Chancheng Hospital, Foshan, Guangdong, 528000, People's Republic of China
| | - Cuiqing Qiu
- Medical Information Office, The Maternal and Children Health Care Hospital (Huzhong Hospital) of Huadu, Guangzhou, Guangdong, 510800, People's Republic of China
| |
Collapse
|
4
|
Liu R, Zhang J, Chu L, Zhang J, Guo Y, Qiao L, Niu Z, Wang M, Farhat Z, Grippo A, Zhang Y, Ma C, Zhang Y, Zhu K, Mu L, Lei L. Association of ambient fine particulate matter exposure with gestational diabetes mellitus and blood glucose levels during pregnancy. ENVIRONMENTAL RESEARCH 2022; 214:114008. [PMID: 35931192 DOI: 10.1016/j.envres.2022.114008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 07/12/2022] [Accepted: 07/26/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Previous studies have examined the associations between ambient fine particulate matter (PM2.5) exposure and gestational diabetes mellitus (GDM). However, limited studies explored the relationships between PM2.5 exposure and blood glucose levels during pregnancy, especially in highly polluted areas. OBJECTIVES To examine the associations of prenatal ambient PM2.5 exposure with GDM and blood glucose levels, and to identify the sensitive exposure windows in a highly air-polluted area. METHODS From July 2016 to October 2017, a birth cohort study was conducted in Beijing, China. Participants were interviewed in each trimester regarding demographics, lifestyle, living and working environment, and medical conditions. Participant's daily ambient PM2.5 levels from 3 m before last menstrual period (LMP) to the third trimester was estimated by a hybrid spatiotemporal model. Indoor air quality index was calculated based on environmental tobacco smoke, ventilation, cooking, painting, pesticide, and herbicide use. Distributed lag non-linear model was applied to explore the sensitive weeks of PM2.5 exposure. RESULTS Of 165 pregnant women, 23 (13.94%) developed GDM. After adjusting for potential confounders, PM2.5 exposure during the 1st trimester was associated with higher odds of GDM (10 μg/m3 increase: OR = 1.89, 95% CI: 1.04-3.49). Each 10 μg/m3 increase in PM2.5 during the 2nd trimester was associated with 17.70% (2.21-33.20), 15.99% (2.96-29.01), 18.82% (4.11-33.52), and 17.10% (3.28-30.92) increase in 1-h, 2-h, Δ1h-fasting (1-h minus fasting), and Δ2h-fasting (2-h minus fasting) blood glucose levels, respectively. PM2.5 exposure at 24th-27th weeks after LMP was associated with increased GDM risk. We identified sensitive exposure windows of 21st-24th weeks for higher 1-h and 2-h blood glucose levels and of 20th-22nd weeks for increased Δ1h-fasting and Δ2h-fasting. CONCLUSIONS Ambient PM2.5 exposure during the second trimester was associated with higher odds of GDM and higher blood glucose levels. Avoiding exposure to high air pollution levels during the sensitive windows might prevent women from developing GDM.
Collapse
Affiliation(s)
- Rujie Liu
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jun Zhang
- Research Center for Public Health, Tsinghua University, Beijing, China
| | - Li Chu
- Department of Obstetrics and Gynecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jun Zhang
- Department of Obstetrics and Gynecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yanjun Guo
- Department of Obstetrics and Gynecology, Aerospace Center Hospital, Beijing, China
| | - Lihua Qiao
- Research Center for Public Health, Tsinghua University, Beijing, China
| | - Zhongzheng Niu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Meng Wang
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Zeinab Farhat
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Alexandra Grippo
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Yifan Zhang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Changxing Ma
- Department of Biostatistics, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Yingying Zhang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Kexin Zhu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA.
| | - Lijian Lei
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China.
| |
Collapse
|
5
|
Eberle C, Stichling S. Environmental health influences in pregnancy and risk of gestational diabetes mellitus: a systematic review. BMC Public Health 2022; 22:1572. [PMID: 35982427 PMCID: PMC9389831 DOI: 10.1186/s12889-022-13965-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 06/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications globally. Environmental risk factors may lead to increased glucose levels and GDM, which in turn may affect not only the health of the mother but assuming hypotheses of "fetal programming", also the health of the offspring. In addition to traditional GDM risk factors, the evidence is growing that environmental influences might affect the development of GDM. We conducted a systematic review analyzing the association between several environmental health risk factors in pregnancy, including climate factors, chemicals and metals, and GDM. Methods We performed a systematic literature search in Medline (PubMed), EMBASE, CINAHL, Cochrane Library and Web of Science Core Collection databases for research articles published until March 2021. Epidemiological human and animal model studies that examined GDM as an outcome and / or glycemic outcomes and at least one environmental risk factor for GDM were included. Results Of n = 91 studies, we classified n = 28 air pollution, n = 18 persistent organic pollutants (POP), n = 11 arsenic, n = 9 phthalate n = 8 bisphenol A (BPA), n = 8 seasonality, n = 6 cadmium and n = 5 ambient temperature studies. In total, we identified two animal model studies. Whilst we found clear evidence for an association between GDM and air pollution, ambient temperature, season, cadmium, arsenic, POPs and phthalates, the findings regarding phenols were rather inconsistent. There were clear associations between adverse glycemic outcomes and air pollution, ambient temperature, season, POPs, phenols, and phthalates. Findings regarding cadmium and arsenic were heterogeneous (n = 2 publications in each case). Conclusions Environmental risk factors are important to consider in the management and prevention of GDM. In view of mechanisms of fetal programming, the environmental risk factors investigated may impair the health of mother and offspring in the short and long term. Further research is needed. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13965-5.
Collapse
Affiliation(s)
- Claudia Eberle
- Medicine With Specialization in Internal Medicine and General Medicine, Hochschule Fulda, University of Applied Sciences, Leipziger Strasse 123, 36037, Fulda, Germany.
| | - Stefanie Stichling
- Medicine With Specialization in Internal Medicine and General Medicine, Hochschule Fulda, University of Applied Sciences, Leipziger Strasse 123, 36037, Fulda, Germany
| |
Collapse
|
6
|
Cheng X, Ji X, Yang D, Zhang C, Chen L, Liu C, Meng X, Wang W, Li H, Kan H, Huang H. Associations of PM 2.5 exposure with blood glucose impairment in early pregnancy and gestational diabetes mellitus. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 232:113278. [PMID: 35131583 DOI: 10.1016/j.ecoenv.2022.113278] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/22/2022] [Accepted: 01/30/2022] [Indexed: 06/14/2023]
Abstract
Exposure to fine particulate matter (PM2.5) during pregnancy has been linked to the risk of gestational diabetes mellitus (GDM), while conclusions are inconsistent. In this study we aimed to estimate the effects of prenatal PM2.5 exposure with blood glucose in early pregnancy and the GDM risk. Participants were recruited from the SH-IPMCH-BTH cohort (n = 41,929), a study of air pollution and birth outcome. All participants provided serum samples for analyses of fasting blood glucose (FBG) and HbA1c during early pregnancy. GDM was diagnosed using an oral glucose tolerance test (OGTT) with the time interval of 1 h. Prenatal exposure to PM2.5 was estimated using gap-filled satellite exposure assessments in Shanghai, China. Both FBG and HbA1c levels were significantly and positively associated with PM2.5 exposure during early pregnancy. A 10 μg/m3 increase of PM2.5 exposure from early to middle pregnancy was associated with the risk of GDM (first trimester OR=1.09, 95% CI: 1.02, 1.16; second trimester OR=1.09, 95% CI: 1.03, 1.16; first two trimester OR=1.15, 95%CI: 1.04, 1.28). The combined effects were greater among elevated FBG and HbA1c women with higher PM2.5 exposure in middle trimester (P for interaction=0.037 and 0.001, respectively). This study found that exposure to PM2.5 exposure in the 1st and 2nd trimesters was related to GDM. FBG and HbA1c played roles in the relationship between PM2.5 exposure in the 2nd trimester and GDM.
Collapse
Affiliation(s)
- Xiaoyue Cheng
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Xinhua Ji
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Dongjian Yang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Chen Zhang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Chen
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Weidong Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Huichu Li
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai, China
| | - Hefeng Huang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.
| |
Collapse
|
7
|
Veras M, Waked D, Saldiva P. Safe in the womb? Effects of air pollution to the unborn child and neonates. J Pediatr (Rio J) 2022; 98 Suppl 1:S27-S31. [PMID: 34740534 PMCID: PMC9510928 DOI: 10.1016/j.jped.2021.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE In this brief review, the authors focus on the effects of gestational exposures to urban air pollution on fetal development and neonatal outcomes. SOURCE OF DATA In this review the authors used PubMed, Web of Science and SciELO research platforms, analyzing papers from the last 30 years. SUMMARY OF THE FINDINGS Epidemiological and experimental evidence agree that gestational exposure to air pollution in urban increases the risks for low birth weight, preterm birth, congenital malformation, intrauterine growth restriction, and neonatal mortality. Furthermore, exposures are associated with increased risks for preeclampsia, hypertension, gestational diabetes. CONCLUSIONS Therefore, it is time for greater involvement and engagement of the health sector in the discussion of public policies that may affect the quality of the environment, and that directly or indirectly impact the health of those who were not yet born.
Collapse
Affiliation(s)
- Mariana Veras
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Laboratório de Patologia Ambiental e Experimental (LIM05), São Paulo, SP, Brazil.
| | - Dunia Waked
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Laboratório de Patologia Ambiental e Experimental (LIM05), São Paulo, SP, Brazil
| | - Paulo Saldiva
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Laboratório de Patologia Ambiental e Experimental (LIM05), São Paulo, SP, Brazil
| |
Collapse
|
8
|
Yan YH, Chien CC, Wang P, Lu MC, Wei YC, Wang JS, Wang JS. Association of exposure to air pollutants with gestational diabetes mellitus in Chiayi City, Taiwan. Front Endocrinol (Lausanne) 2022; 13:1097270. [PMID: 36726471 PMCID: PMC9885121 DOI: 10.3389/fendo.2022.1097270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 12/30/2022] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION We investigated the associations of exposure to particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) and several gaseous pollutants with risk of gestational diabetes mellitus (GDM) in Taiwan. METHODS We retrospectively identified pregnant women who underwent a two-step approach to screen for GDM between 2006 and 2014. Information on concentrations of air pollutants (including PM2.5, sulfur dioxide [SO2], nitrogen oxides [NOx], and ozone [O3]) were collected from a single fixed-site monitoring station. We conducted logistic regression analyses to determine the associations between exposure to air pollutants and risk of GDM. RESULTS A total of 11210 women were analyzed, and 705 were diagnosed with GDM. Exposure to PM2.5 during the second trimester was associated with a nearly 50% higher risk of GDM (odds ratio [OR] 1.47, 95% CI 0.96 to 2.24, p=0.077). The associations were consistent in the two-pollutant model (PM2.5 + SO2 [OR 1.73, p=0.038], PM2.5 + NOx [OR 1.52, p=0.064], PM2.5 + O3 [OR 1.96, p=0.015]), and were more prominent in women with age <30 years and body mass index <25 kg/m2 (interaction p values <0.01). DISCUSSION Exposure to PM2.5 was associated with risk of GDM, especially in women who were younger or had a normal body mass index.
Collapse
Affiliation(s)
- Yuan-Horng Yan
- Department of Medical Research, Kuang Tien General Hospital, Taichung, Taiwan
- Department of Endocrinology and Metabolism, Kuang Tien General Hospital, Taichung, Taiwan
- Department of Nutrition and Institute of Biomedical Nutrition, Hung Kuang University, Taichung, Taiwan
| | - Chu-Chun Chien
- Department of Pathology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Pathology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Panchalli Wang
- Department of Obstetrics and Gynecology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Mei-Chun Lu
- Department of Medical Research, Kuang Tien General Hospital, Taichung, Taiwan
| | - Yu-Ching Wei
- Department of Pathology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Pathology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Jyh-Seng Wang
- Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Jun-Sing Wang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- National Chung Hsing University, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- *Correspondence: Jun-Sing Wang,
| |
Collapse
|
9
|
Zheng Y, Wen X, Bian J, Lipkind H, Hu H. Associations between the chemical composition of PM 2.5 and gestational diabetes mellitus. ENVIRONMENTAL RESEARCH 2021; 198:110470. [PMID: 33217440 DOI: 10.1016/j.envres.2020.110470] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/26/2020] [Accepted: 11/09/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND Fine particulate matter (PM2.5) is a complex mixture of fine particulates with large spatiotemporal heterogeneities in chemical compositions. While PM2.5 has been associated with gestational diabetes mellitus (GDM), little is known about the relationship between specific chemical components of PM2.5 and GDM. We examined the associations between GDM and pregnancy exposures to PM2.5 and its compositions, including sulfate (SO42-), ammonium (NH4+), nitrate (NO3-), organic matter (OM), black carbon (BC), mineral dust (DUST), and sea-salt (SS), and to identify critical windows of exposure. METHODS We used data from the 2005-2015 Florida Vital Statistics Birth Records. A well-validated geoscience-derived model was used to estimate women's pregnancy exposures to PM2.5 and its compositions. Distributed lag models were used to examine the associations and to identify the critical windows of exposure. RESULTS A total of 2,078,669 women were included. In single-pollutant models, after controlling for potential confounders, positive associations between PM2.5 and GDM were observed during the second trimester of pregnancy. We found positive associations between SO42-, NH4+, NO3-, OM and BC, with largest effect sizes observed in the 21-24 weeks of pregnancy. Negative associations were observed for DUST and SS. Consistent results for NH4+, OM, DUST and SS were observed in the multi-pollutant models. CONCLUSIONS Exposures to PM2.5 and its compositions (mainly NH4+, OM) during the second trimester are positively associated with GDM, especially for exposures during the 21-24 weeks of pregnancy. Further studies are needed to confirm the findings and examine the underlying mechanisms.
Collapse
Affiliation(s)
- Yi Zheng
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Xiaoxiao Wen
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Heather Lipkind
- Department of Obstetrics, Gynecology & Reproductive Sciences, School of Medicine, Yale University, New Haven, CT, USA
| | - Hui Hu
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA.
| |
Collapse
|
10
|
Hu Q, Wang D, Yue D, Xu C, Hu B, Cheng P, Zhai Y, Mai H, Li P, Gong J, Zeng X, Jiang T, Mai D, Fu S, Guo L, Lin W. Association of ambient particle pollution with gestational diabetes mellitus and fasting blood glucose levels in pregnant women from two Chinese birth cohorts. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 762:143176. [PMID: 33158526 DOI: 10.1016/j.scitotenv.2020.143176] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 08/21/2020] [Accepted: 10/13/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Fasting blood glucose may capture the adverse effects of air pollution on pregnant women better than the incidence of gestational diabetes mellitus (GDM), but evidence on the association between air pollution and maternal glucose concentrations is limited. OBJECTIVE To investigate the associations between air pollutants, GDM and fasting blood glucose during pregnancy. METHODS We recruited 2326 pregnant women from two birth cohorts located in Guangzhou and Heshan, the Pearl River Delta region (PRD), China. PM10, PM2.5 and black carbon (BC) exposure concentrations in the first and second trimesters of pregnancy were collected at fixed-site monitoring stations for each cohort. Multiple logistic regressions were employed to estimate the associations between particle pollution and GDM. Mixed-effects models were used to evaluate the associations of air pollutants with blood glucose levels. Restricted cubic spline functions were fitted to visualize the concentration-response relationships. Distributed lag non-linear models were used to estimate week-specific lag effects of particle pollution exposure on GDM and blood glucose. Unconstrained distributed lag models with lags of 0-3 weeks were used to examine potential cumulative effects. RESULTS We observed positive and significant associations of PM10, PM2.5 and BC exposure with fasting glucose, particularly in the second trimester. PM10, PM2.5 and BC were strongly correlated and displayed similar cumulative (lag 0-3 weeks) associations with fasting blood glucose. Exposure to particle pollution was not associated with 1-h or 2-h blood glucose. Models estimating the association between air pollutants and GDM were consistent with statistical insignificance. CONCLUSIONS Based on the results of the present study, exposure to air pollution during pregnancy exerts cumulative, adverse effects on fasting glucose levels. This study provides preliminary support for the use of blood glucose levels to explore the potential health impact of air pollution on pregnant women.
Collapse
Affiliation(s)
- Qiansheng Hu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Duo Wang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Dingli Yue
- Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangzhou 510308, Guangdong, China
| | - Chengfang Xu
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, Guangdong, China
| | - Bo Hu
- Department of Clinical Laboratory, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, Guangdong, China
| | - Peng Cheng
- Institute of Mass Spectrometer and Atmospheric Environment, Jinan University, Guangzhou 510632, Guangdong, China
| | - Yuhong Zhai
- Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangzhou 510308, Guangdong, China
| | - Huiying Mai
- Department of Obstetrics and Gynecology, Heshan Maternal and Child Health Hospital, Heshan, 529700 Jiangmen, Guangdong, China
| | - Ping Li
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, Guangdong, China
| | - Jiao Gong
- Department of Clinical Laboratory, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, Guangdong, China
| | - Xiaoling Zeng
- Department of Obstetrics and Gynecology, Heshan Maternal and Child Health Hospital, Heshan, 529700 Jiangmen, Guangdong, China
| | - Tingwu Jiang
- Department of Clinical Laboratory, Heshan Maternal and Child Health Hospital, Heshan, 529700 Jiangmen, Guangdong, China
| | - Dejian Mai
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Shaojie Fu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Lihua Guo
- Department of Obstetrics and Gynecology, Heshan Maternal and Child Health Hospital, Heshan, 529700 Jiangmen, Guangdong, China
| | - Weiwei Lin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China.
| |
Collapse
|
11
|
Zhang H, Zhao Y. Ambient air pollution exposure during pregnancy and gestational diabetes mellitus in Shenyang, China: a prospective cohort study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:7806-7814. [PMID: 33037545 DOI: 10.1007/s11356-020-11143-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/05/2020] [Indexed: 06/11/2023]
Abstract
The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. Reports of the association between air pollution exposure and GDM have been inconsistent in previous studies. We conducted a cohort study to investigate the associations between air pollution exposure and GDM in the city of Shenyang in Northeast China for the first time. We studied interactions with different air pollutant exposures and conducted a stratified analysis according to folic acid intake, age, body mass index (BMI), primiparity, and sleep quality. We found significant associations between prenatal exposure to NOx and SO2 and the development of GDM during the second trimester: the largest effect on GDM was exposure to SO2 (odds ratio (OR): 1.77, 95% confidence interval (CI): 1.23-2.56) in the largest quartile compared with the lowest quartile. Significant interactions between age, BMI, parity, sleep quality, and air pollution exposures were observed; stratified analysis showed stronger associations between GDM and high air pollutant exposure in pregnant women with older age, larger BMI, poorer sleep quality, and more parity. We found that air pollution exposure during the second trimester was significantly associated with GDM in a prospective birth cohort study in Northeast China. SO2, oxynitride (NOX, NO2, NO), CO, and O3 all showed a linear trend effect on GDM. Interactions between prenatal air pollution exposure and other factors, such as age at pregnancy, BMI before pregnancy, primiparity, folic acid intake, and sleep quality, during the second trimester might exist.
Collapse
Affiliation(s)
- Hehua Zhang
- Clinical Reserch Center, Shengjing Hospital of China Medical University, Huaxiang Road No. 39, Tiexi District, China
| | - Yuhong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Sanhao Street, No. 36, Heping District, China.
| |
Collapse
|
12
|
Najafi ML, Zarei M, Gohari A, Haghighi L, Heydari H, Miri M. Preconception air pollution exposure and glucose tolerance in healthy pregnant women in a middle-income country. Environ Health 2020; 19:131. [PMID: 33298083 PMCID: PMC7727159 DOI: 10.1186/s12940-020-00682-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 12/01/2020] [Indexed: 05/11/2023]
Abstract
BACKGROUND Preconception exposure to air pollution has been associated with glucose tolerance during pregnancy. However, the evidence in low and middle-income countries (LMICs) is under debate yet. Therefore, this study aimed to assess the relationship between exposure to ambient particulate matter (PM) and traffic indicators with glucose tolerance in healthy pregnant women in Sabzevar, Iran (2019). METHODS Two-hundred and fifty healthy pregnant women with singleton pregnancies and 24-26 weeks of gestations participated in our study. Land use regression (LUR) models were applied to estimate the annual mean of PM1, PM2.5 and PM10 at the residential address. Traffic indicators, including proximity of women to major roads as well as total streets length in 100, 300 and 500 m buffers around the home were calculated using the street map of Sabzevar. The oral glucose tolerance test (OGTT) was used to assess glucose tolerance during pregnancy. Multiple linear regression adjusted for relevant covariates was used to estimate the association of fasting blood glucose (FBG), 1-h and 2-h post-load glucose with PMs and traffic indicators. RESULTS Exposure to PM1, PM2.5 and PM10 was significantly associated with higher FBG concentration. Higher total streets length in a 100 m buffer was associated with higher FBG and 1-h glucose concentrations. An interquartile range (IQR) increase in proximity to major roads was associated with a decrease of - 3.29 mg/dL (95% confidence interval (CI): - 4.35, - 2.23, P-value < 0.01) in FBG level and - 3.65 mg/dL (95% CI, - 7.01, - 0.28, P-value = 0.03) decrease in 1-h post-load glucose. CONCLUSION We found that higher preconception exposure to air pollution was associated with higher FBG and 1-h glucose concentrations during pregnancy.
Collapse
Affiliation(s)
- Moslem Lari Najafi
- Pharmaceutical Sciences and Cosmetic Products Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Zarei
- Department of Physical Education and Sport Science, Faculty of Human Science, University of Neyshabur, Neyshabur, Iran
| | - Ali Gohari
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Leyla Haghighi
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Hafez Heydari
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran.
| | - Mohammad Miri
- Non-Communicable Diseases Research Center, Department of Environmental Health, School of Health, Sabzevar University of Medical Sciences, PO Box 319, Sabzevar, Iran.
| |
Collapse
|
13
|
Ye B, Zhong C, Li Q, Xu S, Zhang Y, Zhang X, Chen X, Huang L, Wang H, Zhang Z, Huang J, Sun G, Xiong G, Yang X, Hao L, Yang N, Wei S. The Associations of Ambient Fine Particulate Matter Exposure During Pregnancy With Blood Glucose Levels and Gestational Diabetes Mellitus Risk: A Prospective Cohort Study in Wuhan, China. Am J Epidemiol 2020; 189:1306-1315. [PMID: 32286614 DOI: 10.1093/aje/kwaa056] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 04/08/2020] [Accepted: 04/08/2020] [Indexed: 02/06/2023] Open
Abstract
Investigators in previous studies have drawn inconsistent conclusions regarding the relationship between relatively low exposure to fine particulate matter (particulate matter with an aerodynamic diameter ≤2.5 μm (PM2.5)) and risk of gestational diabetes mellitus (GDM), while the association between high PM2.5 exposure and GDM risk has not been well studied. We investigated the association of high PM2.5 exposure during pregnancy with blood glucose levels and GDM risk in Chinese women. The present study was conducted from August 2013 to May 2016 among 3,967 pregnant women in the Tongji Maternal and Child Health Cohort in Wuhan, China. PM2.5 exposure during pregnancy for each participant was estimated by means of land-use regression models. An interquartile-range increase in PM2.5 exposure (33.84 μg/m3 for trimester 1 and 33.23 μg/m3 for trimester 2) was associated with 36% (95% confidence interval (CI): 1.15, 1.61) and 23% (95% CI: 1.01, 1.50) increased odds of GDM during trimester 1 and trimester 2, respectively. An interquartile-range increment of PM2.5 exposure during trimester 1 increased 1-hour and 2-hour blood glucose levels by 1.40% (95% CI: 0.42, 2.37) and 1.82% (95% CI: 0.98, 2.66), respectively. The same increment of PM2.5 exposure during trimester 2 increased fasting glucose level by 0.85% (95% CI: 0.41, 1.29). Our findings suggest that high PM2.5 exposure during pregnancy increases blood glucose levels and GDM risk in Chinese women.
Collapse
|
14
|
Lin Q, Zhang S, Liang Y, Wang C, Wang C, Wu X, Luo C, Ruan Z, Acharya BK, Lin H, Guo X, Yang Y. Ambient air pollution exposure associated with glucose homeostasis during pregnancy and gestational diabetes mellitus. ENVIRONMENTAL RESEARCH 2020; 190:109990. [PMID: 32739627 DOI: 10.1016/j.envres.2020.109990] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/19/2020] [Accepted: 07/21/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND To investigate the effects of air pollution exposure during pregnancy on the indicators of glucose homeostasis and gestational diabetes mellitus (GDM). METHODS We conducted a birth cohort study in Foshan, China during 2015-2019. Oral glucose tolerance test (OGTT) was administered to each participant during pregnancy. GDM was defined according to the International Association of Diabetes and Pregnancy Study Groups criteria (IADPSG). Air pollutant (fine particulate matter (PM2.5), particulate matter with an aerodynamic diameter of 10 μm or less (PM10), sulfate dioxide (SO2), nitrogen dioxide (NO2) and ozone (O3)) concentrations from the air monitoring stations in Foshan were used to estimate individual air pollutant exposure during the first two trimesters. Linear and logistic regression models were employed to estimate the associations between air pollution exposure during the first two trimesters and OGTT glucose levels and GDM. RESULTS Of 12,842 pregnant women, 3055 (23.8%) had GDM. A 10 μg/m3 increase in PM2.5, PM10 and SO2 during trimester 1, trimester 2 and two trimesters were associated with 0.07 mmol/L to 0.29 mmol/L increment in OGTT-fasting glucose levels in single-pollutant model. A 10 μg/m3 increase in NO2 and O3 during two trimesters were associated with 0.15 mmol/L and 0.12 mmol/L decrease in OGTT-fasting glucose in single-pollutant model. However, no significant or weaker effects of O3 during two trimesters on OGTT-fasting glucose were observed in two-pollutant models. Moreover, exposure to PM2.5, PM10 and SO2 were associated with increased risk of GDM in both single- and two-pollutant models. CONCLUSIONS Our study suggests PM2.5, PM10 and SO2 exposure during the first two trimesters might increase the risk of GDM.
Collapse
Affiliation(s)
- Qingmei Lin
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ying Liang
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Changke Wang
- National Climate Center, China Meteorological Administration, Beijing, China
| | - Xueli Wu
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Caihong Luo
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Zengliang Ruan
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Bipin Kumar Acharya
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaoling Guo
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China.
| | - Yin Yang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
| |
Collapse
|
15
|
Yang Y, Lin Q, Liang Y, Ruan Z, Qian ZM, Syberg KM, Howard SW, Wang C, Acharya BK, Zhang Q, Ge H, Wu X, Li K, Guo X, Lin H. The mediation effect of maternal glucose on the association between ambient air pollution and birth weight in Foshan, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 266:115128. [PMID: 32650160 DOI: 10.1016/j.envpol.2020.115128] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 06/10/2020] [Accepted: 06/26/2020] [Indexed: 06/11/2023]
Abstract
Maternal blood glucose level is associated with fetal growth, therefore, its role in the associations between air pollution and birth weight deserves investigation. We examined the mediation effect of maternal blood glucose on the associations between maternal air pollution exposure and birth weight. A total of 10,904 pregnant women in Foshan, China during 2015-2019 were recruited. Oral glucose tolerance test (OGTT) was administered to each participant after late trimester 2. Air pollution data at the monitoring stations in residential districts was used to estimate exposures of each participant during trimester 1 and trimester 2. Mixed-effects linear models were used to estimate the associations between air pollution and birth weight. After controlling for ten covariates, the direct effect of PM2.5 and SO2 (each 10 μg/m3 increment) on birth weight was -15.7 g (95% CI: -29.4, -4.8 g) and -83.6 g (95% CI: -134.8, -33.0 g) during trimester 1. The indirect effect of PM2.5 and SO2 (each 10 μg/m3 increment) on birth weight by increasing maternal fasting glucose level was 6.6 g (95% CI: 4.6, 9.1 g) and 22.0 g (95% CI: 4.1, 44.0 g) during trimester 1. Our findings suggest that air pollution might affect the birth weight through direct and indirect pathway, and the indirect effect might be mediated by maternal blood glucose.
Collapse
Affiliation(s)
- Yin Yang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qingmei Lin
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Ying Liang
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Zengliang Ruan
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, St. Louis, Missouri, USA
| | - Kevin M Syberg
- Department of Health Management and Policy, College for Public Health & Social Justice, Saint Louis University, St. Louis, Missouri, USA
| | - Steven W Howard
- Department of Health Management and Policy, College for Public Health & Social Justice, Saint Louis University, St. Louis, Missouri, USA
| | - Changke Wang
- National Climate Center, China Meteorological Administration, Beijing, China
| | - Bipin Kumar Acharya
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qihao Zhang
- Department of Cell Biology & Institute of Biomedicine, College of Life Science and Technology, Jinan University, Guangzhou, China
| | - Haibo Ge
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Xueli Wu
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Kaihua Li
- HongYang Software Co.,Ltd, Foshan, China
| | - Xiaoling Guo
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
| |
Collapse
|
16
|
Prenatal exposure to ambient air pollution and adverse pregnancy outcomes in Ahvaz, Iran: a generalized additive model. Int Arch Occup Environ Health 2020; 94:309-324. [PMID: 32936369 DOI: 10.1007/s00420-020-01577-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 09/01/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE There is some evidence about the short-term effects of air pollutants on adverse pregnancy outcomes. The aim of this study was to determine the association between air pollutants and spontaneous abortion, stillbirth, gestational hypertension, preeclampsia, gestational diabetes and macrosomia in Ahvaz, which is one of the most polluted cities in the Middle East. METHODS Data on adverse pregnancy outcomes and air pollutants including ozone (O3), nitric oxide (NO), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), particles with a diameter of less than 10 µm (PM10) and particles with a diameter less than 2.5 µm (PM2.5) were inquired from the Health Department of Ahvaz Jundishapur University of Medical Sciences and the Environmental Protection Agency of Khuzestan Province for the years 2008-2018. A time series analysis using the generalized additive model (GAM) with up to 6-day lags was used. RESULTS The results showed that the SO2 pollutant on 0, 1, 3, 4, and 6-day lags and PM10 on lag 0 had direct and significant associations with spontaneous abortion. NO, NO2 and CO on 0-6-day lags, and O3 on 6-day lags showed direct and significant associations with preeclampsia. NO and NO2 pollutants showed significant and direct associations with gestational diabetes, during 0- and 6-day lags. NO on 0-, 3- and 4-day lags, CO in all 0-6-day lags and PM2.5 on 1-, 3-, 5-, and 6-day lags showed direct and significant associations with macrosomia. None of the pollutants showed significant associations with stillbirth or gestational hypertension. CONCLUSIONS The results of this study suggest that some air pollutants are associated with spontaneous abortion, preeclampsia, gestational diabetes and macrosomia. This study further emphasizes the need to control ambient air pollution.
Collapse
|
17
|
Yu G, Ao J, Cai J, Luo Z, Martin R, Donkelaar AV, Kan H, Zhang J. Fine particular matter and its constituents in air pollution and gestational diabetes mellitus. ENVIRONMENT INTERNATIONAL 2020; 142:105880. [PMID: 32593838 DOI: 10.1016/j.envint.2020.105880] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/01/2020] [Accepted: 06/05/2020] [Indexed: 05/06/2023]
Abstract
BACKGROUND Ambient air pollution has been linked to the development of gestational diabetes mellitus (GDM). However, previous studies provided inconsistent findings and no study has examined the effects of complex chemical constituents of the particular matter on GDM, especially in developing countries. Therefore, we aim to investigate the associations of exposure to PM2.5 (particular matter ≤ 2.5 μm) and its constituents with GDM, and to identify susceptible exposure window in a large survey in China. METHODS The China Labor and Delivery Survey was a cross-sectional investigation conducted in 24 provinces in China between 2015 and 2016. A random sample of all deliveries in each participating hospital was selected and detailed obstetric and newborn information was extracted from medical records. Average concentrations of PM2.5 and six constituents (organic matter, black carbon, sulfate, nitrate, ammonium and soil dust) were estimated (1 km × 1 km) using a combined geoscience-statistical model. GDM was diagnosed based on an oral glucose tolerance test (OGTT) between 24 to 28 weeks of gestation and according to IADPSG criteria. Generalized linear mixed models were used to adjust for potential confounders. RESULTS A total of 54,517 subjects from 55 hospitals were included. The incidence of GDM was 10.8%. An interquartile range (IQR) increase in PM2.5 exposure in the 2nd trimester of pregnancy was associated with an increased GDM risk in the single pollutant model, [adjusted odds ratio (aOR) = 1.11 and 95% confidence interval (CI): 1.01-1.22]. Exposure to organic matter (aOR = 1.14; 95%CI: 1.05-1.23), black carbon (aOR = 1.15; 95%CI: 1.07-1.25) and nitrate (aOR = 1.13; 95%CI: 1.02-1.24) during 2nd trimester were associated with increased risks of GDM. Associations between constituents and GDM were robust after controlling for total PM2.5 mass and accounting for multi-collinearity. CONCLUSIONS Exposure to PM2.5 in 2nd trimester of pregnancy was associated with an increased risk of GDM. Organic matter, black carbon and nitrate may be the main culprits for the association.
Collapse
Affiliation(s)
- Guoqi Yu
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200092, China
| | - Junjie Ao
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200092, China
| | - Jing Cai
- School of Public Health, Fudan University, Shanghai 200032, China
| | - Zhongcheng Luo
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200092, China
| | - Randall Martin
- Department of Physics and Atmospheric Science, Dalhousie University, 6300 Coburg Road, Halifax, Nova Scotia B3H 3J5, Canada
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, 6300 Coburg Road, Halifax, Nova Scotia B3H 3J5, Canada
| | - Haidong Kan
- School of Public Health, Fudan University, Shanghai 200032, China.
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200092, China; School of Public Health, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China.
| |
Collapse
|
18
|
Zhang M, Wang X, Yang X, Dong T, Hu W, Guan Q, Tun HM, Chen Y, Chen R, Sun Z, Chen T, Xia Y. Increased risk of gestational diabetes mellitus in women with higher prepregnancy ambient PM 2.5 exposure. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 730:138982. [PMID: 32388108 DOI: 10.1016/j.scitotenv.2020.138982] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Air pollution is a serious environmental problem in China. This study was designed to investigate whether exposure to particulate matter with an aerodynamic diameter ≤ 2.5 μm (PM2.5) before pregnancy is associated with gestational diabetes mellitus (GDM) and fasting glucose in China. METHODS We recruited subjects and collected clinical data from the Nanjing Maternity and Child Health Care Hospital from July 2016 to October 2017. A series of validated land-use regression (LUR) models were built to assess individual exposure to PM2.5 in a 1 × 1 km area at both work and home addresses following a time-weighted pattern. Multiple linear regression and logistic regression analyses were performed to examine the association between PM2.5 exposure and GDM and fasting glucose. RESULTS In total, 11,639 of 16,995 women were included in the final analysis. Among the 11,639 women, 2776 (23.85%) had GDM. Individual exposure to PM2.5 within three months before pregnancy ranged from 21.58 to 85.92 μg/m3. Positive associations were observed among the interquartile ranges (IQRs) of exposure to PM2.5 within three months before pregnancy and GDM (OR = 2.61, 95% CI: 1.40-4.93, p < .01) as well as fasting glucose levels (β = 0.57, 95% CI: 0.45-0.68, p < .01). The diabetogenic effects of PM2.5 gradually increased from the first month before pregnancy, peaked in the second month and then gradually decreased until the third month when the week-specific exposure were analyzed to identify the sensitive time window. CONCLUSION Our study confirmed that higher exposure to PM2.5 within three months before pregnancy is significantly associated with increased risk of GDM and elevated fasting glucose levels, reflecting the importance of preconceptional environmental exposure in the development of maternal GDM.
Collapse
Affiliation(s)
- Mingzhi Zhang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Xu Wang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Xu Yang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Tianyu Dong
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Weiyue Hu
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Quanquan Guan
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Hein M Tun
- HKU-Pasteur Research Pole, School of Public Health, Li KaShing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yi Chen
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, China
| | - Rui Chen
- School of Public Health, Capital Medical University, China
| | - Zhiwei Sun
- School of Public Health, Capital Medical University, China
| | - Ting Chen
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Hospital, Nanjing, China.
| | - Yankai Xia
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
| |
Collapse
|
19
|
Kang J, Liao J, Xu S, Xia W, Li Y, Chen S, Lu B. Associations of exposure to fine particulate matter during pregnancy with maternal blood glucose levels and gestational diabetes mellitus: Potential effect modification by ABO blood group. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2020; 198:110673. [PMID: 32361495 DOI: 10.1016/j.ecoenv.2020.110673] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 04/16/2020] [Accepted: 04/21/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Previous studies have examined the relationships between prenatal fine particulate matter (PM2.5) exposure and gestational diabetes mellitus (GDM), but the results were inconsistent. Furthermore, the possible effect modification by ABO blood group has not been explored. OBJECTIVES To assess the associations of PM2.5 exposures during pregnancy with maternal glucose levels as well as GDM, and further to evaluate the potential effect modification by ABO blood group. METHODS Between January 2013 and January 2015, 4783 pregnant women were enrolled in our study based on a birth cohort in Wuhan. Daily PM2.5 exposure levels for each woman during pregnancy were estimated using a spatial-temporal land-use regression model. Linear regressions with general estimating equations (GEE) were performed to assess the associations between trimester-specific PM2.5 exposures and maternal glucose levels. Modified Poisson regressions with GEE analyses were used to evaluate the impacts of PM2.5 exposures during each trimester on the risk of GDM. The associations of PM2.5 exposure during the whole study period with glucose levels and GDM were estimated using multiple linear regression model and modified Poisson regression model, respectively. We conducted a stratified analysis to explore the potential effect modification by ABO blood group. RESULTS Among all the 4783 participants, 394 (8.24%) had GDM. Exposure to PM2.5 was found to be positively associated with elevated fasting glucose level during the whole study period [0.382 mg/dL, 95% confidence interval (CI): 0.179-0.586, per 10 μg/m3 increase in PM2.5], the first trimester (0.154 mg/dL ,95% CI: 0.017-0.291) and the second trimester (0.541 mg/dL, 95% CI: 0.390-0.692). No statistically significant results were observed between PM2.5 and 1-h and 2-h glucose levels during any study period. Increased risks of GDM for each 10 μg/m3 increase in PM2.5 levels were observed during the whole study period [relative risk (RR): 1.120, 95% CI: 1.021-1.228] and the first trimester (RR: 1.074, 95% CI: 1.012-1.141), but not the second trimester (RR: 1.035, 95% CI: 0.969-1.106). Stratified analysis indicated that the associations of PM2.5 exposures with GDM were more pronounced among pregnant women with blood group A, but no significant effect modifications were observed. CONCLUSION Our study enriched epidemiological evidence linking PM2.5 exposures during pregnancy to elevated maternal glucose levels and increased risk of GDM. More importantly, we first highlighted that the impact of PM2.5 on GDM might be greater among pregnant women with blood group A.
Collapse
Affiliation(s)
- Jiawei Kang
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Jiaqiang Liao
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Yuanyuan Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Siyi Chen
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Bin Lu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China.
| |
Collapse
|
20
|
Yao M, Liu Y, Jin D, Yin W, Ma S, Tao R, Tao F, Zhu P. Relationship betweentemporal distribution of air pollution exposure and glucose homeostasis during pregnancy. ENVIRONMENTAL RESEARCH 2020; 185:109456. [PMID: 32278159 DOI: 10.1016/j.envres.2020.109456] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Mounting evidence has demonstrated that air pollution exposure is associated with the increased prevalence of gestational diabetes mellitus (GDM). However, the long-term exposure effect and the time window of the maximum effect of these air pollutants on GDM and glucose homeostasis during pregnancy are unclear. METHODS We conducted this study on 5427 nondiabetic pregnant women who were admitted from three hospitals in Hefei City, China, between 2015 and 2018. The data regarding the average exposure to particulate matter (PM), sulfur dioxide (SO2), and ozone (O3) were estimated in a fixed monitoring station in Hefei. We used logistic regression and multiple linear regression to assess the effects of air pollutants on GDM and glucose homeostasis. RESULTS Of the 5427 participants, 1119 (20.6%) had GDM. We found prepregnancy exposure to air pollutants was associated with the risk of GDM in the single pollutant model [odds and 95% confidence interval (CI) of GDM for an interquartile range (IQR) increase was 1.24 (1.06-1.45) for PM2.5, 1.42 (1.26-1.59) for PM10, 1.21 (1.10-1.33) for SO2 and1.19 (1.08-1.31) for O3]. The risk of GDM before pregnancy was higher with long-term exposure to high-concentration pollutants compared with the risk in pregnant women who were not exposed to high-concentration pollutants (χ2 = 41.52, p for trend <0.0001); the ORs and 95% CI values for the exposure times of 1, 2, and 3 months were 1.28 (0.96-1.72), 1.52 (1.06-2.19), and 1.69 (1.11-2.57), respectively. The results showed a positive effect of exposure to higher-concentration air pollutants 1 year before pregnancy on glucose homeostasis during pregnancy. The time windows of the maximum effect of PM2.5, PM10, SO2, and O3 on GDM were different. The time windows of the maximum effect of PM2.5, PM10, and SO2 were 6 months, 5 months, and 1 month before the last menstrual period (LMP) and 3 months after the LMP, respectively. The time windows of the maximum effect of air pollution on glucose homeostasis indicators from the 2-h 75-g oral glucose tolerance test were similar to the abovementioned results. CONCLUSIONS Prepregnancy long-term air pollution exposure was associated with a higher risk of developing GDM by affecting glucose metabolism. The time window of the maximum effect of PM on GDM and glucose metabolism indicators was observed earlier than that of SO2 and O3.
Collapse
Affiliation(s)
- Mengnan Yao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.
| | - Yang Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Dan Jin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Wanjun Yin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Shuangshuang Ma
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Ruixue Tao
- Department of Gynecology and Obstetrics, Hefei First People's Hospital, Hefei, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.
| |
Collapse
|
21
|
Zhang Y, Li T, Ma R, Yin Z, Wang J, He MZ, Xu D, Gao X, Wang Q, Kraus VB, Lv Y, Zhong Y, Kinney PL, Shi X. Long-term exposure to ambient fine particulate matter and fasting blood glucose level in a Chinese elderly cohort. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 717:137191. [PMID: 32062280 PMCID: PMC7183512 DOI: 10.1016/j.scitotenv.2020.137191] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/17/2020] [Accepted: 02/07/2020] [Indexed: 06/10/2023]
Abstract
Fasting blood glucose level is the primary indicator for the diagnosis of diabetes. We aim to conduct a longitudinal study on the association between long-term fine particulate matter (PM2.5) exposure and fasting blood glucose concentrations. We recruited and followed up 1449 participants older than 65 years of age in 2009, 2012, 2014, and 2017 in eight counties in China. Fasting blood glucose was repeatedly measured 3697 times in total among these participants. Data on annual ground-level PM2.5 concentrations with a 0.01° spatial resolution from 2005 to 2016 were used to assess exposures. An increase of 10 μg/m3 in 3-year average exposure to PM2.5 was associated with an increase of 0.146 mmol/L (95% confidence interval [CI]: 0.045, 0.248) in fasting blood glucose in all participants. The association was more pronounced among the subgroup with diabetes compared to the subgroup without diabetes (P < .05). In conclusion, Long-term PM2.5 exposure was associated with an increase in fasting blood glucose levels among elderly people. Elderly individuals with diabetes are particularly vulnerable to high level exposures of PM2.5. SUMMARY: Long-term PM2.5 exposure was associated with an increase in fasting blood glucose levels among elderly people. Elderly individuals with diabetes are particularly vulnerable to high level exposures of PM2.5.
Collapse
Affiliation(s)
- Yi Zhang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tiantian Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Runmei Ma
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhaoxue Yin
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiaonan Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mike Z He
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, USA
| | - Dandan Xu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA 16802, USA
| | - Qing Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Yuebin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yu Zhong
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Patrick L Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Xiaoming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| |
Collapse
|
22
|
Tang X, Zhou JB, Luo F, Han Y, Heianza Y, Cardoso MA, Qi L. Air pollution and gestational diabetes mellitus: evidence from cohort studies. BMJ Open Diabetes Res Care 2020; 8:8/1/e000937. [PMID: 32193198 PMCID: PMC7103802 DOI: 10.1136/bmjdrc-2019-000937] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 01/07/2020] [Accepted: 01/14/2020] [Indexed: 12/16/2022] Open
Abstract
Exposure to different air pollutants has been linked to type 2 diabetes mellitus, but the evidence for the association between air pollutants and gestational diabetes mellitus (GDM) has not been systematically evaluated. We systematically retrieved relevant studies from PubMed, Embase, and the Web of Science, and performed stratified analyses and regression analyses. Thirteen studies were analyzed, comprising 1 547 154 individuals from nine retrospective studies, three prospective studies, and one case-control study. Increased exposure to particulate matter ≤2.5 µm in diameter (PM2.5) was not associated with the increased risk of GDM (adjusted OR 1.03, 95% CI 0.99 to 1.06). However, subgroup analysis showed positive correlation of PM2.5 exposure in the second trimester with an increased risk of GDM (combined OR 1.07, 95% CI 1.00 to 1.13). Among pollutants other than PM2.5, significant association between GDM and nitrogen dioxide (NO2) (OR 1.05, 95% CI 1.01 to 1.10), nitrogen oxide (NOx) (OR 1.03, 95% CI 1.01 to 1.05), and sulfur dioxide (SO2) (OR 1.09, 95% CI 1.03 to 1.15) was noted. There was no significant association between exposure to black carbon or ozone or carbon monoxide or particulate matter ≤10 µm in diameter and GDM. Thus, systematic review of existing evidence demonstrated association of exposure to NO2, NOx, and SO2, and the second trimester exposure of PM2.5 with the increased risk of GDM. Caution may be exercised while deriving conclusions from existing evidence base because of the limited number and the observational nature of studies.
Collapse
Affiliation(s)
- Xingyao Tang
- Department of Education, Beijing Tongren Hospital, Beijing, China
| | - Jian-Bo Zhou
- Department of Endocrinology, Beijing Tongren Hospital, Beijing, China
| | - Fuqiang Luo
- Department of Education, Beijing Tongren Hospital, Beijing, China
| | - Yipeng Han
- Department of Education, Beijing Tongren Hospital, Beijing, China
| | - Yoriko Heianza
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Marly Augusto Cardoso
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Lu Qi
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| |
Collapse
|
23
|
Ma R, Zhang Y, Sun Z, Xu D, Li T. Effects of ambient particulate matter on fasting blood glucose: A systematic review and meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 258:113589. [PMID: 31841764 DOI: 10.1016/j.envpol.2019.113589] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/05/2019] [Accepted: 11/06/2019] [Indexed: 06/10/2023]
Abstract
Studies have found that ambient particulate matter (PM) affects fasting blood glucose. However, the results are not consistent. We conducted a systematic review and meta-analysis to determine the relationship between PM with an aerodynamic diameter of 10 μm or less (PM10) and PM with an aerodynamic diameter of 2.5 μm or less (PM2.5) and fasting blood glucose. We searched PubMed, Web of Science, the Wanfang Database and the China National Knowledge Infrastructure up to April 1, 2019. A total of 24 papers were included in the review, and 17 studies with complete or convertible quantitative information were included in the meta-analysis. The studies were divided into groups by PM size fractions (PM10 and PM2.5) and length of exposure. Long-term exposures were based on annual average concentrations, and short-term exposures were those lasting less than 28 days. In the long-term exposure group, fasting blood glucose increased 0.10 mmol/L (95% CI: 0.02, 0.17) per 10 μg/m3 of increased PM10 and 0.23 mmol/L (95% CI: 0.01, 0.45) per 10 μg/m3 of increased PM2.5. In the short-term exposure group, fasting blood glucose increased 0.02 mmol/L (95% CI: -0.01, 0.04) per 10 μg/m3 of increased PM10 and 0.08 mmol/L (95% CI: 0.04, 0.11) per 10 μg/m3 of increased PM2.5. Further prospective studies are needed to explore the relationship between ambient PM exposure and fasting blood glucose.
Collapse
Affiliation(s)
- Runmei Ma
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi Zhang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhiying Sun
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dandan Xu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Zhejiang Provincial Center for Disease Control and Prevention, Zhejiang, China
| | - Tiantian Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| |
Collapse
|
24
|
Cai L, Wang S, Gao P, Shen X, Jalaludin B, Bloom MS, Wang Q, Bao J, Zeng X, Gui Z, Chen Y, Huang C. Effects of ambient particulate matter on fasting blood glucose among primary school children in Guangzhou, China. ENVIRONMENTAL RESEARCH 2019; 176:108541. [PMID: 31271922 DOI: 10.1016/j.envres.2019.108541] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 06/06/2019] [Accepted: 06/17/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Exposure to ambient particulate matter (PM) has been linked with diabetes and elevated blood glucose in adults. However, there are few reports on the effects of PM on fasting blood glucose (FBG) among children. OBJECTIVES The study aimed to assess the associations between medium-term exposure of ambient particles with diameters ≤2.5 μm (PM2.5), and ≤10 μm (PM10) and FBG in a general population of children, and also to explore the modifying effects of diet. METHODS In this cross-sectional study, we enrolled 4234 children (aged 6-13 years) residing in Guangzhou, China, in 2017. Individual PM2.5 and PM10 exposures during the 186-day period before each physical examination were retrospectively estimated by an inverse distance weighting interpolation and time-weighted approach according to their home address, school address, and activity patterns. Linear mixed effect models were used to examine the relationships between PM2.5 and PM10 with FBG after adjusting for covariates. RESULTS We found that per 10 μg/m3 increase in PM2.5 and PM10 levels during the 186-day period were associated with 2.3% (95% CI: 1.0%, 3.8%) higher FBG and 0.9% (95% CI: 0.5%, 1.4%) higher FBG, respectively. Stronger effect estimates were observed among subgroups of children with a family history of diabetes, and higher intake of sugar-sweetened beverages (SSBs). Also, we found significant interactions between PM2.5 concentration and family history of diabetes and SSBs intake on FBG. CONCLUSIONS Medium-term exposure to ambient PM2.5 and PM10 were associated with higher FBG levels in children, and that higher SSBs intake might modify these associations.
Collapse
Affiliation(s)
- Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, China
| | - Suhan Wang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, China; Laboratory of Meteorology and Health, Shanghai Meteorological Service, China
| | - Peng Gao
- Guangdong Province Key Laboratory for Climate Change and Natural Disaster Studies, School of Atmospheric Sciences, Sun Yat-sen University, China
| | - Xiaoting Shen
- Center for Reproductive Medicine, The First Affiliated Hospital of Sun Yat-sen University, China
| | - Bin Jalaludin
- Population Health, South Western Sydney Local Health District, Liverpool, NSW, 2170, Australia
| | - Michael S Bloom
- Department of Environmental Health Sciences and Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY, 12144, USA
| | - Qiong Wang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, China; Laboratory of Meteorology and Health, Shanghai Meteorological Service, China
| | - Junzhe Bao
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, China; Laboratory of Meteorology and Health, Shanghai Meteorological Service, China
| | - Xia Zeng
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, China
| | - Zhaohuan Gui
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, China
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, China.
| | - Cunrui Huang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, China; Laboratory of Meteorology and Health, Shanghai Meteorological Service, China.
| |
Collapse
|
25
|
Liao J, Chen X, Xu S, Li Y, Zhang B, Cao Z, Zhang Y, Liang S, Hu K, Xia W. Effect of residential exposure to green space on maternal blood glucose levels, impaired glucose tolerance, and gestational diabetes mellitus. ENVIRONMENTAL RESEARCH 2019; 176:108526. [PMID: 31202042 DOI: 10.1016/j.envres.2019.108526] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/30/2019] [Accepted: 06/05/2019] [Indexed: 05/26/2023]
Abstract
BACKGROUND Residential surrounding green spaces can affect human health. However, limited studies have examined their impacts on maternal blood glucose homeostasis outcomes. OBJECTIVE We examined the associations of residential exposure to green space with maternal blood glucose levels, gestational impaired glucose tolerance (IGT), and gestational diabetes mellitus (GDM). METHODS Pregnant women were recruited from a prospective birth cohort between October 2012 and September 2015. Exposure to green space was calculated as the mean value of the normalized difference vegetation index (NDVI) within a 300-m circular buffer area surrounding each residence. Maternal glucose was measured between 24 and 28 weeks of gestation, and gestational IGT and GDM were diagnosed using valid methods. We estimated the associations of residential NDVI with maternal glucose levels using multiple linear regression models with adjustment for age, education, BMI, passive smoking during pregnancy, parity, season of conception, income, and urbancity. We estimated the relative risks of residential NDVI with IGT and GDM using a generalized estimating equation model with modified Poisson regression. The mediation effects of residential exposure to air pollution and maternal physical activity were assessed using causal mediation analysis. RESULTS Of 6807 pregnant women, 751 (11.3%) and 604 (8.8%) were diagnosed with IGT and GDM, respectively. One SD increment of residential NDVI was associated with a decrease of 0.06 mmol/L (95% CI: -0.07, -0.05), 0.09 mmol/L (95% CI: -0.13, -0.05), and 0.06 mmol/L (95% CI: -0.09, -0.03) in maternal fasting glucose levels, 1-h glucose levels, and 2-h glucose levels, respectively, as well as reduced risks of incident IGT (RR: 0.92, 95% CI: 0.86, 0.99) and GDM (RR: 0.85, 95% CI: 0.79, 0.92). The association between residential NDVI and maternal fasting glucose levels was partly mediated by maternal exposure to PM2.5. CONCLUSION Living with higher levels of green space was significantly associated with decreased maternal glucose levels and attenuated risks of incident maternal IGT and GDM. Our findings provide evidence linking green space to better maternal glucose outcomes. More studies are needed to further explore the maternal and child health benefits related to our findings.
Collapse
Affiliation(s)
- Jiaqiang Liao
- Key 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, People's Republic of China
| | - Xinmei Chen
- Key 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, People's Republic of China
| | - Shunqing Xu
- Key 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, People's Republic of China
| | - Yuanyuan Li
- Key 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, People's Republic of China
| | - Bin Zhang
- Women and Children Medical and Healthcare Center of Wuhan, Wuhan, Hubei, People's Republic of China
| | - Zhongqiang Cao
- Women and Children Medical and Healthcare Center of Wuhan, Wuhan, Hubei, People's Republic of China
| | - Yiming Zhang
- Women and Children Medical and Healthcare Center of Wuhan, Wuhan, Hubei, People's Republic of China
| | - Shengwen Liang
- Wuhan Environmental Monitoring Center, Wuhan, Hubei Province, 430000, China
| | - Ke Hu
- Wuhan Environmental Monitoring Center, Wuhan, Hubei Province, 430000, China
| | - Wei Xia
- Key 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, People's Republic of China.
| |
Collapse
|
26
|
Choe SA, Eliot MN, Savitz DA, Wellenius GA. Ambient air pollution during pregnancy and risk of gestational diabetes in New York City. ENVIRONMENTAL RESEARCH 2019; 175:414-420. [PMID: 31154231 PMCID: PMC6590689 DOI: 10.1016/j.envres.2019.04.030] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 04/25/2019] [Accepted: 04/26/2019] [Indexed: 05/03/2023]
Abstract
BACKGROUND Emerging evidence suggests a potential association between ambient air pollution and risk of gestational diabetes mellitus (GDM), but results have been inconsistent. Accordingly, we assessed the associations between ambient fine particulate matter (PM2.5) and nitrogen dioxide (NO2) levels with risk of GDM. METHODS Using linked data from birth certificates, hospital discharge diagnoses, and air pollution estimates informed by the New York City Community Air Survey, we fit conditional logistic regression models to evaluate the association between residential levels of PM2.5 and NO2 with risk of GDM among 256,372 singleton live births of non-smoking mothers in New York City born 2008-2010, adjusting for sociodemographic factors and stratified on zip code of maternal address. RESULTS GDM was identified in 17,065 women, yielding a risk of GDM in the study sample of 67 per 1000 deliveries. In single pollutant models, 1st and 2nd trimester PM2.5 was associated with a lower and higher risk of GDM, respectively. In models mutually adjusting for PM2.5 levels in both trimesters, GDM was associated with PM2.5 levels in the 2nd trimester (OR: 1.06, 95% CI: 1.02, 1.10 per interquartile range increase in PM2.5), but not the 1st trimester (OR: 0.99, 95% CI: 0.96, 1.02). Conversely, GDM was associated with NO2 during the 1st trimester (OR: 1.05, 95% CI: 1.01, 1.09), but not the 2nd trimester (OR: 1.02, 95% CI: 0.98, 1.06). The positive associations between pollutants and GDM were robust to different model specifications. PM2.5 in the 2nd trimester was more strongly associated with GDM among mothers who were aged <35 years and not Medicaid recipients. NO2 in the 1st trimester was more strongly associated with GDM among overweight and parous women. CONCLUSIONS In this large cohort of singleton births in New York City, NO2 in the 1st trimester and PM2.5 in the 2nd trimester were associated with higher odds of GDM, while 1st trimester PM2.5 was weakly and inconsistently associated with lower odds of GDM.
Collapse
Affiliation(s)
- Seung-Ah Choe
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; Department of Obstetrics and Gynecology, CHA University School of Medicine, Gyeonggi, South Korea
| | - Melissa N Eliot
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - David A Savitz
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Gregory A Wellenius
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
| |
Collapse
|
27
|
Padula AM, Yang W, Lurmann FW, Balmes J, Hammond SK, Shaw GM. Prenatal exposure to air pollution, maternal diabetes and preterm birth. ENVIRONMENTAL RESEARCH 2019; 170:160-167. [PMID: 30579990 PMCID: PMC6373725 DOI: 10.1016/j.envres.2018.12.031] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/03/2018] [Accepted: 12/14/2018] [Indexed: 05/21/2023]
Abstract
Prenatal exposure to ambient air pollution has been associated with preterm birth in several studies. Associations between air pollution and gestational or pre-existing diabetes have been hypothesized but are not well established. We examined the association between air pollution exposure in pregnancy and gestational diabetes and whether the association between air pollution and preterm birth is modified by diabetes (gestational or pre-existing) in a highly polluted area of California. Birth certificates and hospital discharge data from all singleton births from 2000 to 2006 to women living in four counties in the San Joaquin Valley of California were linked to criteria air pollution and traffic density measurements at the geocoded maternal residence. Air pollutants were dichotomized at the highest quartile and compared to the lower three quartiles. Logistic regression models were adjusted for maternal race-ethnicity, age, education, payment of birth expenses, and prenatal care. There were consistent inverse associations between exposure to air pollution during the first two trimesters and gestational diabetes (statistically significant odds ratios (OR) less than 1). When stratified by any diabetes (gestational or pre-existing), associations between air pollution exposure during pregnancy and categories of preterm birth (20-27, 28-31, 32-33, 34-36 weeks) were generally similar with few exceptions of exposures to carbon monoxide (CO) and particulate matter < 2.5 µm (PM2.5). Those with diabetes and exposure higher levels of CO (in first trimester or entire pregnancy) or PM2.5 (in first trimester) had higher risk of extremely preterm birth (20-27 weeks) compared with those without diabetes. The associations between traffic-related air pollution and gestational diabetes were in the unexpected ("protective") direction. Among those with any diabetes, associations were stronger between CO and PM2.5 and extremely preterm birth.
Collapse
Affiliation(s)
- Amy M Padula
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
| | - Wei Yang
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
| | | | - John Balmes
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA; Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - S Katharine Hammond
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Gary M Shaw
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
| |
Collapse
|
28
|
Melody SM, Ford J, Wills K, Venn A, Johnston FH. Maternal exposure to short-to medium-term outdoor air pollution and obstetric and neonatal outcomes: A systematic review. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 244:915-925. [PMID: 30469286 DOI: 10.1016/j.envpol.2018.10.086] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 10/16/2018] [Accepted: 10/18/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Little is known about the impacts of maternal exposure to acute episodes of outdoor air pollution, such as that resulting from wildfires, on obstetric and neonatal outcomes. This systematic review aims to synthesise the existing literature exploring the relationship between maternal exposure to short-to medium-term changes in outdoor air quality and obstetric and neonatal outcomes. METHODS A systematic search of peer-reviewed articles using PubMed, Cochrane Library, EMBASE, ScienceDirect, Web of Science, ProQuest, GreenFILE and Scopus was conducted in January 2018 using selected search terms. Quality of included studies were assessed using the Newcastle Ottawa Scale. RESULTS Eleven studies were included; eight assessed the impact of maternal exposure to air pollution exacerbation events, such as wildfires, oil well fires and volcanic eruptions, and three assessed the impact of improvement events, such as the 2018 Beijing Olympics and closure of industrial activities, on obstetric and neonatal outcomes. Studies were highly heterogenous in methodology. Six studies found a significant association between acute changes in air quality and markers of fetal growth restriction, while two did not. Three studies found an adverse association between acute changes in air quality and markers of gestational maturity, and one did not. CONCLUSION Overall, there is some evidence that maternal exposure to acute changes in air quality of short-to medium-term duration increases the risk of fetal growth restriction and preterm birth. The relationship for other adverse obstetric or neonatal outcomes is less clear.
Collapse
Affiliation(s)
- Shannon M Melody
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, Australia.
| | - Jane Ford
- Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, New South Wales, Australia; Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Karen Wills
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, Australia
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, Australia
| | - Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, Australia.
| |
Collapse
|
29
|
Lucht SA, Hennig F, Matthiessen C, Ohlwein S, Icks A, Moebus S, Jöckel KH, Jakobs H, Hoffmann B. Air Pollution and Glucose Metabolism: An Analysis in Non-Diabetic Participants of the Heinz Nixdorf Recall Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:047001. [PMID: 29616776 PMCID: PMC6071794 DOI: 10.1289/ehp2561] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 02/26/2018] [Accepted: 02/26/2018] [Indexed: 05/05/2023]
Abstract
BACKGROUND Despite the importance of understanding the connection between air pollution exposure and diabetes, studies investigating links between air pollution and glucose metabolism in nondiabetic adults are limited. OBJECTIVE We aimed to estimate the association of medium-term air pollution exposures with blood glucose and glycated hemoglobin A1c (HbA1c) among nondiabetics. METHODS This study included observations from nondiabetic participants (nobs=7,108) of the population-based Heinz Nixdorf Recall study at baseline (2000–2003) and follow-up examination (2006–2008). Daily fine particulate matter (aerodynamic diameter≤2.5 μm, PM2.5; aerodynamic diameter≤10 μm, PM10), accumulation mode particle number (PNAM), and nitrogen dioxide (NO2) exposures were estimated at participants’ residences using the spatiotemporal European Air Pollution Dispersion (EURAD) chemistry transport model. We evaluated the associations between medium-term air pollution exposures (28- and 91-d means) and glucose metabolism measures using mixed linear regression and adjusting for season, meteorology, and personal characteristics. A range of other exposure windows (1-, 2-, 3-, 7-, 14-, 45-, 60-, 75-, 105-, 120-, and 182-d means) were also evaluated to identify potentially relevant biological windows. RESULTS We observed positive associations between PM2.5 and PNAM exposures and blood glucose levels [e.g., 28-d PM2.5: 0.91 mg/dL (95% CI: 0.38, 1.44) per 5.7 μg/m3]. PM2.5, PM10, and PNAM exposures were positively associated with HbA1c [e.g., 91-d PM2.5: 0.07 p.p. (95% CI: 0.04, 0.10) per 4.0 μg/m3]. Mean exposures during longer exposure windows (75- to 105-d) were most strongly associated with HbA1c, whereas 7- to 45-d exposures were most strongly associated with blood glucose. NO2 exposure was not associated with blood glucose or with HbA1c. CONCLUSIONS Medium-term PM and PNAM exposures were positively associated with glucose measures in nondiabetic adults. These findings indicate that reducing ambient air pollution levels may decrease the risk of diabetes. https://doi.org/10.1289/EHP2561.
Collapse
Affiliation(s)
- Sarah A Lucht
- Environmental Epidemiology Group, Institute of Occupational, Social and Environmental Medicine, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Frauke Hennig
- Environmental Epidemiology Group, Institute of Occupational, Social and Environmental Medicine, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Clara Matthiessen
- Environmental Epidemiology Group, Institute of Occupational, Social and Environmental Medicine, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Simone Ohlwein
- Environmental Epidemiology Group, Institute of Occupational, Social and Environmental Medicine, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Andrea Icks
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Düsseldorf, Germany
| | - Susanne Moebus
- Institute of Medical Informatics, University Hospital Essen, University of Duisburg-Essen, Biometry and Epidemiology (IMIBE), Essen, Germany
| | - Karl-Heinz Jöckel
- Institute of Medical Informatics, University Hospital Essen, University of Duisburg-Essen, Biometry and Epidemiology (IMIBE), Essen, Germany
| | - Hermann Jakobs
- Rhenish Institute for Environmental Research (RIU), University of Cologne, Cologne, Germany
| | - Barbara Hoffmann
- Environmental Epidemiology Group, Institute of Occupational, Social and Environmental Medicine, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| |
Collapse
|
30
|
Li W, Dorans KS, Wilker EH, Rice MB, Kloog I, Schwartz JD, Koutrakis P, Coull BA, Gold DR, Meigs JB, Fox CS, Mittleman MA. Ambient air pollution, adipokines, and glucose homeostasis: The Framingham Heart Study. ENVIRONMENT INTERNATIONAL 2018; 111:14-22. [PMID: 29161632 PMCID: PMC5800943 DOI: 10.1016/j.envint.2017.11.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 11/13/2017] [Accepted: 11/13/2017] [Indexed: 05/22/2023]
Abstract
OBJECTIVE To examine associations of proximity to major roadways, sustained exposure to fine particulate matter (PM2.5), and acute exposure to ambient air pollutants with adipokines and measures of glucose homeostasis among participants living in the northeastern United States. METHODS We included 5958 participants from the Framingham Offspring cohort examination cycle 7 (1998-2001) and 8 (2005-2008) and Third Generation cohort examination cycle 1 (2002-2005) and 2 (2008-2011), who did not have type 2 diabetes at the time of examination visit. We calculated 2003 annual average PM2.5 at participants' home address, residential distance to the nearest major roadway, and daily PM2.5, black carbon (BC), sulfate, nitrogen oxides (NOx), and ozone concentrations. We used linear mixed effects models for fasting glucose, insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) which were measured up to twice, and used linear regression models for adiponectin, resistin, leptin, and hemoglobin A1c (HbA1c) which were measured only once, adjusting for demographics, socioeconomic position, lifestyle, time, and seasonality. RESULTS The mean age was 51years and 55% were women. Participants who lived 64m (25th percentile) from a major roadway had 0.28% (95% CI: 0.05%, 0.51%) higher fasting plasma glucose than participants who lived 413m (75th percentile) away, and the association appeared to be driven by participants who lived within 50m from a major roadway. Higher exposures to 3- to 7-day moving averages of BC and NOx were associated with higher glucose whereas the associations for ozone were negative. The associations otherwise were generally null and did not differ by median age, sex, educational attainment, obesity status, or prediabetes status. CONCLUSIONS Living closer to a major roadway or acute exposure to traffic-related air pollutants were associated with dysregulated glucose homeostasis but not with adipokines among participants from the Framingham Offspring and Third Generation cohorts.
Collapse
Affiliation(s)
- Wenyuan Li
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Cardiovascular Epidemiology Research Unit, Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Kirsten S Dorans
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Cardiovascular Epidemiology Research Unit, Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Elissa H Wilker
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Cardiovascular Epidemiology Research Unit, Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Mary B Rice
- Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Joel D Schwartz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Brent A Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Diane R Gold
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - James B Meigs
- Department of Medicine, Harvard Medical School and Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Caroline S Fox
- National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States; Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, MD, United States
| | - Murray A Mittleman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Cardiovascular Epidemiology Research Unit, Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.
| |
Collapse
|
31
|
Mukherjee A, Agrawal M. A Global Perspective of Fine Particulate Matter Pollution and Its Health Effects. REVIEWS OF ENVIRONMENTAL CONTAMINATION AND TOXICOLOGY 2018; 244:5-51. [PMID: 28361472 DOI: 10.1007/398_2017_3] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Fine particulate matter (PM) in the ambient air is implicated in a variety of human health issues throughout the globe. Regulation of fine PM in the atmosphere requires information on the dimension of the problem with respect to variations in concentrations and sources. To understand the current status of fine particles in the atmosphere and their potential harmful health effects in different regions of the world this review article was prepared based on peer-reviewed scientific papers, scientific reports, and database from government organizations published after the year 2000 to evaluate the global scenario of the PM2.5 (particles <2.5 μm in aerodynamic diameter), its exceedance of national and international standards, sources, mechanism of toxicity, and harmful health effects of PM2.5 and its components. PM2.5 levels and exceedances of national and international standards were several times higher in Asian countries, while levels in Europe and USA were mostly well below the respective standards. Vehicular traffic has a significant influence on PM2.5 levels in urban areas; followed by combustion activities (biomass, industrial, and waste burning) and road dust. In urban atmosphere, fine particles are mostly associated with different health effects with old aged people, pregnant women, and more so children being the most susceptible ones. Fine PM chemical constituents severely effect health due to their carcinogenic or mutagenic nature. Most of the research indicated an exceedance of fine PM level of the standards with a diverse array of health effects based on PM2.5 chemical constituents. Emission reduction policies with epidemiological studies are needed to understand the benefits of sustainable control measures for fine PM mitigation.
Collapse
Affiliation(s)
- Arideep Mukherjee
- Laboratory of Air Pollution and Global Climate Change, Department of Botany, Banaras Hindu University, Varanasi, 221005, India
| | - Madhoolika Agrawal
- Laboratory of Air Pollution and Global Climate Change, Department of Botany, Banaras Hindu University, Varanasi, 221005, India.
| |
Collapse
|
32
|
Maternal Exposure to Air Pollutants and Risk of Gestational Diabetes Mellitus in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14121604. [PMID: 29261145 PMCID: PMC5751021 DOI: 10.3390/ijerph14121604] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 11/26/2017] [Accepted: 12/15/2017] [Indexed: 01/13/2023]
Abstract
Mounting evidence has shown an increased risk of gestational diabetes mellitus (GDM) in association with elevated exposure to air pollution. However, limited evidence is available concerning the effect of specific air pollutant(s) on GDM incidence. We conducted this case-control study on 6717 mothers with GDM diagnosed in 2006–2013 and 6717 age- and year of delivery-matched controls to further address the risk of GDM in relation to specific air pollutant. Both cases and controls were selected from a cohort of 1-million beneficiaries of Taiwan’s National Health Insurance program registered in 2005. Maternal exposures to mean daily air pollutant concentration, derived from 76 fixed air quality monitoring stations within the 12-week period prior to pregnancy and during the 1st and 2nd trimesters, were assessed by the spatial analyst method (i.e., ordinary kriging) with the ArcGIS software. After controlling for potential confounders and other air pollutants, an increase in pre-pregnancy exposure of 1 inter-quartile range (IQR) for PM2.5 and SO2 was found to associate with a significantly elevated odds ratio (OR) of GDM at 1.10 (95% confidence interval (CI) 1.03–1.18 and 1.37 (95% CI 1.30–1.45), respectively. Exposures to PM2.5 and SO2 during the 1st and 2nd trimesters were also associated with significantly increased ORs, which were 1.09 (95% CI 1.02–1.17) and 1.07 (95% CI 1.01–1.14) for PM2.5, and 1.37 (95% CI 1.30–1.45) and 1.38 (95% CI 1.31–1.46) for SO2. It was concluded that higher pre- and post-pregnancy exposures to PM2.5 and SO2 for mothers were associated with a significantly but modestly elevated risk of GDM.
Collapse
|
33
|
Pedersen M, Olsen SF, Halldorsson TI, Zhang C, Hjortebjerg D, Ketzel M, Grandström C, Sørensen M, Damm P, Langhoff-Roos J, Raaschou-Nielsen O. Gestational diabetes mellitus and exposure to ambient air pollution and road traffic noise: A cohort study. ENVIRONMENT INTERNATIONAL 2017; 108:253-260. [PMID: 28892786 DOI: 10.1016/j.envint.2017.09.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 08/31/2017] [Accepted: 09/01/2017] [Indexed: 05/21/2023]
Abstract
BACKGROUND Road traffic is a main source of air pollution and noise. Both exposures have been associated with type 2 diabetes, but associations with gestational diabetes mellitus (GDM) have been studied less. OBJECTIVES We aimed to examine single and joint associations of exposure to air pollution and road traffic noise on GDM in a prospective cohort. METHODS We identified GDM cases from self-reports and hospital records, using two different criteria, among 72,745 singleton pregnancies (1997-2002) from the Danish National Birth Cohort. We modeled nitrogen dioxide (NO2) and noise from road traffic (Lden) exposure at all pregnancy addresses. RESULTS According to the two diagnostic criteria: the Danish clinical guidelines, which was our main outcome, and the WHO standard during recruitment period, a total of 565 and 210 women, respectively, had GDM. For both exposures no risk was evident for the common Danish criterion of GDM. A 10-μg/m3 increase in NO2 exposure during first trimester was, however, associated with an increased risk of WHO-GDM (adjusted odds ratio (OR)=1.24; 95% confidence interval (CI): 1.03, 1.49). The corresponding OR associated with a 10-dB higher road traffic noise level was 1.15 (0.94 to 1.18). In mutually adjusted models the OR for NO2 remained similar 1.22 (0.98, 1.53) whereas that for road traffic noise decreased to 1.03 (0.80, 1.32). Significant associations were also observed for exposure averaged over the 2nd and 3rd trimesters and the full pregnancy. CONCLUSIONS No risk was evident for the common Danish criterion of GDM. NO2 was associated with higher risk for GDM according to the WHO criterion, which might be due to selection bias.
Collapse
Affiliation(s)
- Marie Pedersen
- Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, 1014 Copenhagen K, Denmark; Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark.
| | - Sjurdur F Olsen
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institute, Artillerivej 5, 2300 Copenhagen S, Denmark; Department of Nutrition, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Thorhallur I Halldorsson
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institute, Artillerivej 5, 2300 Copenhagen S, Denmark; Faculty of Food Science and Nutrition, University of Iceland, Sæmundargata 2, 101 Reykjavik, Iceland; Unit for Nutrition Research, Landspitali University Hospital, Eiriksgata 29, Reykjavik, Iceland
| | - Cuilin Zhang
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6100 Executive Blvd, Rm 7B03, Rockville, MD 20852, USA
| | - Dorrit Hjortebjerg
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000 Roskilde, Denmark
| | - Charlotta Grandström
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institute, Artillerivej 5, 2300 Copenhagen S, Denmark
| | - Mette Sørensen
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Copenhagen University Hospital (Rigshospitalet), Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; Clinical Institute of Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark; Department of Obstetrics, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark
| | - Jens Langhoff-Roos
- Department of Obstetrics, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark
| | - Ole Raaschou-Nielsen
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark; Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000 Roskilde, Denmark
| |
Collapse
|