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Nazarpour S, Shokati Poursani A, Mousavi M, Ramezani Tehrani F, Behboudi-Gandevani S. Investigation of the relationship between air pollution and gestational diabetes. J OBSTET GYNAECOL 2024; 44:2362962. [PMID: 38853776 DOI: 10.1080/01443615.2024.2362962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 05/27/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) can have negative effects on both the pregnancy and perinatal outcomes, as well as the long-term health of the mother and the child. It has been suggested that exposure to air pollution may increase the risk of developing GDM. This study investigated the relationship between exposure to air pollutants with gestational diabetes. METHODS The present study is a retrospective cohort study. We used data from a randomised community trial conducted between September 2016 and January 2019 in Iran. During this period, data on air pollutant levels of five cities investigated in the original study, including 6090 pregnant women, were available. Concentrations of ozone (O3), nitric oxide (NO), nitrogen dioxide (NO2), nitrogen oxides (NOx), sulphur dioxide (SO2), carbon monoxide (CO), particulate matter < 2.5 (PM2.5) or <10 μm (PM10) were obtained from air pollution monitoring stations. Exposure to air pollutants during the three months preceding pregnancy and the first, second and third trimesters of pregnancy for each participant was estimated. The odds ratio was calculated based on logistic regression in three adjusted models considering different confounders. Only results that had a p < .05 were considered statistically significant. RESULTS None of the logistic regression models showed any statistically significant relationship between the exposure to any of the pollutants and GDM at different time points (before pregnancy, in the first, second and third trimesters of pregnancy and 12 months in total) (p > .05). Also, none of the adjusted logistic regression models showed any significant association between PM10 exposure and GDM risk at all different time points after adjusting for various confounders (p > .05). CONCLUSIONS This study found no association between GDM risk and exposure to various air pollutants before and during the different trimesters of pregnancy. This result should be interpreted cautiously due to the lack of considering all of the potential confounders.
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Affiliation(s)
- Sima Nazarpour
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Midwifery, Varamin-Pishva Branch, Islamic Azad University, Tehran, Iran
| | - Afshin Shokati Poursani
- Department of Chemical Engineering - Health, Safety & Environment, Najafabad Branch, Islamic Azad University, Najafabad, Iran
| | - Maryam Mousavi
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ganguly A, Ghosh S, Shin BC, Touma M, Wadehra M, Devaskar SU. Gestational exposure to air pollutants perturbs metabolic and placenta-fetal phenotype. Reprod Toxicol 2024; 128:108657. [PMID: 39002939 DOI: 10.1016/j.reprotox.2024.108657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 07/02/2024] [Accepted: 07/04/2024] [Indexed: 07/15/2024]
Abstract
Air pollution (AP) is detrimental to pregnancies including increasing risk factors of gestational diabetes mellitus. We hypothesized that exposure to AP causes cardiovascular and metabolic disruption thereby altering placental gene expression, which in turn affects the placental phenotype and thereby embryonic/fetal development. To test this hypothesis, we investigated the impact of intra-nasal instilled AP upon gestational day 16-19 maternal mouse cardiovascular and metabolic status, placental nutrient transporters, and placental-fetal size and morphology. To further unravel mechanisms, we also examined placental total DNA 5'-hydroxymethylation and bulk RNA sequenced gene expression profiles. AP exposed pregnant mice and fetuses were tachycardic with a reduction in maternal left ventricular fractional shortening and increased uterine artery with decreased umbilical artery systolic peak velocities. In addition, they were hyperglycemic, glucose intolerant and insulin resistant, with changes in placental glucose (Glut3) and fatty acid (Fatp1 & Cd36) transporters, and a spatial disruption of cells expressing Glut10 that imports L-dehydroascorbic acid in protecting against oxidative stress. Placentas revealed inflammatory cellular infiltration with associated cellular edema and necrosis, with dilated vascular spaces and hemorrhage. Placental and fetal body weights decreased in mid-gestation with a reduction in brain cortical thickness emerging in late gestation. Placental total DNA 5'-hydroxymethylation was 2.5-fold higher, with perturbed gene expression profiles involving key metabolic, inflammatory, transcriptional, cellular polarizing and processing genes and pathways. We conclude that gestational exposure to AP incites a maternal inflammatory response resulting in features mimicking maternal gestational diabetes mellitus with altered placental DNA 5'-hydroxymethylation, gene expression, and associated injury.
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Affiliation(s)
- Amit Ganguly
- Department of Pediatrics & the UCLA Children's Discovery and Innovation Institute, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095-1752, USA
| | - Shubhamoy Ghosh
- Department of Pediatrics & the UCLA Children's Discovery and Innovation Institute, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095-1752, USA
| | - Bo-Chul Shin
- Department of Pediatrics & the UCLA Children's Discovery and Innovation Institute, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095-1752, USA
| | - Marlin Touma
- Department of Pediatrics & the UCLA Children's Discovery and Innovation Institute, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095-1752, USA
| | - Madhuri Wadehra
- Department of Pathology, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095-1752, USA
| | - Sherin U Devaskar
- Department of Pediatrics & the UCLA Children's Discovery and Innovation Institute, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095-1752, USA.
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Ganguly A, Ghosh S, Jin P, Wadehra M, Devaskar SU. Omega-3 Reverses the Metabolic and Epigenetically Regulated Placental Phenotype acquired from Pre-conceptional and Peri-conceptional Exposure to Air Pollutants. J Nutr Biochem 2024:109735. [PMID: 39122219 DOI: 10.1016/j.jnutbio.2024.109735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 08/02/2024] [Accepted: 08/05/2024] [Indexed: 08/12/2024]
Abstract
Air pollution is detrimental to pregnancy adversely affecting maternal and child health. Our objective was to unravel epigenetic mechanisms mediating the effect of pre-conception, periconception, and gestational exposure to inhaled air pollutants (AP) upon the maternal and placental-fetal phenotype and explore the benefit of an omega-3 rich dietary intervention. To this end, we investigated intra-nasal instilled AP during 8 weeks of preconception, periconception, and gestation (G; D0 to 18) upon GD16-19 maternal mouse metabolic status, placental nutrient transporters, placental-fetal size, and placental morphology. Pre-pregnant mice were glucose intolerant and insulin resistant, while pregnant mice were glucose intolerant but displayed no major placental macro-nutrient transporter changes, except for an increase in CD36. Placentas revealed inflammatory cellular infiltration with cellular edema, necrosis, hemorrhage, and an increase in fetal body weight. Upon examination of placental genome-wide epigenetic processes of DNA sequence specific 5'-hydroxymethylation (5'-hmC) and 5'-methylation (5'-mC) upon RNA sequenced gene expression profiles, revealed changes in key metabolic, inflammatory, transcriptional, and cellular processing genes and pathways. An omega-3 rich anti-inflammatory diet from preconception (8 weeks) through periconception and gestation (GD0-18), ameliorated all these maternal and placental-fetal adverse effects. We conclude that pre-conceptional, periconceptional and gestational exposures to AP incite a maternal inflammatory response resulting in features of pre-existing maternal diabetes mellitus with injury to the placental-fetal unit. DNA 5'-mC more than 5'-hmC mediated AP induced maternal inflammatory and metabolic dysregulation which together alter placental gene expression and phenotype. A dietary intervention partially reversing these adversities provides possibilities for a novel nutrigenomic therapeutic strategy.
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Affiliation(s)
- Amit Ganguly
- Department of Pediatrics & the UCLA Children's Discovery and Innovation Institute, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095, USA
| | - Shubhamoy Ghosh
- Department of Pediatrics & the UCLA Children's Discovery and Innovation Institute, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095, USA
| | - Peng Jin
- Department of Human Genetics, Emory University School of Medicine, 615 Michael ST NE, Atlanta, GA 30322, USA
| | - Madhuri Wadehra
- Department of Pathology, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095, USA
| | - Sherin U Devaskar
- Department of Pediatrics & the UCLA Children's Discovery and Innovation Institute, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095, USA.
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Wan Z, Zhang S, Zhuang G, Liu W, Qiu C, Lai H, Liu W. Effect of fine particulate matter exposure on gestational diabetes mellitus risk: a retrospective cohort study. Eur J Public Health 2024; 34:787-793. [PMID: 38783609 PMCID: PMC11293809 DOI: 10.1093/eurpub/ckae094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The literature on the association between fine particulate matter (PM2.5) exposure and gestational diabetes mellitus (GDM) risk has focused mainly on exposure during the first and second trimesters, and the research results are inconsistent. Therefore, this study aimed to investigate the associations between PM2.5 exposure during preconception, the first trimester and second trimester and GDM risk in pregnant women in Guangzhou. METHODS A retrospective cohort study of 26 354 pregnant women was conducted, estimating PM2.5, particulate matter with a diameter >10 µm (PM10), sulphur dioxide (SO2), carbon monoxide (CO) and ozone (O3) exposure during preconception and the first and second trimesters. Analyses were performed using Cox proportional hazards models and nonlinear distributed lag models. RESULTS The study found that exposure to PM2.5 or a combination of two pollutants (PM2.5+PM10, PM2.5+SO2, PM2.5+CO and PM2.5+O3) was found to be significantly associated with GDM risk (P < 0.05). In the second trimester, with significant interactions found for occupation and anaemia between PM2.5 and GDM. When the PM2.5 concentrations were ≥19.56, ≥25.69 and ≥23.87 μg/m3 during preconception and the first and second trimesters, respectively, the hazard ratio for GDM started to increase. The critical window for PM2.5 exposure was identified to be from 9 to 11 weeks before conception. CONCLUSIONS Our study results suggest that PM2.5 exposure during preconception and the first and second trimesters increases the risk of GDM, with the preconception period appearing to be the critical window for PM2.5 exposure.
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Affiliation(s)
- Zhenyan Wan
- Division of Neonatology, The Maternal and Children Health Care Hospital (Huzhong Hospital) of Huadu, Guangzhou, Guangdong, People’s Republic of China
| | - Shandan Zhang
- Division of Neonatology, The Maternal and Children Health Care Hospital (Huzhong Hospital) of Huadu, Guangzhou, Guangdong, People’s Republic of China
| | - Guiying Zhuang
- Division of Neonatology, The Maternal and Children Health Care Hospital (Huzhong Hospital) of Huadu, Guangzhou, Guangdong, People’s Republic of China
| | - Weiqi Liu
- Department of Clinical Laboratory, The Maternal and Children Health Care Hospital (Huzhong Hospital) of Huadu, Guangzhou, Guangdong, People’s Republic of China
| | - Cuiqing Qiu
- Medical Information Office, The Maternal and Children Health Care Hospital (Huzhong Hospital) of Huadu, Guangzhou, Guangdong, People’s Republic of China
| | - Huiqin Lai
- Department of Clinical Laboratory, Guanzhou Yuexiu Liurong Community Health Service Center, Guangzhou, Guangdong, People’s Republic of China
| | - Weiling Liu
- Department of Clinical Laboratory, Foshan Fosun Chancheng Hospital, Foshan, Guangdong, People’s Republic of China
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Huang X, Liang W, Yang R, Jin L, Zhao K, Chen J, Shang X, Zhou Y, Wang X, Yu H. Variations in the LINGO2 and GLIS3 Genes and Gene-Environment Interactions Increase Gestational Diabetes Mellitus Risk in Chinese Women. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:11596-11605. [PMID: 38888423 DOI: 10.1021/acs.est.4c03221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
Gestational diabetes mellitus (GDM) has been found to be a common complication in pregnant women, known to escalate the risk of negative obstetric outcomes. In our study, we genotyped 1,566 Chinese pregnant women for two single nucleotide polymorphisms (SNPs) in the LINGO2 gene and one SNP in the GLIS3 gene, utilizing targeted next-generation sequencing. The impact of two interacting genes, and the interaction of genes with the environment─including exposure to particulate matter (PM2.5), ozone (O3), and variations in prepregnancy body mass index (BMI)─on the incidence of GDM were analyzed using logistic regression. Our findings identify the variants LINGO2 rs10968576 (P = 0.022, OR = 1.224) and rs1412239 (P = 0.018, OR = 1.231), as well as GLIS3 rs10814916 (P = 0.028, OR = 1.172), as risk mutations significantly linked to increased susceptibility to GDM. Further analysis underscores the crucial role of gene-gene and gene-environment interactions in the development of GDM among Chinese women (P < 0.05). Particularly, the individuals carrying the rs10968576 G-rs1412239 G-rs10814916 C haplotype exhibit increased susceptibility to GDM during the prepregnancy period when interacting with PM2.5, O3, and BMI (P = 8.004 × 10-7, OR = 1.206; P = 6.3264 × 10-11, OR = 1.280; P = 9.928 × 10-7, OR = 1.334, respectively). In conclusion, our research emphasizes the importance of the interaction between specific gene variations─LINGO2 and GLIS3─and environmental factors in influencing GDM risk. Notably, we found significant associations between these gene variations and GDM risk across various environmental exposure periods.
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Affiliation(s)
- Xiao Huang
- Department of Immunology, Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi Medical University, Zunyi 563000, China
| | - Weiwei Liang
- Department of Immunology, Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi Medical University, Zunyi 563000, China
| | - Runqiu Yang
- Department of Immunology, Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi Medical University, Zunyi 563000, China
| | - Lei Jin
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100091, China
| | - Kai Zhao
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Juan Chen
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Xuejun Shang
- Department of Urology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210023, China
| | - Yuanzhong Zhou
- School of Public Health, Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi Medical University, Zunyi 563000, China
| | - Xin Wang
- Department of Immunology, Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi Medical University, Zunyi 563000, China
| | - Hongsong Yu
- Department of Immunology, Special Key Laboratory of Gene Detection and Therapy of Guizhou Province, Zunyi Medical University, Zunyi 563000, China
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Li Y, Yang Z. The causal effect of exposure to air pollution on risk of adverse pregnancy outcomes: A two-sample Mendelian randomisation study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 928:172234. [PMID: 38615756 DOI: 10.1016/j.scitotenv.2024.172234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/10/2024] [Accepted: 04/03/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Epidemiological studies have examined the relation between air pollution (NOx, NO2, PM2.5, PM2.5-10, and PM10) and adverse pregnancy outcomes (APOs). There's increasing evidence that air pollution increases the risk of APOs. However, the results of these studies are controversial, and the causal relation remains uncertain. We aimed to assess whether a genetic causal link exists between air pollution and APOs and the potential effects of this relation. METHODS A novel two-sample Mendelian randomisation (MR) study used pooled data from a large-scale complete genome correlation study. The primary analysis method was inverse variance weighting (IVW), which explored the expose-outcome relationship for assessing single nucleotide polymorphisms (SNPs) associated with air pollution. Further sensitivity analysis, including MR-PRESSO, MR-Egger regression, and leave-one analysis, was used to test the consistency of the results. RESULTS There was a significant correlation between air pollution-related SNPs and APOs. A robust causal link was found between genetic susceptibility to air pollution and APOs. CONCLUSIONS Our MR analysis reveals a genetic causal relation between air pollution and APOs, which may help provide new insights into further mechanisms and clinical studies in air pollution-mediated APOs.
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Affiliation(s)
- Yanhui Li
- Department of Obstetrics and Gynecology, Shandong University Qilu Hospital, 107 Wenhua West Road, Lixia District, Jinan City, Shandong Province, China.
| | - Zhou Yang
- Department of Obstetrics and Gynecology, Shandong University Qilu Hospital, 107 Wenhua West Road, Lixia District, Jinan City, Shandong Province, China
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Ahn TG, Kim YJ, Lee G, You YA, Kim SM, Chae R, Hur YM, Park MH, Bae JG, Lee SJ, Kim YH, Na S. Association Between Individual Air Pollution (PM 10, PM 2.5) Exposure and Adverse Pregnancy Outcomes in Korea: A Multicenter Prospective Cohort, Air Pollution on Pregnancy Outcome (APPO) Study. J Korean Med Sci 2024; 39:e131. [PMID: 38599601 PMCID: PMC11004777 DOI: 10.3346/jkms.2024.39.e131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 03/05/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Prenatal exposure to ambient air pollution is linked to a higher risk of unfavorable pregnancy outcomes. However, the association between pregnancy complications and exposure to indoor air pollution remains unclear. The Air Pollution on Pregnancy Outcomes research is a hospital-based prospective cohort research created to look into the effects of aerodynamically exposed particulate matter (PM)10 and PM2.5 on pregnancy outcomes. METHODS This prospective multicenter observational cohort study was conducted from January 2021 to June 2023. A total of 662 women with singleton pregnancies enrolled in this study. An AirguardK® air sensor was installed inside the homes of the participants to measure the individual PM10 and PM2.5 levels in the living environment. The time-activity patterns and PM10 and PM2.5, determined as concentrations from the time-weighted average model, were applied to determine the anticipated exposure levels to air pollution of each pregnant woman. The relationship between air pollution exposure and pregnancy outcomes was assessed using logistic and linear regression analyses. RESULTS Exposure to elevated levels of PM10 throughout the first, second, and third trimesters as well as throughout pregnancy was strongly correlated with the risk of pregnancy problems according to multiple logistic regression models adjusted for variables. Except for in the third trimester of pregnancy, women exposed to high levels of PM2.5 had a high risk of pregnancy complications. During the second trimester and entire pregnancy, the risk of preterm birth (PTB) increased by 24% and 27%, respectively, for each 10 μg/m3 increase in PM10. Exposure to high PM10 levels during the second trimester increased the risk of gestational diabetes mellitus (GDM) by 30%. The risk of GDM increased by 15% for each 5 μg/m3 increase in PM2.5 during the second trimester and overall pregnancy, respectively. Exposure to high PM10 and PM2.5 during the first trimester of pregnancy increased the risk of delivering small for gestational age (SGA) infants by 96% and 26%, respectively. CONCLUSION Exposure to high concentrations of PM10 and PM2.5 is strongly correlated with the risk of adverse pregnancy outcomes. Exposure to high levels of PM10 and PM2.5 during the second trimester and entire pregnancy, respectively, significantly increased the risk of PTB and GDM. Exposure to high levels of PM10 and PM2.5 during the first trimester of pregnancy considerably increased the risk of having SGA infants. Our findings highlight the need to measure individual particulate levels during pregnancy and the importance of managing air quality in residential environment.
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Affiliation(s)
- Tae Gyu Ahn
- Department of Obstetrics and Gynecology, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, Ewha Womans University Mokdong Hospital, Ewha Medical Research Institute College of Medicine, Seoul, Korea
| | - Gain Lee
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Young-Ah You
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Soo Min Kim
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Rin Chae
- Division of Artificial Intelligence and Software/Artificial Intelligence Convergence, Ewha Womans University, Seoul, Korea
| | - Young Min Hur
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Mi Hye Park
- Department of Obstetrics and Gynecology, Ewha Womans University Seoul Hospital, Seoul, Korea
| | - Jin-Gon Bae
- Department of Obstetrics and Gynecology, School of Medicine, Keimyung University, Dongsan Medical Center, Daegu, Korea
| | - Soo-Jeong Lee
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Young-Han Kim
- Department of Obstetrics and Gynecology, Severance Hospital, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
| | - Sunghun Na
- Department of Obstetrics and Gynecology, Kangwon National University School of Medicine, Chuncheon, Korea.
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Zhu K, Mendola P, Barnabei VM, Wang M, Hageman Blair R, Schwartz J, Shelton J, Lei L, Mu L. Association of prenatal exposure to PM 2.5 and NO 2 with gestational diabetes in Western New York. ENVIRONMENTAL RESEARCH 2024; 244:117873. [PMID: 38072106 DOI: 10.1016/j.envres.2023.117873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/20/2023] [Accepted: 12/03/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Although many studies have examined the association between prenatal air pollution exposure and gestational diabetes (GDM), the relevant exposure windows remain inconclusive. We aim to examine the association between preconception and trimester-specific exposure to PM2.5 and NO2 and GDM risk and explore modifying effects of maternal age, pre-pregnancy body mass index (BMI), smoking, exercise during pregnancy, race and ethnicity, and neighborhood disadvantage. METHODS Analyses included 192,508 birth records of singletons born to women without pre-existing diabetes in Western New York, 2004-2016. Daily PM2.5 and NO2 at 1-km2 grids were estimated from ensemble-based models. We assigned each birth with exposures averaged in preconception and each trimester based on residential zip-codes. We used logistic regression to examine the associations and distributed lag models (DLMs) to explore the sensitive windows by month. Relative excess risk due to interaction (RERI) and multiplicative interaction terms were calculated. RESULTS GDM was associated with PM2.5 averaged in the first two trimesters (per 2.5 μg/m3: OR = 1.08, 95% CI: 1.01, 1.14) or from preconception to the second trimester (per 2.5 μg/m3: OR = 1.10, 95% CI: 1.03, 1.18). NO2 exposure during each averaging period was associated with GDM risk (per 10 ppb, preconception: OR = 1.10, 95% CI: 1.06, 1.14; first trimester: OR = 1.12, 95% CI: 1.08, 1.16; second trimester: OR = 1.10, 95% CI: 1.06, 1.14). In DLMs, sensitive windows were identified in the 5th and 6th gestational months for PM2.5 and one month before and three months after conception for NO2. Evidence of interaction was identified for pre-pregnancy BMI with PM2.5 (P-for-interaction = 0.023; RERI = 0.21, 95% CI: 0.10, 0.33) and with NO2 (P-for-interaction = 0.164; RERI = 0.16, 95% CI: 0.04, 0.27). CONCLUSION PM2.5 and NO2 exposure may increase GDM risk, and sensitive windows may be the late second trimester for PM2.5 and periconception for NO2. Women with higher pre-pregnancy BMI may be more susceptible to exposure effects.
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Affiliation(s)
- Kexin Zhu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Pauline Mendola
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Vanessa M Barnabei
- Department of Obstetrics and Gynecology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Meng Wang
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Rachael Hageman Blair
- Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - James Shelton
- Department of Obstetrics and Gynecology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Lijian Lei
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA.
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Xu Y, O'Sharkey K, Cabison J, Rosales M, Chavez T, Johnson M, Yang T, Cho SH, Chartier R, Grubbs B, Lurvey N, Lerner D, Lurmann F, Farzan S, Bastain TM, Breton C, Wilson JP, Habre R. Sources of personal PM 2.5 exposure during pregnancy in the MADRES cohort. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024:10.1038/s41370-024-00648-z. [PMID: 38326532 DOI: 10.1038/s41370-024-00648-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Personal exposure to fine particulate matter (PM2.5) is impacted by different sources each with different chemical composition. Determining these sources is important for reducing personal exposure and its health risks especially during pregnancy. OBJECTIVE Identify main sources and their contributions to the personal PM2.5 exposure in 213 women in the 3rd trimester of pregnancy in Los Angeles, CA. METHODS We measured 48-hr integrated personal PM2.5 exposure and analyzed filters for PM2.5 mass, elemental composition, and optical carbon fractions. We used the EPA Positive Matrix Factorization (PMF) model to resolve and quantify the major sources of personal PM2.5 exposure. We then investigated bivariate relationships between sources, time-activity patterns, and environmental exposures in activity spaces and residential neighborhoods to further understand sources. RESULTS Mean personal PM2.5 mass concentration was 22.3 (SD = 16.6) μg/m3. Twenty-five species and PM2.5 mass were used in PMF with a final R2 of 0.48. We identified six sources (with major species in profiles and % contribution to PM2.5 mass) as follows: secondhand smoking (SHS) (brown carbon, environmental tobacco smoke; 65.3%), fuel oil (nickel, vanadium; 11.7%), crustal (aluminum, calcium, silicon; 11.5%), fresh sea salt (sodium, chlorine; 4.7%), aged sea salt (sodium, magnesium, sulfur; 4.3%), and traffic (black carbon, zinc; 2.6%). SHS was significantly greater in apartments compared to houses. Crustal source was correlated with more occupants in the household. Aged sea salt increased with temperature and outdoor ozone, while fresh sea salt was highest on days with westerly winds from the Pacific Ocean. Traffic was positively correlated with ambient NO2 and traffic-related NOx at residence. Overall, 76.8% of personal PM2.5 mass came from indoor or personal compared to outdoor sources. IMPACT We conducted source apportionment of personal PM2.5 samples in pregnancy in Los Angeles, CA. Among identified sources, secondhand smoking contributed the most to the personal exposure. In addition, traffic, crustal, fuel oil, fresh and aged sea salt sources were also identified as main sources. Traffic sources contained markers of combustion and non-exhaust wear emissions. Crustal source was correlated with more occupants in the household. Aged sea salt source increased with temperature and outdoor ozone and fresh sea salt source was highest on days with westerly winds from the Pacific Ocean.
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Affiliation(s)
- Yan Xu
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA, USA.
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA.
| | - Karl O'Sharkey
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Jane Cabison
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Marisela Rosales
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Thomas Chavez
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Mark Johnson
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Tingyu Yang
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | | | | | - Brendan Grubbs
- Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | | | | | | | - Shohreh Farzan
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Carrie Breton
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - John P Wilson
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
- Department of Civil & Environmental Engineering, Computer Science, and Sociology, University of Southern California, Los Angeles, CA, USA
| | - Rima Habre
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
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10
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Decrue F, Townsend R, Miller MR, Newby DE, Reynolds RM. Ambient air pollution and maternal cardiovascular health in pregnancy. Heart 2023; 109:1586-1593. [PMID: 37217298 DOI: 10.1136/heartjnl-2022-322259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/18/2023] [Indexed: 05/24/2023] Open
Abstract
In this review, we summarise the current epidemiological and experimental evidence on the association of ambient (outdoor) air pollution exposure and maternal cardiovascular health during pregnancy. This topic is of utmost clinical and public health importance as pregnant women represent a potentially susceptible group due to the delicate balance of the feto-placental circulation, rapid fetal development and tremendous physiological adaptations to the maternal cardiorespiratory system during pregnancy.Several meta-analyses including up to 4 245 170 participants provide robust evidence that air pollutants, including particulate matter, nitrogen oxides and others, have adverse effects on the development of hypertensive disorders of pregnancy, gestational diabetes mellitus and cardiovascular events during labour. Potential underlying biological mechanisms include oxidative stress with subsequent endothelial dysfunction and vascular inflammation, β-cell dysfunction and epigenetic changes. Endothelial dysfunction can lead to hypertension by impairing vasodilatation and promoting vasoconstriction. Air pollution and the consequent oxidative stress can additionally accelerate β-cell dysfunction, which in turn triggers insulin resistance leading to gestational diabetes mellitus. Epigenetic changes in placental and mitochondrial DNA following air pollution exposures can lead to altered gene expression and contribute to placental dysfunction and induction of hypertensive disorders of pregnancy.The maternal and fetal consequences of such cardiovascular and cardiometabolic disease during pregnancy can be serious and long lasting, including preterm birth, increased risk of type 2 diabetes mellitus or cardiovascular disease later in life. Acceleration of efforts to reduce air pollution is therefore urgently needed to realise the full health benefits for pregnant mothers and their children.
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Affiliation(s)
- Fabienne Decrue
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - Rosemary Townsend
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - Mark R Miller
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - David E Newby
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - Rebecca M Reynolds
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
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11
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Xia YY, de Seymour JV, Yang XJ, Zhou LW, Liu Y, Yang Y, Beck KL, Conlon CA, Mansell T, Novakovic B, Saffery R, Han TL, Zhang H, Baker PN. Hair and cord blood element levels and their relationship with air pollution, dietary intake, gestational diabetes mellitus, and infant neurodevelopment. Clin Nutr 2023; 42:1875-1888. [PMID: 37625317 DOI: 10.1016/j.clnu.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 07/30/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND & AIMS Exposure to a range of elements, air pollution, and specific dietary components in pregnancy has variously been associated with gestational diabetes mellitus (GDM) risk or infant neurodevelopmental problems. We measured a range of pregnancy exposures in maternal hair and/or infant cord serum and tested their relationship to GDM and infant neurodevelopment. METHODS A total of 843 pregnant women (GDM = 224, Non-GDM = 619) were selected from the Complex Lipids in Mothers and Babies cohort study. Forty-eight elements in hair and cord serum were quantified using inductively coupled plasma-mass spectrometry analysis. Binary logistic regression was used to estimate the associations between hair element concentrations and GDM risk, while multiple linear regression was performed to analyze the relationship between hair/cord serum elements and air pollutants, diet exposures, and Bayley Scales of infant neurodevelopment at 12 months of age. RESULTS After adjusting for maternal age, BMI, and primiparity, we observed that fourteen elements in maternal hair were associated with a significantly increased risk of GDM, particularly Ta (OR = 9.49, 95% CI: 6.71, 13.42), Re (OR = 5.21, 95% CI: 3.84, 7.07), and Se (OR = 5.37, 95% CI: 3.48, 8.28). In the adjusted linear regression model, three elements (Rb, Er, and Tm) in maternal hair and infant cord serum were negatively associated with Mental Development Index scores. For dietary exposures, elements were positively associated with noodles (Nb), sweetened beverages (Rb), poultry (Cs), oils and condiments (Ca), and other seafood (Gd). In addition, air pollutants PM2.5 (LUR) and PM10 were negatively associated with Ta and Re in maternal hair. CONCLUSIONS Our findings highlight the potential influence of maternal element exposure on GDM risk and infant neurodevelopment. We identified links between levels of these elements in both maternal hair and infant cord serum related to air pollutants and dietary factors.
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Affiliation(s)
- Yin-Yin Xia
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Department of Occupational and Environmental Hygiene, School of Public Health, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China; Mass Spectrometry Center of Maternal Fetal Medicine, Chongqing Medical University, Chongqing, China
| | - Jamie V de Seymour
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, New Zealand
| | - Xiao-Jia Yang
- Department of Occupational and Environmental Hygiene, School of Public Health, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Lin-Wei Zhou
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yue Liu
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Department of Occupational and Environmental Hygiene, School of Public Health, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China; Mass Spectrometry Center of Maternal Fetal Medicine, Chongqing Medical University, Chongqing, China
| | - Yang Yang
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Mass Spectrometry Center of Maternal Fetal Medicine, Chongqing Medical University, Chongqing, China
| | - Kathryn L Beck
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, New Zealand
| | - Cathryn A Conlon
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, New Zealand
| | - Toby Mansell
- Molecular Immunity, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Boris Novakovic
- Molecular Immunity, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Richard Saffery
- Molecular Immunity, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Ting-Li Han
- Mass Spectrometry Center of Maternal Fetal Medicine, Chongqing Medical University, Chongqing, China; Department of Obstetrics and Gynaecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Life Sciences, Chongqing Medical University, Chongqing, China.
| | - Hua Zhang
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Mass Spectrometry Center of Maternal Fetal Medicine, Chongqing Medical University, Chongqing, China.
| | - Philip N Baker
- College of Life Sciences, University of Leicester, Leicester, United Kingdom
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Niu Z, Habre R, Yang T, Grubbs BH, Eckel SP, Toledo-Corral CM, Johnston J, Dunton GF, Lurvey N, Al-Marayati L, Lurmann F, Pavlovic N, Bastain TM, Breton CV, Farzan SF. Preconceptional and prenatal exposure to air pollutants and risk of gestational diabetes in the MADRES prospective pregnancy cohort study. LANCET REGIONAL HEALTH. AMERICAS 2023; 25:100575. [PMID: 37727593 PMCID: PMC10505827 DOI: 10.1016/j.lana.2023.100575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 09/21/2023]
Abstract
Background Air pollution has been associated with gestational diabetes mellitus (GDM). We aim to investigate susceptible windows of air pollution exposure and factors determining population vulnerability. Methods We ascertained GDM status in the prospective Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) pregnancy cohort from Los Angeles, California, USA. We calculated the relative risk of GDM by exposure to ambient particulate matter (PM10; PM2.5), nitrogen dioxide (NO2), and ozone (O3) in each week from 12 weeks before to 24 weeks after conception, adjusting for potential confounders, with distributed lag models to identify susceptible exposure windows. We examined effect modification by prenatal depression, median-split pre-pregnancy BMI (ppBMI) and age. Findings Sixty (9.7%) participants were diagnosed with GDM among 617 participants (mean age: 28.2 years, SD: 5.9; 78.6% Hispanic, 11.8% non-Hispanic Black). GDM risk increased with exposure to PM2.5, PM10, and NO2 in a periconceptional window ranging from 5 weeks before to 5 weeks after conception: interquartile-range increases in PM2.5, PM10, and NO2 during this window were associated with increased GDM risk by 5.7% (95% CI: 4.6-6.8), 8.9% (8.1-9.6), and 15.0% (13.9-16.2), respectively. These sensitive windows generally widened, with greater effects, among those with prenatal depression, with age ≥28 years, or with ppBMI ≥27.5 kg/m2, than their counterparts. Interpretation Preconception and early-pregnancy are susceptible windows of air pollutants exposure that increased GDM risk. Prenatal depression, higher age, or higher ppBMI may increase one's vulnerability to air pollution-associated GDM risk. Funding National Institutes of Health, Environmental Protection Agency.
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Affiliation(s)
- Zhongzheng Niu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Tingyu Yang
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Brendan H. Grubbs
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sandrah P. Eckel
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Claudia M. Toledo-Corral
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Health Sciences, California State University, Northridge, Northridge, CA, USA
| | - Jill Johnston
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Genevieve F. Dunton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Laila Al-Marayati
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | | | - Theresa M. Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Shohreh F. Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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13
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Cao L, Diao R, Shi X, Cao L, Gong Z, Zhang X, Yan X, Wang T, Mao H. Effects of Air Pollution Exposure during Preconception and Pregnancy on Gestational Diabetes Mellitus. TOXICS 2023; 11:728. [PMID: 37755739 PMCID: PMC10534707 DOI: 10.3390/toxics11090728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 09/28/2023]
Abstract
This study aimed to investigate the association between air pollution and gestational diabetes mellitus (GDM) in small- and medium-sized cities, identify sensitive periods and major pollutants, and explore the effects of air pollution on different populations. A total of 9820 women who delivered in Handan Maternal and Child Health Hospital in the Hebei Province from February 2018 to July 2020 were included in the study. Logistic regression and principal component logistic regression models were used to assess the effects of air pollution exposure during preconception and pregnancy on GDM risk and the differences in the effects across populations. The results suggested that each 20 μg/m3 increase in PM2.5 and PM10 exposure during preconception and pregnancy significantly increased the risk of GDM, and a 10 μg/m3 increase in NO2 exposure during pregnancy was also associated with the risk of GDM. In a subgroup analysis, pregnant women aged 30-35 years, nulliparous women, and those with less than a bachelor's education were the most sensitive groups. This study provides evidence for an association between air pollution and the prevalence of GDM, with PM2.5, PM10, and NO2 as risk factors for GDM.
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Affiliation(s)
- Lei Cao
- China Institute for Radiation Protection, Taiyuan 030006, China
- Tianjin Key Laboratory of Urban Transport Emission Research & State Environmental Protection Key, Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Tianjin 300071, China
| | - Ruiping Diao
- Handan Maternal and Children Health Hospital, Handan 056001, China
| | - Xuefeng Shi
- China Institute for Radiation Protection, Taiyuan 030006, China
| | - Lu Cao
- China Institute for Radiation Protection, Taiyuan 030006, China
| | - Zerui Gong
- China Institute for Radiation Protection, Taiyuan 030006, China
| | - Xupeng Zhang
- China Institute for Radiation Protection, Taiyuan 030006, China
| | - Xiaohan Yan
- China Institute for Radiation Protection, Taiyuan 030006, China
| | - Ting Wang
- Tianjin Key Laboratory of Urban Transport Emission Research & State Environmental Protection Key, Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Tianjin 300071, China
| | - Hongjun Mao
- Tianjin Key Laboratory of Urban Transport Emission Research & State Environmental Protection Key, Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Tianjin 300071, China
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14
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Zhao G, Zhang F, Zhong Y, Zhang Y, Zhang X, Zhu S, Zhang X, Li T, Zhu W, Li D. Independent and interactive effects of ozone and thermal inversion exposure on the risk of gestational diabetes mellitus in Wuhan, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:91315-91323. [PMID: 37477814 DOI: 10.1007/s11356-023-28855-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/14/2023] [Indexed: 07/22/2023]
Abstract
The adverse effects of exposure to thermal inversion (TI) and ozone (O3) on human health have been reported; however, there are few studies have explored the independent and potential interactive effects of them on gestational diabetes mellitus (GDM). A total of 31,262 pregnant women from the Wuhan Children's Hospital covering the period from 2017 to 2021 were included in this study. The logistic regression adjusted for the covariates was applied to explore the independent effect of exposure to O3 and TI on GDM. The relative excess risk due to the interaction (RERI) analysis was applied to assess the possible interactive effect. Per 10 μg/m3 increased in O3 (OR = 1.069, 95% CI: 1.049, 1.089) during the first trimester and per 10 days increased in TI (OR = 1.041, 95% CI: 1.005, 1.080) in the second trimester were significantly associated with the risk of GDM. The synergistic effect of exposure to TI and O3 was larger than their sum effect (RERI = 0.330, 95% CI: 0.170, 0.476). This study added further support for public health-related policy to improve maternal health by curbing TI and O3.
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Affiliation(s)
- Gaichan Zhao
- Department of Obstetrics and Gynecology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China
- Yuhua District Center for Disease Control and Prevebtion, Shijiazhuang, 050021, China
| | - Faxue Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Yuanyuan Zhong
- Department of Obstetrics and Gynecology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China
| | - Yan Zhang
- Department of Obstetrics and Gynecology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China
| | - Xupeng Zhang
- Department of Public Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Shijie Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Xiaowei Zhang
- Department of Public Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Tianzhou Li
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Wei Zhu
- Department of Obstetrics and Gynecology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China.
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China.
| | - Dejia Li
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China
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15
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Qiu Z, Li W, Qiu Y, Chen Z, Yang F, Xu W, Gao Y, Liu Z, Li Q, Jiang M, Liu H, Zhan Y, Dai L. Third trimester as the susceptibility window for maternal PM 2.5 exposure and preterm birth: A nationwide surveillance-based association study in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 880:163274. [PMID: 37019233 DOI: 10.1016/j.scitotenv.2023.163274] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/17/2023] [Accepted: 03/31/2023] [Indexed: 05/27/2023]
Abstract
Maternal PM2.5 exposure has been identified as a potential risk factor for preterm birth, yet the inconsistent findings on the susceptible exposure windows may be partially due to the influence of gaseous pollutants. This study aims to examine the association between PM2.5 exposure and preterm birth during different susceptible exposure windows after adjusting for exposure to gaseous pollutants. We collected 2,294,188 records of singleton live births from 30 provinces of China from 2013 to 2019, and the gridded daily concentrations of air pollutants (including PM2.5, O3, NO2, SO2, and CO) were derived by using machine learning models for assessing individual exposure. We employed logistic regression to develop single-pollutant models (including PM2.5 only) and co-pollutant models (including PM2.5 and a gaseous pollutant) to estimate the odds ratio for preterm birth and its subtypes, with adjustment for maternal age, neonatal sex, parity, meteorological conditions, and other potential confounders. In the single-pollutant models, PM2.5 exposure in each trimester was significantly associated with preterm birth, and the third trimester exposure showed a stronger association with very preterm birth than that with moderate to late preterm birth. The co-pollutant models revealed that preterm birth might be significantly associated only with maternal exposure to PM2.5 in the third trimester, and not with exposure in the first or second trimester. The observed significant associations between preterm birth and maternal PM2.5 exposure in the first and second trimesters in single-pollutant models might primarily be influenced by exposure to gaseous pollutants. Our study provides evidence that the third trimester may be the susceptible window for maternal PM2.5 exposure and preterm birth. The association between PM2.5 exposure and preterm birth could be influenced by gaseous pollutants, which should be taken into consideration when evaluating the impact of PM2.5 exposure on maternal and fetal health.
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Affiliation(s)
- Zhimei Qiu
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, Sichuan 610065, China; The Joint Laboratory for Pulmonary Development and Related Diseases, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Wenyan Li
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, China
| | - Yang Qiu
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Zhiyu Chen
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, China
| | - Fumo Yang
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, Sichuan 610065, China; College of Carbon Neutrality Future Technology, Sichuan University, Chengdu, Sichuan 610065, China
| | - Wenli Xu
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, China
| | - Yuyang Gao
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, China
| | - Zhen Liu
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, China
| | - Qi Li
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, China
| | - Min Jiang
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan 610041, China
| | - Hanmin Liu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, China; NHC Key Laboratory of Chronobiology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yu Zhan
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, Sichuan 610065, China; College of Carbon Neutrality Future Technology, Sichuan University, Chengdu, Sichuan 610065, China
| | - Li Dai
- The Joint Laboratory for Pulmonary Development and Related Diseases, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China; National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan 610041, China.
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Gong Z, Yue H, Li Z, Bai S, Cheng Z, He J, Wang H, Li G, Sang N. Association between maternal exposure to air pollution and gestational diabetes mellitus in Taiyuan, North China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 875:162515. [PMID: 36868286 DOI: 10.1016/j.scitotenv.2023.162515] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The effect of air pollution on human health has been a major concern, especially the association between air pollution and gestational diabetes mellitus (GDM). METHODS In this study, we conducted a retrospective cohort study in Taiyuan, a typical energy production base in China. This study included 28,977 pairs of mothers and infants between January 2018 and December 2020. To screen for GDM, oral glucose tolerance test (OGTT) was performed in pregnant women at 24-28 weeks of gestation. Logistic regression was used to assess the trimester-specific association between 5 common air pollutants (PM10, PM2.5, NO2, SO2, and O3) and GDM, and the weekly-based association was also assessed using distributed lag non-linear models (DLNMs). Odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated for the association between GDM and each air pollutant. RESULTS The overall incidence of GDM was 3.29 %. PM2.5 was positively associated with GDM over the second trimester (OR [95 % CI], 1.105 [1.021, 1.196]). O3 was positively associated with GDM in the preconception period (OR [95 % CI], 1.125 [1.024, 1.236]), the first trimester (OR [95 % CI], 1.088 [1.019, 1.161]) and the 1st + 2nd trimester (OR [95 % CI], 1.643 [1.387, 1.945]). For the weekly-based association, PM2.5 was positively associated with GDM at 19-24 weeks of gestation, with the strongest association at week 24 (OR [95 % CI], 1.044 [1.021, 1.067]). PM10 was positively associated with GDM at 18-24 weeks of gestation, with the strongest association at week 24 (OR [95 % CI], 1.016 [1.003, 1.030]). O3 was positively associated with GDM during the 3rd week before conception to the 8th gestational week, with the strongest association at week 3 of gestation (OR [95 % CI], 1.054 [1.032, 1.077]). CONCLUSION The findings are important for the development of effective air quality policies and the optimization of preventive strategies for preconception and prenatal care.
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Affiliation(s)
- Zhihua Gong
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi 030006, PR China; Department of Clinical Laboratory, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi 030032, PR China; Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China
| | - Huifeng Yue
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi 030006, PR China
| | - Zhihong Li
- Taiyuan Taihang Hospital, Taiyuan, Shanxi 030006, PR China
| | - Shuqing Bai
- Taiyuan Taihang Hospital, Taiyuan, Shanxi 030006, PR China
| | - Zhonghui Cheng
- Xiaodian District Maternal and Child Health Care Hospital, Taiyuan 030032, PR China
| | - Jing He
- Department of Obstetrics and Gynecology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi 030032, PR China; Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China
| | - Huimin Wang
- Fengtai Mental Health Center, Beijing 100071, PR China
| | - Guangke Li
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi 030006, PR China.
| | - Nan Sang
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi 030006, PR China
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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.
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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.
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18
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Yu S, Zhang M, Zhu J, Yang X, Bigambo FM, Snijders AM, Wang X, Hu W, Lv W, Xia Y. The effect of ambient ozone exposure on three types of diabetes: a meta-analysis. Environ Health 2023; 22:32. [PMID: 36998068 PMCID: PMC10061724 DOI: 10.1186/s12940-023-00981-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Ozone as an air pollutant is gradually becoming a threat to people's health. However, the effect of ozone exposure on risk of developing diabetes, a fast-growing global metabolic disease, remains controversial. OBJECTIVE To evaluate the impact of ambient ozone exposure on the incidence rate of type 1, type 2 and gestational diabetes mellitus. METHOD We systematically searched PubMed, Web of Science, and Cochrane Library databases before July 9, 2022, to determine relevant literature. Data were extracted after quality evaluation according to the Newcastle Ottawa Scale (NOS) and the agency for healthcare research and quality (AHRQ) standards, and a meta-analysis was used to evaluate the correlation between ozone exposure and type 1 diabetes mellitus (T1D), type 2 diabetes mellitus (T2D), and gestational diabetes mellitus (GDM). The heterogeneity test, sensitivity analysis, and publication bias were performed using Stata 16.0. RESULTS Our search identified 667 studies from three databases, 19 of which were included in our analysis after removing duplicate and ineligible studies. Among the remaining studies, three were on T1D, five were on T2D, and eleven were on GDM. The result showed that ozone exposure was positively correlated with T2D [effect size (ES) = 1.06, 95% CI: 1.02, 1.11] and GDM [pooled odds ratio (OR) = 1.01, 95% CI: 1.00, 1.03]. Subgroup analysis demonstrated that ozone exposure in the first trimester of pregnancy might raise the risk of GDM. However, no significant association was observed between ozone exposure and T1D. CONCLUSION Long-term exposure to ozone may increase the risk of T2D, and daily ozone exposure during pregnancy was a hazard factor for developing GDM. Decreasing ambient ozone pollution may reduce the burden of both diseases.
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Affiliation(s)
- Sirui Yu
- State Key Laboratory of Reproductive Medicine, Center for Global Health, Institute of Toxicology, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Mingzhi Zhang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, Institute of Toxicology, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jiamin Zhu
- State Key Laboratory of Reproductive Medicine, Center for Global Health, Institute of Toxicology, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, 211166, China
| | - Xu Yang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, Institute of Toxicology, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Francis Manyori Bigambo
- State Key Laboratory of Reproductive Medicine, Center for Global Health, Institute of Toxicology, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, 211166, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Antoine M Snijders
- Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA
| | - Xu Wang
- Department of Endocrinology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Weiyue Hu
- State Key Laboratory of Reproductive Medicine, Center for Global Health, Institute of Toxicology, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, 211166, China.
- Department of Nutrition and Food Safety, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, 211166, China.
| | - Wei Lv
- Healthcare Management Program, School of Business, Nanjing University, 22 Hankou Rd, Nanjing, 210093, China.
| | - Yankai Xia
- State Key Laboratory of Reproductive Medicine, Center for Global Health, Institute of Toxicology, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, 211166, China.
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.
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Nazarpour S, Ramezani Tehrani F, Valizadeh R, Amiri M. The relationship between air pollutants and gestational diabetes: an updated systematic review and meta-analysis. J Endocrinol Invest 2023:10.1007/s40618-023-02037-z. [PMID: 36807891 DOI: 10.1007/s40618-023-02037-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 02/08/2023] [Indexed: 02/21/2023]
Abstract
PURPOSE Air pollution is an environmental stimulus that may predispose pregnant women to gestational diabetes mellitus (GDM). This systematic review and meta-analysis were conducted to investigate the relationship between air pollutants and GDM. METHODS PubMed, Web of Science, and Scopus were systematically searched for retrieving English articles published from January 2020 to September 2021, investigating the relationship of exposure to ambient air pollution or levels of air pollutants with GDM and related parameters, including fasting plasma glucose (FPG), insulin resistance, and impaired glucose tolerance. Heterogeneity and publication bias were evaluated using I-squared (I2), and Begg's statistics, respectively. We also performed the subgroup analysis for particulate matters (PM2.5, PM10), Ozone (O3), and sulfur dioxide (SO2) in the different exposure periods. RESULTS A total of 13 studies examining 2,826,544 patients were included in this meta-analysis. Compared to non-exposed women, exposure to PM2.5 increases the odds (likelihood of occurrence outcome) of GDM by 1.09 times (95% CI 1.06, 1.12), whereas exposure to PM10 has more effect by OR of 1.17 (95% CI 1.04, 1.32). Exposure to O3 and SO2 increases the odds of GDM by 1.10 times (95% CI 1.03, 1.18) and 1.10 times (95% CI 1.01, 1.19), respectively. CONCLUSIONS The results of the study show a relationship between air pollutants PM2.5, PM10, O3, and SO2 and the risk of GDM. Although evidence from various studies can provide insights into the linkage between maternal exposure to air pollution and GDM, more well-designed longitudinal studies are recommended for precise interpretation of the association between GDM and air pollution by adjusting all potential confounders.
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Affiliation(s)
- S Nazarpour
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 24 Parvaneh, Yaman Street, Velenjak, P.O. Box: 19395-4763, Tehran, 1985717413, Islamic Republic of Iran
- Department of Midwifery, Varamin-Pishva Branch, Islamic Azad University, Tehran, Iran
| | - F Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 24 Parvaneh, Yaman Street, Velenjak, P.O. Box: 19395-4763, Tehran, 1985717413, Islamic Republic of Iran.
| | - R Valizadeh
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
- Minimally Invasive Surgery Research Center, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - M Amiri
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 24 Parvaneh, Yaman Street, Velenjak, P.O. Box: 19395-4763, Tehran, 1985717413, Islamic Republic of Iran
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20
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Yang Y, Ma X, Pang W, Jiang C. Causal Associations of PM2.5 and GDM: A Two-Sample Mendelian Randomization Study. TOXICS 2023; 11:171. [PMID: 36851046 PMCID: PMC9961059 DOI: 10.3390/toxics11020171] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 01/17/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Epidemiological studies have linked particulate matter (PM2.5) to gestational diabetes mellitus (GDM). However, the causality of this association has not been established; Mendelian randomization was carried out using summary data from genome-wide association studies (GWAS). For the analysis of the causal relationship between PM2.5 and GDM, the inverse variance weighted (IVW) method was used. The exposure data came from a GWAS dataset of IEU analysis of the United Kingdom Biobank phenotypes consisting of 423,796 European participants. The FinnGen consortium provided the GDM data, which included 6033 cases and 123,000 controls. We also performed multivariate MR (MVMR), adjusting for body mass index (BMI) and smoking. As a result, we found that each standard deviation increase in PM2.5 is associated with a 73.6% increase in the risk of GDM (OR: 1.736; 95%CI: 1.226-2.457). Multivariable MR analysis showed that the effect of PM2.5 on GDM remained after accounting for BMI and smoking. Our results demonstrate a causal relationship between PM2.5 and GDM.
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Affiliation(s)
- Yi Yang
- Guangxi Engineering Research Center for Pharmaceutical Molecular Screening and Druggability Evaluation, Guilin Medical University, Guilin 541199, China
- School of Pharmacy, Guilin Medical University, Guilin 541199, China
| | - Xianli Ma
- Guangxi Engineering Research Center for Pharmaceutical Molecular Screening and Druggability Evaluation, Guilin Medical University, Guilin 541199, China
- School of Pharmacy, Guilin Medical University, Guilin 541199, China
| | - Weiyi Pang
- Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Heath, Guilin Medical University, Guilin 541199, China
| | - Caina Jiang
- Guangxi Engineering Research Center for Pharmaceutical Molecular Screening and Druggability Evaluation, Guilin Medical University, Guilin 541199, China
- School of Pharmacy, Guilin Medical University, Guilin 541199, China
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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.
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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.
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Zhang L, Wang P, Zhou Y, Cheng Y, Li J, Xiao X, Yin C, Li J, Meng X, Zhang Y. Associations of ozone exposure with gestational diabetes mellitus and glucose homeostasis: Evidence from a birth cohort in Shanghai, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 857:159184. [PMID: 36202368 DOI: 10.1016/j.scitotenv.2022.159184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Associations between individual exposure to ozone (O3) and gestational diabetes mellitus (GDM) have rarely been investigated, and critical windows of O3 exposure for GDM have not been identified. OBJECTIVES We aimed to explore the associations of gestational O3 exposure with GDM and glucose homeostasis as well as to identify the potential critical windows. METHODS A total of 7834 pregnant women were included. Individual O3 exposure concentrations were evaluated using a high temporal-spatial resolution model. Each participant underwent an oral glucose tolerance test (OGTT) to screen for GDM between 24 and 28 gestational weeks. Multiple logistic and multiple linear regression models were used to estimate the associations of O3 with GDM risks and with blood glucose levels of OGTT, respectively. Distributed lag nonlinear models (DLNMs) were used to estimate the critical windows of O3 exposure for GDM. RESULTS Nearly 13.29 % of participants developed GDM. After controlling for covariates, we observed increased GDM risks per IQR increment of O3 exposure in the first trimester (OR = 1.738, 95 % CI: 1.002-3.016) and the first two trimesters (OR = 1.576, 95 % CI: 1.005-2.473). Gestational O3 exposure was positively associated with increased fasting blood glucose (the first trimester: β = 2.964, 95 % CI: 1.529-4.398; the first two trimesters: β = 1.620, 95 % CI: 0.436-2.804) and 2 h blood glucose (the first trimester: β = 6.569, 95 % CI: 1.775-11.363; the first two trimesters: β = 6.839, 95 % CI: 2.896-10.782). We also observed a concentration-response relationship of gestational O3 exposure with GDM risk, as well as fasting and 2 h blood glucose levels. Additionally, 5-10 gestational weeks was identified as a critical window of O3 exposure for GDM development. CONCLUSION In summary, we found that gestational O3 exposure disrupts glucose homeostasis and increases the risk of GDM in pregnant women. Furthermore, 5-10 gestational weeks could be a critical window for the effects of O3 exposure on GDM.
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Affiliation(s)
- Liyi Zhang
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Pengpeng Wang
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Yuhan Zhou
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Yukai Cheng
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Jialin Li
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Xirong Xiao
- Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - Chuanmin Yin
- Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - Jiufeng Li
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Xia Meng
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
| | - Yunhui Zhang
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
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Ren Z, Yuan J, Luo Y, Wang J, Li Y. Association of air pollution and fine particulate matter (PM2.5) exposure with gestational diabetes: a systematic review and meta-analysis. ANNALS OF TRANSLATIONAL MEDICINE 2023; 11:23. [PMID: 36760250 PMCID: PMC9906206 DOI: 10.21037/atm-22-6306] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/12/2023] [Indexed: 01/16/2023]
Abstract
Background The association between air pollution (AP) and gestational diabetes mellitus (GDM), especially between different pollutants and GDM, remains controversial and debatable. Hence, we conducted this systematic review and meta-analysis to provide comprehensive evidence-based support for the association between AP and GDM. Methods The databases of the Cochrane Library, Embase, PubMed, and Web of Science were searched from inception to 1 April 2022, in combination with manual retrieval. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of case-control studies and cohort studies, while the Joana Brigg's Institute (JBI) critical appraisal checklist was used for the quality assessment of cross-sectional studies. Results We identified 35 epidemiological studies (including 33 cohort studies, 1 cross-sectional study, and 1 case-control study) covering 6,939,725 pregnant women, of whom 865,460 were GDM patients. The NOS score of all included case-control studies and cohort studies was higher than six, and one of the included cross-sectional studies was rated as high quality according to the JBI assessment. Meta-analysis showed that fine particulate matter and air pollutants [PM2.5, odds ratio (OR) =1.06, 95% confidence interval (CI): 1.05-1.08, Z =7.76, P<0.001; PM10, OR =1.06, 95% CI: 1.01-1.11, Z =2.62, P=0.009; sulfur dioxide (SO2), OR =1.18, 95% CI: 1.10-1.26, Z = 4.69, P<0.001; nitric oxide (NO), OR =1.04, 95% CI: 1.03-1.06,Z =3.33, P=0.001; nitrogen oxides (NOX), OR =1.07, 95% CI: 1.04-1.11, Z =3.93, P<0.001; black carbon (BC), OR =1.08, 95% CI: 1.06-1.10, Z =7.58, P<0.001] was associated with GDM. Furthermore, no significant association was observed between O3, CO, and nitrogen dioxide (NO2) exposure and GDM. Conclusions Exposure to PM2.5, PM10, SO2, NO, NOX, and BC significantly increases the risk of GDM. AP is a remediable environmental trigger that can be prevented by human interventions, such as lowering AP levels or limiting human exposure to air pollutants. The government should strengthen the supervision of air quality and make air quality information more transparent. Besides, living conditions are crucial during pregnancy. Living in a place with more green areas is recommended, and indoor air purification should also be enhanced.
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Affiliation(s)
- Zhonglian Ren
- Department of Obstetrics and Gynecology, Chengdu Shuangliu District Maternal and Child Health Hospital, Chengdu, China
| | - Jiaying Yuan
- Science and education section, Chengdu Shuangliu District Maternal and Child Health Hospital, Chengdu, China
| | - Ya Luo
- Department of Obstetrics and Gynecology, Chengdu Shuangliu District Maternal and Child Health Hospital, Chengdu, China
| | - Juan Wang
- Department of Obstetrics and Gynecology, Chengdu Shuangliu District Maternal and Child Health Hospital, Chengdu, China
| | - Yanqin Li
- Department of Obstetrics and Gynecology, Chengdu Shuangliu District Maternal and Child Health Hospital, Chengdu, China
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Yu Z, Feng Y, Chen Y, Zhang X, Zhao X, Chang H, Zhang J, Gao Z, Zhang H, Huang C. Green space, air pollution and gestational diabetes mellitus: A retrospective cohort study in central China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 249:114457. [PMID: 38321676 DOI: 10.1016/j.ecoenv.2022.114457] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/08/2022] [Accepted: 12/19/2022] [Indexed: 02/08/2024]
Abstract
Emerging evidence suggests residential surrounding green space is beneficial for human health. The association between green space and GDM showed inconsistent results, and potential effect modification of green space with air pollution is still unclear. This study aims to evaluate the association between green space and GDM, and further explore potential interaction and medication effects. Participants were recruited from a retrospective cohort study between 2015 and 2020 in Henan, China. Residential green space based on normalized difference vegetation index (NDVI) and air pollution exposure were estimated using spatial-statistical models. Multivariate logistic regression was applied to evaluate the association between per 0.1 unit increase in NDVI with 4 buffer sizes (250 m, 500 m, 1000 m, 2000 m) and GDM. We examined potential interaction of green space and air pollutants on GDM. Mediating effects of air pollution associated with green space exposure on GDM were also investigated by causal mediation analyses. A total of 46,665 eligible pregnant women were identified. There were 4092 (8.8 %) women diagnosed with GDM according to the IADPSG criteria. We found that per 0.1-unit increment in NDVI250 m, NDVI500 m, NDVI1000 m and NDVI2000 m in second trimester were associated with the decreased risk of GDM, with adjusted OR of 0.921(95 %CI: 0.890-0.953), 0.922 (95 %CI: 0.891-0.953), 0.921 (95 %CI: 0.892-0.952) and 0.921 (95 %CI: 0.892-0.951), respectively. We identified significant interactions between second trimester PM2.5 and O3 exposure and NDVI for GDM (Pinteraction < 0.001). The causal mediation analysis showed that PM2.5 mediated approximately 2.5-5.5 % of the association between green space and GDM, while the estimated mediating effect of O3 was approximately 30.1-38.5 %. In conclusion, our study indicates that residential green space was associated with a reduced risk of GDM, particularly second trimester. Green space may benefit to GDM partly mediated by a reduction in PM2.5 and O3.
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Affiliation(s)
- Zengli Yu
- School of Public Health, Zhengzhou University, Zhengzhou, China; NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention, Zhengzhou, China
| | - Yang Feng
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yao Chen
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoan Zhang
- The Third Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Zhao
- The Third Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui Chang
- The Third Hospital of Zhengzhou University, Zhengzhou, China
| | - Junxi Zhang
- NHC Key Laboratory of Birth Defects Prevention & Henan Key Laboratory of Population Defects Prevention, Zhengzhou, China
| | - Zhan Gao
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huanhuan Zhang
- School of Public Health, Zhengzhou University, Zhengzhou, China.
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
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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.
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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
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Zheng Y, Bian J, Hart J, Laden F, Soo-Tung Wen T, Zhao J, Qin H, Hu H. PM 2.5 Constituents and Onset of Gestational Diabetes Mellitus: Identifying Susceptible Exposure Windows. ATMOSPHERIC ENVIRONMENT (OXFORD, ENGLAND : 1994) 2022; 291:119409. [PMID: 37151750 PMCID: PMC10162772 DOI: 10.1016/j.atmosenv.2022.119409] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Fine particulate matter (PM2.5) has been linked to gestational diabetes mellitus (GDM). However, PM2.5 is a complex mixture with large spatiotemporal heterogeneities, and women with early-onset GDM (i.e., diagnosed before 24th gestation week) have distinct maternal characteristics and a higher risk of worse health outcomes compared with those with late-onset GDM (i.e., diagnosed in or after 24th gestation week). We aimed to examine differential impacts of PM2.5 and its constituents on early- vs. late-onset GDM, and to identify corresponding susceptible exposure windows. We leveraged statewide linked electronic health records and birth records data in Florida in 2012-2017. Exposures to PM2.5 and its constituents (i.e., sulfate [SO4 2-], ammonium [NH4 +], nitrate [NO3 -], organic matter [OM], black carbon [BC], mineral dust [DUST], and sea-salt [SS]) were spatiotemporally linked to pregnant women based on their residential histories. Cox proportional hazards models and multinomial logistic regression were used to examine the associations of PM2.5 and its constituents with GDM and its onsets. Distributed non-linear lag models were implemented to identify susceptible exposure windows. Exposures to PM2.5, SO4 2-, NH4 +, and BC were statistically significantly associated with higher hazards of GDM. Exposures to PM2.5 during weeks 1-12 of gestation were positively associated with GDM. Associations of early-onset GDM with PM2.5 in the 1st and 2nd trimesters, SO4 2- in the 1st and 2nd trimesters, and NO3 - in the preconception and 1st trimester were considerably stronger than observations for late-onset GDM. Our findings suggest there are differential associations of PM2.5 and its constituents with early- vs. late-onset GDM, with different susceptible exposure windows. This study helps better understand the impacts of air pollution on GDM accounting for its physiological heterogeneity.
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Affiliation(s)
- Yi Zheng
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Jaime Hart
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Francine Laden
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Tony Soo-Tung Wen
- Department of Obstetrics and Gynecology, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Jinying Zhao
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Huaizhen Qin
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Hui Hu
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Li Z, Xu R, Wang Z, Qian N, Qian Y, Peng J, Zhu X, Guo C, Li X, Xu Q, Wei Y. Ozone exposure induced risk of gestational diabetes mellitus. CHEMOSPHERE 2022; 308:136241. [PMID: 36041521 DOI: 10.1016/j.chemosphere.2022.136241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/17/2022] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
Numerous studies have shown that air pollution seems to be able to cause many diseases. Considering the possible mechanism of action and the same growth trend, the present study is designed to examine whether and how air pollutants, especially ozone (O3) exposure, are associated with the incidence of gestational diabetes mellitus (GDM). By a retrospective cohort, we analyzed the records of 45439 pregnant women from 2013 to 2018 and matched them to maternal exposure to O3. We found that the increased odds of GDM is associated with increased O3 concentrations from the 1st month before pregnancy to the 3rd month during pregnancy. Specially, the odds ratios (ORs) of these associations were largest in the 1st month before pregnancy, suggesting that the effect of O3 pollution on GDM occurred in pre-pregnancy period. Moreover, the exposure-response plot in the 1st month before pregnancy showed that the odds of GDM increased with the increasing concentration of O3. Our findings provide the evidence that O3 exposure in both pre-pregnancy and pregnancy period elevates the odds of GDM, suggesting that more intensive air pollution controls are needed to improve the health of pregnant women and their offspring.
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Affiliation(s)
- Zhigang Li
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Rongrong Xu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, China
| | - Zhanshan Wang
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Nianfeng Qian
- Hai Dian Maternal & Child Health Hospital, Beijing, China
| | - Yan Qian
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Jianhao Peng
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Xiaojing Zhu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Chen Guo
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Xiaoqian Li
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Qiujin Xu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, China
| | - Yongjie Wei
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, China.
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28
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Xu Y, Yi L, Cabison J, Rosales M, O'Sharkey K, Chavez TA, Johnson M, Lurmann F, Pavlovic N, Bastain TM, Breton CV, Wilson JP, Habre R. The impact of GPS-derived activity spaces on personal PM 2.5 exposures in the MADRES cohort. ENVIRONMENTAL RESEARCH 2022; 214:114029. [PMID: 35932832 DOI: 10.1016/j.envres.2022.114029] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/22/2022] [Accepted: 07/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND In-utero exposure to particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5) is associated with low birth weight and health risks later in life. Pregnant women are mobile and locations they spend time in contribute to their personal PM2.5 exposures. Therefore, it is important to understand how mobility and exposures encountered within activity spaces contribute to personal PM2.5 exposures during pregnancy. METHODS We collected 48-h integrated personal PM2.5 samples and continuous geolocation (GPS) data for 213 predominantly Hispanic/Latina pregnant women in their 3rd trimester in Los Angeles, CA. We also collected questionnaires and modeled outdoor air pollution and meteorology in their residential neighborhood. We calculated three GPS-derived activity space measures of exposure to road networks, greenness (NDVI), parks, traffic volume, walkability, and outdoor PM2.5 and temperature. We used bivariate analyses to screen variables (GPS-extracted exposures in activity spaces, individual characteristics, and residential neighborhood exposures) based on their relationship with personal, 48-h integrated PM2.5 concentrations. We then built a generalized linear model to explain the variability in personal PM2.5 exposure and identify key contributing factors. RESULTS Indoor PM2.5 sources, parity, and home ventilation were significantly associated with personal exposure. Activity-space based exposure to roads was associated with significantly higher personal PM2.5 exposure, while greenness was associated with lower personal PM2.5 exposure (β = -3.09 μg/m3 per SD increase in NDVI, p-value = 0.018). The contribution of outdoor PM2.5 to personal exposure was positive but relatively lower (β = 2.05 μg/m3 per SD increase, p-value = 0.016) than exposures in activity spaces and the indoor environment. The final model explained 34% of the variability in personal PM2.5 concentrations. CONCLUSIONS Our findings highlight the importance of activity spaces and the indoor environment on personal PM2.5 exposures of pregnant women living in Los Angeles, CA. This work also showcases the multiple, complex factors that contribute to total personal PM2.5 exposure.
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Affiliation(s)
- Yan Xu
- Spatial Sciences Institute, University of Southern California, USA.
| | - Li Yi
- Spatial Sciences Institute, University of Southern California, USA.
| | - Jane Cabison
- Department of Population and Public Health Sciences, University of Southern California, USA.
| | - Marisela Rosales
- Department of Population and Public Health Sciences, University of Southern California, USA.
| | - Karl O'Sharkey
- Department of Population and Public Health Sciences, University of Southern California, USA.
| | - Thomas A Chavez
- Department of Population and Public Health Sciences, University of Southern California, USA.
| | - Mark Johnson
- Department of Population and Public Health Sciences, University of Southern California, USA.
| | | | | | - Theresa M Bastain
- Department of Population and Public Health Sciences, University of Southern California, USA.
| | - Carrie V Breton
- Department of Population and Public Health Sciences, University of Southern California, USA.
| | - John P Wilson
- Spatial Sciences Institute, University of Southern California, USA; Department of Population and Public Health Sciences, University of Southern California, USA; Department of Civil & Environmental Engineering, Computer Science, and Sociology, University of Southern California, USA.
| | - Rima Habre
- Spatial Sciences Institute, University of Southern California, USA; Department of Population and Public Health Sciences, University of Southern California, USA.
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29
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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.
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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.
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30
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Zhou X, Li C, Cheng H, Xie J, Li F, Wang L, Ding R. Association between ambient air pollution exposure during pregnancy and gestational diabetes mellitus: a meta-analysis of cohort studies. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:68615-68635. [PMID: 35543789 DOI: 10.1007/s11356-022-20594-3] [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: 01/13/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
Numerous studies have evaluated the association between air pollution and gestational diabetes mellitus (GDM), but the findings were inconsistent. This meta-analysis aimed to provide higher grade evidence on the association of air pollution with GDM based on previous studies. PubMed, Web of science, China National Knowledge Infrastructure (CNKI), and Wanfang Data Knowledge Service Platform (Wanfang) were searched comprehensively up to September 2021. Totally, 20 eligible cohort studies were finally included, for which the pooled RR and 95% CIs were estimated. Stratified analyses by study regions and units of pollutant increase were conducted for further investigation. Sensitivity analyses were also performed to assess the robustness. The finding showed that PM2.5, PM10, NO2, and SO2 exposure increased the risk of GDM, while O3 exposure reduced GDM risk. Specifically, PM2.5 exposure in the first and second trimesters, NO2 and SO2 exposure in the first trimester significantly increased the risk of GDM, with the RR ranging from 1.015 to 1.032. In addition, the elevation of GDM risk induced by PM2.5, PM10, and O3 exposure was more pronounced in Asian subjects than in American subjects. The meta-analysis provides high-quality evidence on the effect of maternal air pollution exposure on GDM in each exposure period.
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Affiliation(s)
- Xinyu Zhou
- First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Changlian Li
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Han Cheng
- First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Junyi Xie
- First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Feng Li
- First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Lishan Wang
- First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Rui Ding
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
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31
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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.
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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
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Jackson TW, Henriquez AR, Snow SJ, Schladweiler MC, Fisher AA, Alewel DI, House JS, Kodavanti UP. Adrenal stress hormone regulation of hepatic homeostatic function after an acute ozone exposure in Wistar-Kyoto male rats. Toxicol Sci 2022; 189:73-90. [PMID: 35737395 DOI: 10.1093/toxsci/kfac065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Ozone-induced lung injury and inflammation and pulmonary/hypothalamus gene expression changes are diminished in adrenalectomized (AD) rats. Acute ozone exposure induces metabolic alterations concomitant with increases in epinephrine and corticosterone. We hypothesized that adrenal hormones are responsible for observed hepatic ozone effects, and in AD rats, these changes would be diminished. 5-7 days after sham (SH) or AD surgeries, male Wistar-Kyoto rats were exposed to air or 0.8-ppm ozone for 4-hrs. Serum samples were analyzed for metabolites and liver for transcriptional changes immediately post-exposure. Ozone increased circulating triglycerides, cholesterol, free fatty-acids, and leptin in SH but not AD rats. Ozone-induced inhibition of glucose-mediated insulin release was absent in AD rats. Unlike diminution of ozone-induced hypothalamus and lung mRNA expression changes, AD in air-exposed rats (AD-air/SH-air) caused differential hepatic expression of ∼1000 genes. Likewise, ozone in AD rats caused differential expression of ∼1000 genes (AD-ozone/AD-air). Ozone-induced hepatic changes in SH rats reflected enrichment for pathways involving metabolic processes, including acetyl-CoA biosynthesis, TCA cycle, and sirtuins. Upstream predictor analysis identified similarity to responses produced by glucocorticoids and pathways involving forskolin. These changes were absent in AD rats exposed to ozone. However, ozone caused unique changes in AD liver mRNA reflecting activation of synaptogenesis, neurovascular coupling, neuroinflammation, and insulin signaling with inhibition of senescence pathways. In these rats, upstream predictor analysis identified numerous microRNAs involved in glucocorticoid insufficiency. These data demonstrate the critical role of adrenal stress hormones in ozone-induced hepatic homeostasis and necessitate further research elucidating their role in propagating environmentally driven diseases.
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Affiliation(s)
- Thomas W Jackson
- Oak Ridge Institute for Science and Education Research Participation Program, U.S. Environmental Protection Agency, Research Triangle Park, NC, 27711, USA
| | - Andres R Henriquez
- Oak Ridge Institute for Science and Education Research Participation Program, U.S. Environmental Protection Agency, Research Triangle Park, NC, 27711, USA
| | - Samantha J Snow
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC, 27711, USA
| | - Mette C Schladweiler
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC, 27711, USA
| | - Anna A Fisher
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC, 27711, USA
| | - Devin I Alewel
- Oak Ridge Institute for Science and Education Research Participation Program, U.S. Environmental Protection Agency, Research Triangle Park, NC, 27711, USA
| | - John S House
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, 27709, USA
| | - Urmila P Kodavanti
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC, 27711, USA
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Gao J, Luo M, Zhao S, Wang H, Li X, Xu P, Ma W, Liu C. Effect of PM2.5 exposure on gestational hypertension, fetal size in preeclampsia-like rats. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:45808-45820. [PMID: 35152352 DOI: 10.1007/s11356-021-18233-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
Studies have shown intriguing associations between gestational PM2.5 exposure and preeclampsia (PE), as well as fetal growth restriction (FGR). This study investigated the impact of PM2.5 exposure on gestational hypertension and fetal outcome in a preeclampsia-like rat model. Pregnant Sprague Dawley rats were exposed to either filtered (FA) or PM2.5-contaminated air during the whole pregnancy period. A PE-like rat model was established by intraperitoneal injection of L-NAME (300 mg/kg) from gestational day (GD) 12 to until GD20. Systolic blood pressure (SBP), weight gain, pup weight and placental weight were measured. The percentages of rat Treg/Th17 cells and Th17-related cytokines were examined by flow cytometry. Gene expression profiles were analyzed by microarray, and the expression of differentially expressed genes was validated by qRT-PCR. The results showed that maternal PM2.5 exposure had no effect on SBP but was associated with low birth weight (LBW) and a higher labyrinth/basal zone ratio. The percentages of splenic Th17 cells from the PM2.5 group of PE-like rats were higher than those from the FA or PM2.5 groups of healthy controls. A significantly decreased Treg/Th17 cell ratio was found in the PM2.5 group of PE-like rats. The mRNA expression of Foxp3 was downregulated, while the mRNA expression of RORα and RORγτ was upregulated after PM2.5 exposure. Furthermore, we observed that both the mRNA and protein levels of TNF-a, CCL2, CCL3 and CCR1 increased in the PM2.5 groups. Our study suggested that systemic inflammation may contribute to the development of FGR associated with PM2.5 exposure throughout pregnancy.
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Affiliation(s)
- Jie Gao
- Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- Department of Obstetrics and Gynecology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Mei Luo
- Central Laboratory, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Shuo Zhao
- Department of Obstetrics and Gynecology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Hailing Wang
- Department of Obstetrics and Gynecology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Xuan Li
- Department of Obstetrics and Gynecology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Pili Xu
- Department of Obstetrics and Gynecology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Wei Ma
- Department of Obstetrics and Gynecology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Chongdong Liu
- Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
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Zou X, Fang J, Yang Y, Wu R, Wang S, Xu H, Jia J, Yang H, Yuan N, Hu M, Zhao Y, Xie Y, Zhu Y, Wang T, Deng Y, Song X, Ma X, Huang W. Maternal exposure to traffic-related ambient particles and risk of gestational diabetes mellitus with isolated fasting hyperglycaemia: A retrospective cohort study in Beijing, China. Int J Hyg Environ Health 2022; 242:113973. [PMID: 35447399 DOI: 10.1016/j.ijheh.2022.113973] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Ambient particles have been associated with gestational diabetes mellitus (GDM), however, no study has evaluated the effects of traffic-related ambient particles on the risks of GDM subgroups classified by oral glucose tolerance test (OGTT) values. METHODS A retrospective analysis was conducted among 24,001 pregnant women who underwent regular prenatal care and received OGTT at Haidian Maternal and Child Health Hospital in Beijing, China, 2014-2017. A total of 3,168 (13.2%) pregnant women were diagnosed with GDM, including 1,206 with isolated fasting hyperglycaemia (GDM-IFH). At a fixed-location monitoring station, routinely monitored ambient particles included fine particulate matter (PM2.5), black carbon (BC) and particles in size ranges of 5-560 nm (PNC5-560). Contributions of PNC5-560 sources were apportioned by positive matrix factorization model. Logistic regression model was applied to estimate odds ratio (OR) of ambient particles on GDM risk. RESULTS Among the 24,001 pregnancy women recruited in this study, 3,168 (13.2%) were diagnosed with GDM, including 1,206 with isolated fasting hyperglycaemia (GDM-IFH) and 1,295 with isolated post-load hyperglycaemia (GDM-IPH). We observed increased GDM-IFH risk with per interquartile range increase in first-trimester exposures to PM2.5 (OR = 1.94; 95% Confidence Intervals: 1.23-3.07), BC (OR = 2.14; 1.73-2.66) and PNC5-560 (OR = 2.46; 1.90-3.19). PNC5-560 originated from diesel and gasoline vehicle emissions were found in associations with increases in GDM-IFH risk, but not in GDM-IPH risk. CONCLUSION Our findings suggest that exposure to traffic-related ambient particles may increase GDM risk by exerting adverse effects on fasting glucose levels during pregnancy, and support continuing efforts to reduce traffic emissions for protecting vulnerable population who are at greater risk of glucose metabolism disorder.
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Affiliation(s)
- Xiaoxuan Zou
- Hadian Maternal and Child Health Hospital, Haidian District, Beijing, China
| | - Jiakun Fang
- Department of Occupational and Environmental Health, Peking University School of Public Health, And Peking University Institute of Environmental Medicine, Beijing, China
| | - Ying Yang
- National Research Institute for Family Planning, China; Graduate School of Peking Union Medical College, Dongcheng District, Beijing, China; National Human Genetic Resources Center, Haidian District, Beijing, China.
| | - Rongshan Wu
- Department of Occupational and Environmental Health, Peking University School of Public Health, And Peking University Institute of Environmental Medicine, Beijing, China; State Key Laboratory of Environmental Criteria and Risk Assessment, State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Shuo Wang
- Hadian Maternal and Child Health Hospital, Haidian District, Beijing, China
| | - Hongbing Xu
- Department of Occupational and Environmental Health, Peking University School of Public Health, And Peking University Institute of Environmental Medicine, Beijing, China
| | - Jiajing Jia
- National Research Institute for Family Planning, China; Graduate School of Peking Union Medical College, Dongcheng District, Beijing, China
| | - Haishan Yang
- Hadian Maternal and Child Health Hospital, Haidian District, Beijing, China
| | - Ningman Yuan
- Department of Occupational and Environmental Health, Peking University School of Public Health, And Peking University Institute of Environmental Medicine, Beijing, China
| | - Meina Hu
- Hadian Maternal and Child Health Hospital, Haidian District, Beijing, China
| | - Yinzhu Zhao
- Hadian Maternal and Child Health Hospital, Haidian District, Beijing, China
| | - Yunfei Xie
- Department of Occupational and Environmental Health, Peking University School of Public Health, And Peking University Institute of Environmental Medicine, Beijing, China
| | - Yutong Zhu
- Department of Occupational and Environmental Health, Peking University School of Public Health, And Peking University Institute of Environmental Medicine, Beijing, China
| | - Tong Wang
- Department of Occupational and Environmental Health, Peking University School of Public Health, And Peking University Institute of Environmental Medicine, Beijing, China
| | - Yuzhi Deng
- National Research Institute for Family Planning, China; Graduate School of Peking Union Medical College, Dongcheng District, Beijing, China
| | - Xiaoming Song
- Department of Occupational and Environmental Health, Peking University School of Public Health, And Peking University Institute of Environmental Medicine, Beijing, China
| | - Xu Ma
- National Research Institute for Family Planning, China; Graduate School of Peking Union Medical College, Dongcheng District, Beijing, China; National Human Genetic Resources Center, Haidian District, Beijing, China
| | - Wei Huang
- Hadian Maternal and Child Health Hospital, Haidian District, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Peking University, Beijing, China.
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Fang J, Yang Y, Zou X, Xu H, Wang S, Wu R, Jia J, Xie Y, Yang H, Yuan N, Hu M, Deng Y, Zhao Y, Wang T, Zhu Y, Ma X, Fan M, Wu J, Song X, Huang W. Maternal exposures to fine and ultrafine particles and the risk of preterm birth from a retrospective study in Beijing, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 812:151488. [PMID: 34742962 DOI: 10.1016/j.scitotenv.2021.151488] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/02/2021] [Accepted: 11/02/2021] [Indexed: 06/13/2023]
Abstract
Maternal exposure to fine particulate matter (PM2.5) has been associated with increased risk of preterm birth (PTB), but evidence on particles in smaller sizes and PTB risk remains limited. In this retrospective analysis, we included birth records of 24,001 singleton live births from Haidian Maternal and Child Health Hospital in Beijing, China, 2014-2017. Concurrently, number concentrations of size-fractioned particles in size ranges of 5-560 nm (PNC5-560) and mass concentrations of PM2.5, black carbon (BC) and gaseous pollutants were measured from a fixed-location monitoring station in central Haidian District. Logistic regression models were used to estimate the odds ratio (OR) of air pollutants on PTB risk after controlling for temperature, relative humidity, and individual covariates (e.g., maternal age, ethnicity, gravidity, parity, gestational weight gain, fetal gender, the year and season of conception). Positive matrix factorization models were then used to apportion the sources of PNC5-560. Among the 1062 (4.4%) PTBs, increased PTB risk was observed during the third trimester of pregnancy per 10 μg/m3 increase in PM2.5 [OR = 1.92; 95% Confidence Interval (95% CI): 1.76, 2.09], per 1000 particles/cm3 increase in PNC25-100 (OR = 1.09; 95% CI: 1.03, 1.15) and PNC100-560 (OR = 1.22; 95% CI: 1.05, 1.42). Among the identified sources of PNC5-560, emissions from gasoline and diesel vehicles were significantly associated with increased PTB risk, with ORs of 1.14 (95% CI: 1.01, 1.29) and 1.11 (95% CI: 1.04, 1.18), respectively. Exposures to other traffic-related air pollutants, such as BC and nitrogen dioxide (NO2) were also significantly associated with increased PTB risk. Our findings highlight the importance of traffic emission reduction in urban areas.
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Affiliation(s)
- Jiakun Fang
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
| | - Ying Yang
- National Research Institute for Family Planning, Beijing, China; Graduate School of Peking Union Medical College, Beijing, China; National Human Genetic Resources Center, Beijing, China.
| | - Xiaoxuan Zou
- Hadian Maternal and Child Health Hospital, Beijing, China
| | - Hongbing Xu
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
| | - Shuo Wang
- Hadian Maternal and Child Health Hospital, Beijing, China
| | - Rongshan Wu
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China; State Key Laboratory of Environmental Criteria and Risk Assessment, State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Jiajing Jia
- Graduate School of Peking Union Medical College, Beijing, China
| | - Yunfei Xie
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
| | - Haishan Yang
- Graduate School of Peking Union Medical College, Beijing, China
| | - Ningman Yuan
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
| | - Meina Hu
- Graduate School of Peking Union Medical College, Beijing, China
| | - Yuzhi Deng
- Graduate School of Peking Union Medical College, Beijing, China
| | - Yinzhu Zhao
- Graduate School of Peking Union Medical College, Beijing, China
| | - Tong Wang
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
| | - Yutong Zhu
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
| | - Xu Ma
- National Human Genetic Resources Center, Beijing, China; Hadian Maternal and Child Health Hospital, Beijing, China; State Key Laboratory of Environmental Criteria and Risk Assessment, State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Meng Fan
- Aerospace Information Research Institute, Chinese Academy of Sciences, State Key Laboratory of Remote Sensing Science, Beijing, China
| | - Jianbin Wu
- State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry (LAPC), Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, China
| | - Xiaoming Song
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
| | - Wei Huang
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Peking University, Beijing, China.
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Liu WY, Lu JH, He JR, Zhang LF, Wei DM, Wang CR, Xiao X, Xia HM, Qiu X. Combined effects of air pollutants on gestational diabetes mellitus: A prospective cohort study. ENVIRONMENTAL RESEARCH 2022; 204:112393. [PMID: 34798119 DOI: 10.1016/j.envres.2021.112393] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/19/2021] [Accepted: 11/13/2021] [Indexed: 06/13/2023]
Abstract
Exposures to multiple air pollutants during pregnancy have been associated with the risk of gestational diabetes mellitus (GDM). However, their combined effects are unclear. We aimed to evaluate the combined associations of five air pollutants from pre-pregnancy to the 2nd trimester with GDM. This study included 20,113 participants from the Born in Guangzhou Cohort Study (BIGCS). The inverse distance-weighted models were used to estimate individual air pollutant exposure, namely ozone (O3), nitrogen dioxide (NO2), sulfur dioxide (SO2), particulate matter less than 10 μm in diameter (PM10), and less than 2.5 μm in diameter (PM2.5). We estimated stage-specific associations of air pollutants with GDM using generalized estimating equation, and departures from additive joint effects were assessed using the relative excess risk (RERI) and the joint relative risk (JRR). Of the 20,113 participants, 3440 women (17.1%) were diagnosed with GDM. In the adjusted model, increased concentrations of O3 and SO2 3-6 months before pregnancy were associated with GDM occurrence, as well as O3 and PM10 in the 1st trimester, the adjusted relative risk (95% confident intervals) [RRs (95%CI)] ranged from 1.05 (1.00, 1.09) to 1.21 (1.04, 1.40). The largest JRR for GDM was the combination of SO2, NO2, and PM10 in the 1st trimester (JRR = 1.32, 95% CI: 1.10, 1.59). The JRR for O3 and SO2 was less than their additive joint effects [RERI = -0.25 (-0.47, -0.04), P for interaction = 0.048]. Associations of air pollutants with GDM differed somewhat by pre-pregnancy BMI and season. This study added new evidence to the current understanding of the combined effects of multiple air pollutants on GDM. Public health strategies were needed to reduce the adverse effects of air pollution exposure on pregnant women.
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Affiliation(s)
- Wen-Yu Liu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jin-Hua Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jian-Rong He
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Li-Fang Zhang
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Dong-Mei Wei
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Cheng-Rui Wang
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiong Xiao
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hui-Min Xia
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China; Provincial Clinical Research Center for Child Health, Guangdong, China
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Women's Health, Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China; Provincial Clinical Research Center for Child Health, Guangdong, China.
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Mai D, Xu C, Lin W, Yue D, Fu S, Lin J, Yuan L, Zhao Y, Zhai Y, Mai H, Zeng X, Jiang T, Li X, Dai J, You B, Xiao Q, Wei Q, Hu Q. Association of abnormal-glucose tolerance during pregnancy with exposure to PM 2.5 components and sources. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 292:118468. [PMID: 34748887 DOI: 10.1016/j.envpol.2021.118468] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 10/15/2021] [Accepted: 11/03/2021] [Indexed: 06/13/2023]
Abstract
Maternal exposure to PM2.5 has been associated with abnormal glucose tolerance during pregnancy, but little is known about which constituents and sources are most relevant to glycemic effects. We conducted a retrospective cohort study of 1148 pregnant women to investigate associations of PM2.5 chemical components with gestational diabetes mellitus (GDM) and impaired glucose tolerance (IGT) and to identify the most harmful sources in Heshan, China from January 2015 to July 2016. We measured PM2.5 using filter-based method and analyzed them for 28 constituents, including carbonaceous species, water-soluble ions and metal elements. Contributions of PM2.5 sources were assessed by positive matrix factorization (PMF). Logistic regression model was used to estimate composition-specific and source-specific effects on GDM/IGT. Random forest algorithm was applied to evaluate the relative importance of components to GDM and IGT. PM2.5 total mass and several chemical constituents were associated with GDM and IGT across the early to mid-gestation periods, as were the PM2.5 sources fossil fuel/oil combustion, road dust, metal smelting, construction dust, electronic waster, vehicular emissions and industrial emissions. The trimester-specific associations differed among pollutants and sources. The third and highest quartile of elemental carbon, ammonium (NH4+), iron (Fe) and manganese (Mn) across gestation were consistently associated with higher odds of GDM/IGT. Maternal exposures to zinc (Zn), titanium (Ti) and vehicular emissions during the first trimester, and vanadium (V), nickel (Ni), road dust and fossil fuel/oil combustion during the second trimester were more important for GDM/IGT. This study provides important new evidence that maternal exposure to PM2.5 components and sources is significantly related to elevated risk for abnormal glucose tolerance during pregnancy.
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Affiliation(s)
- Dejian Mai
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Chengfang Xu
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, Guangdong, China
| | - Weiwei Lin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.
| | - Dingli Yue
- Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangzhou, 510308, China
| | - Shaojie Fu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Jianqing Lin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Luan Yuan
- Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangzhou, 510308, China
| | - Yan Zhao
- Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangzhou, 510308, China
| | - Yuhong Zhai
- Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangzhou, 510308, China
| | - Huiying Mai
- Department of Obstetrics and Gynecology, Heshan Maternal and Child Health Hospital, Heshan, 529700, Jiangmen, 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
| | - Xuejiao Li
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, Guangdong, China
| | - Jiajia Dai
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Boning You
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Qin Xiao
- Experimental Teaching Center, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Qing Wei
- Experimental Teaching Center, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Qiansheng Hu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
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Sun Y, Li X, Benmarhnia T, Chen JC, Avila C, Sacks DA, Chiu V, Slezak J, Molitor J, Getahun D, Wu J. Exposure to air pollutant mixture and gestational diabetes mellitus in Southern California: Results from electronic health record data of a large pregnancy cohort. ENVIRONMENT INTERNATIONAL 2022; 158:106888. [PMID: 34563749 PMCID: PMC9022440 DOI: 10.1016/j.envint.2021.106888] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/07/2021] [Accepted: 09/17/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND Epidemiological findings are inconsistent regarding the associations between air pollution exposure during pregnancy and gestational diabetes mellitus (GDM). Several limitations exist in previous studies, including potential outcome and exposure misclassification, unassessed confounding, and lack of simultaneous consideration of air pollution mixtures and particulate matter (PM) constituents. OBJECTIVES To assess the association between GDM and maternal residential exposure to air pollution, and the joint effect of the mixture of air pollutants and PM constituents. METHODS Detailed clinical data were obtained for 395,927 pregnancies in southern California (2008-2018) from Kaiser Permanente Southern California (KPSC) electronic health records. GDM diagnosis was based on KPSC laboratory tests. Monthly average concentrations of fine particulate matter < 2.5 μm (PM2.5), <10 μm (PM10), nitrogen dioxide (NO2), and ozone (O3) were estimated using kriging interpolation of Environmental Protection Agency's routine monitoring station data, while PM2.5 constituents (i.e., sulfate, nitrate, ammonium, organic matter and black carbon) were estimated using a fine-resolution geoscience-derived model. A multilevel logistic regression was used to fit single-pollutant models; quantile g-computation approach was applied to estimate the joint effect of air pollution and PM component mixtures. Main analyses adjusted for maternal age, race/ethnicity, education, median family household income, pre-pregnancy BMI, smoking during pregnancy, insurance type, season of conception and year of delivery. RESULTS The incidence of GDM was 10.9% in the study population. In single-pollutant models, we observed an increased odds for GDM associated with exposures to PM2.5, PM10, NO2 and PM2.5 constituents. The association was strongest for NO2 [adjusted odds ratio (OR) per interquartile range: 1.176, 95% confidence interval (CI): 1.147-1.205)]. In multi-pollutant models, increased ORs for GDM in association with one quartile increase in air pollution mixtures were found for both kriging-based regional air pollutants (NO2, PM2.5, and PM10, OR = 1.095, 95% CI: 1.082-1.108) and PM2.5 constituents (i.e., sulfate, nitrate, ammonium, organic matter and black carbon, OR = 1.258, 95% CI: 1.206-1.314); NO2 (78%) and black carbon (48%) contributed the most to the overall mixture effects among all krigged air pollutants and all PM2.5 constituents, respectively. The risk of GDM associated with air pollution exposure were significantly higher among Hispanic mothers, and overweight/obese mothers. CONCLUSION This study found that exposure to a mixture of ambient PM2.5, PM10, NO2, and PM2.5 chemical constituents was associated with an increased risk of GDM. NO2 and black carbon PM2.5 contributed most to GDM risk.
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Affiliation(s)
- Yi Sun
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA
| | - Xia Li
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health and Scripps Institution of Oceanography, University of California, San Diego, 9500 Gilman Drive #0725, CA La Jolla 92093, USA
| | - Jiu-Chiuan Chen
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Chantal Avila
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - David A Sacks
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA; Department of Obstetrics and Gynecology, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Vicki Chiu
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Jeff Slezak
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - John Molitor
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR 97331, USA
| | - Darios Getahun
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA.
| | - Jun Wu
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA.
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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.
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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,
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Yu Y, Jerrett M, Paul KC, Su J, Shih IF, Wu J, Lee E, Inoue K, Haan M, Ritz B. Ozone Exposure, Outdoor Physical Activity, and Incident Type 2 Diabetes in the SALSA Cohort of Older Mexican Americans. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:97004. [PMID: 34494856 PMCID: PMC8425281 DOI: 10.1289/ehp8620] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 05/28/2023]
Abstract
BACKGROUND Type 2 diabetes is a leading contributor to the global burden of morbidity and mortality. Ozone (O3) exposure has previously been linked to diabetes. OBJECTIVE We studied the impact of O3 exposure on incident diabetes risk in elderly Mexican Americans and investigated whether outdoor physical activity modifies the association. METHODS We selected 1,090 Mexican American participants from the Sacramento Area Latino Study on Aging conducted from 1998 to 2007. Ambient O3 exposure levels were modeled with a land-use regression built with saturation monitoring data collected at 49 sites across the Sacramento metropolitan area. Using Cox proportional hazard models, we estimated the risk of developing incident diabetes based on average O3 exposure modeled for 5-y prior to incident diabetes diagnosis or last follow-up. Further, we estimated outdoor leisure-time physical activity at baseline and investigated whether higher vs. lower levels modified the association between O3 exposure and diabetes. RESULTS In total, 186 incident diabetes cases were identified during 10-y follow-up. Higher levels of physical activity were negatively associated with incident diabetes [hazard ratio (HR)=0.64 (95% CI: 0.43, 0.95)]. The estimated HRs for incident diabetes was 1.13 (95% CI: 1.00, 1.28) per 10-ppb increment of 5-y average O3 exposure; also, this association was stronger among those physically active outdoors [HR=1.52 (95% CI: 1.21, 1.90)], and close to null for those reporting lower levels of outdoor activity [HR=1.04 (95% CI: 0.90, 1.20), pinteraction=0.01]. CONCLUSIONS Our findings suggest that ambient O3 exposure contributes to the development of type 2 diabetes, particularly among those with higher levels of leisure-time outdoor physical activity. Policies and strategies are needed to reduce O3 exposure to guarantee that the health benefits of physical activity are not diminished by higher levels of O3 pollution in susceptible populations such as older Hispanics. https://doi.org/10.1289/EHP8620.
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Affiliation(s)
- Yu Yu
- Department of Epidemiology, University of California at Los Angeles (UCLA) Fielding School of Public Health, Los Angeles, California, USA
- Department of Environmental Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Michael Jerrett
- Department of Environmental Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Kimberly C. Paul
- Department of Epidemiology, University of California at Los Angeles (UCLA) Fielding School of Public Health, Los Angeles, California, USA
| | - Jason Su
- Division of Environmental Health Sciences, University of California, Berkley School of Public Health, Berkeley, California, USA
| | - I-Fan Shih
- Department of Epidemiology, University of California at Los Angeles (UCLA) Fielding School of Public Health, Los Angeles, California, USA
| | - Jun Wu
- Department of Environmental and Occupational Health, Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, Irvine, California, USA
| | - Eunice Lee
- Department of Environmental Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Kosuke Inoue
- Department of Epidemiology, University of California at Los Angeles (UCLA) Fielding School of Public Health, Los Angeles, California, USA
| | - Mary Haan
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Beate Ritz
- Department of Epidemiology, University of California at Los Angeles (UCLA) Fielding School of Public Health, Los Angeles, California, USA
- Department of Environmental Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA
- Department of Neurology, UCLA David Geffen School of Medicine, Los Angeles, California, USA
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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.
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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.
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Kim JH, Choi YY, Yoo SI, Kang DR. Association between ambient air pollution and high-risk pregnancy: A 2015-2018 national population-based cohort study in Korea. ENVIRONMENTAL RESEARCH 2021; 197:110965. [PMID: 33722528 DOI: 10.1016/j.envres.2021.110965] [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: 11/30/2020] [Revised: 02/26/2021] [Accepted: 02/27/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Several studies have indicated that prenatal exposure to ambient air pollution is associated with an increased risk of gestational diabetes mellitus, hypertensive disorder during pregnancy, preterm birth, and stillbirth. However, no previous study has focused on the association between the number of pregnancy complications and exposure to ambient air pollution. OBJECTIVES To investigate the association between prenatal exposure to ambient air pollutants and the number of pregnancy complications in high-risk pregnancies. METHODS We collected data on gestational diabetes mellitus, hypertensive disorder during pregnancy, preterm birth, and stillbirth from the National Health Information Databases, provided by the Korean National Health Insurance Service.R To assess individual-level exposure to air pollutants, a spatial prediction model and area-averaging approach were used. RESULTS From 2015 to 2018, data of 789,595 high-risk pregnancies were analyzed. The ratio of gestational diabetes mellitus in the country was the highest, followed by preterm birth, hypertensive disorder during pregnancy, and stillbirth. Approximately 71.7% of pregnant women (566,143) presented with one pregnancy complication in identical pregnancies, 27.5% (216,714) presented with two, and 0.9% (6738) presented with three or more. Multiple logistic regression models with adjustments for age, residence, and income variables indicated that the risk of having two or more pregnancy complications was positively associated with the exposure to higher levels of PM10 (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.09-1.12) and PM2.5 (OR, 1.14; 95% CI, 1.12-1.15). The highest quartile presented higher odds of two or more pregnancy complications compared with the lower three quartiles of PM10, PM2.5, CO, NO2, and SO2 exposures (p < 0.001). CONCLUSION The results indicate that the risk of pregnancy complications is positively associated with the exposure to the high concentrations of PM10, PM2.5, CO, NO2, and SO2.
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Affiliation(s)
- Ju Hee Kim
- Department of Nursing, College of Nursing Science, Kyung Hee University, Seoul, 02447, Republic of Korea.
| | - Yoon Young Choi
- Artificial Intelligence Big Data Medical Center, Wonju College of Medicine, Yonsei University, Wonju, 26426, Republic of Korea
| | - Soo-In Yoo
- Department of Nursing, College of Nursing Science, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Dae Ryong Kang
- Department of Precision Medicine, Wonju College of Medicine, Yonsei University, Wonju, 26426, Republic of Korea.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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Rammah A, Whitworth KW, Symanski E. Particle air pollution and gestational diabetes mellitus in Houston, Texas. ENVIRONMENTAL RESEARCH 2020; 190:109988. [PMID: 32745750 DOI: 10.1016/j.envres.2020.109988] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/17/2020] [Accepted: 07/20/2020] [Indexed: 05/05/2023]
Abstract
BACKGROUND There is mixed evidence implicating prenatal exposure to particulate matter <2.5 μm in aerodynamic diameter (PM2.5) in the risk of gestational diabetes mellitus (GDM) and only one study has examined exposure to PM2.5 constituents, which vary with location because of different emission sources. METHODS We conducted a retrospective cohort study of singleton live births in Harris County, Texas from 2008 to 2013. With data from the Texas Commission on Environmental Quality (TCEQ), we spatially interpolated maternal exposures to total and speciated PM2.5, nitrogen dioxide (NO2) and ozone (O3) over the 12-week preconception period and trimesters 1 and 2. We estimated odds ratios (OR) and 95% confidence intervals (CI) for the association between pre-conception and pregnancy exposures to total and speciated PM2.5 and odds of GDM, adjusted for temperature and maternal covariates. We also evaluated confounding from NO2 and O3 exposures in multi-pollutant models. RESULTS An interquartile range (IQR) increase in total PM2.5 exposure was associated with elevated odds for developing GDM over the preconception (adjusted OR = 1.09, 95% CI: 1.06, 1.12), first trimester (OR = 1.13, 95% CI: 1.10, 1.17) and second trimester (OR = 1.13, 95% CI: 1.09, 1.17) periods. Effect estimates increased with adjustment for NO2 and O3. We observed modest increases in odds of GDM for IQR increases in first trimester ammonium ion PM2.5 (OR = 1.03, 95% CI: 1.00, 1.05) and sulfate PM2.5 (OR = 1.03, 95% CI: 1.00, 1.05) exposures, as well as preconception Cr PM2.5 exposures (OR = 1.05, 95% CI: 1.02, 1.07). CONCLUSION Exposures to PM2.5, before and during pregnancy were associated with elevated odds of GDM. Mitigating air pollution exposures may reduce the risk of GDM and its long-term implications for maternal and child health.
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Affiliation(s)
- Amal Rammah
- Center for Precision Environmental Health, Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Kristina W Whitworth
- Center for Precision Environmental Health, Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Elaine Symanski
- Center for Precision Environmental Health, Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, USA.
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Qu Y, Yang B, Lin S, Bloom MS, Nie Z, Ou Y, Mai J, Wu Y, Gao X, Dong G, Liu X. Associations of greenness with gestational diabetes mellitus: The Guangdong Registry of Congenital Heart Disease (GRCHD) study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 266:115127. [PMID: 32650202 DOI: 10.1016/j.envpol.2020.115127] [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: 12/04/2019] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 06/11/2023]
Abstract
Gestational diabetes mellitus (GDM) is associated with adverse short- and long-term health outcomes among mothers and their offspring. GDM affects 0.6%-15% of pregnancies worldwide and its incidence is increasing. However, intervention strategies are lacking for GDM. Previous studies indicated a protective association between greenspace and type 2 diabetes mellitus (T2DM), while few studies have explored the association between greenness and GDM. This study aimed to investigate the association between residential greenness and GDM among women from 40 clinical centers in Guangdong province, south China. The study population comprised 5237 pregnant mothers of fetuses and infants without birth defects, from 2004 to 2016. There were n = 157 diagnosed with GDM according to World Health Organization criteria. We estimated residential greenness using the Normalized Difference Vegetation Index (NDVI), derived from satellite imagery using a spatial-statistical model. Associations between greenness during pregnancy and GDM were assessed by confounder-adjusted random effects log-binomial regression models, with participating centers as the random effect. One interquartile increments of NDVI250m, NDVI500m and NDVI1000m were associated with 13% (RR = 0.87, 95%CI: 0.87-0.87), 8% (RR = 0.92, 95%CI: 0.91-0.92) and 3% (RR = 0.97, 95%CI: 0.97-0.97) lower risks for GDM, respectively. However, NDVI3000m was not significantly associated with GDM (RR = 0.96, 95%CI: 0.78-1.19). The risk for GDM decreased monotonically with greater NDVI. The protective effect of greenness on GDM was stronger among women with lower socioeconomic status and in environments with a lower level air pollutants. Our results suggest that greenness might provide an effective intervention to decrease GDM. Greenness and residential proximity to greenspace should be considered in community planning to improve maternal health outcomes.
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Affiliation(s)
- Yanji Qu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, China
| | - Boyi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Shao Lin
- Department of Environmental Health Sciences, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY, 12144, USA; Department of Epidemiology and Biostatistics, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY, 12144, USA
| | - Michael S Bloom
- Department of Environmental Health Sciences, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY, 12144, USA; Department of Epidemiology and Biostatistics, University at Albany, State University of New York, One University Place, Rensselaer, Albany, NY, 12144, USA
| | - Zhiqiang Nie
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, China
| | - Yanqiu Ou
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, China
| | - Jinzhuang Mai
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, China
| | - Yong Wu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, China
| | - Xiangmin Gao
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, China
| | - Guanghui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Xiaoqing Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, Guangdong, China.
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