Relationship betweentemporal distribution of air pollution exposure and glucose homeostasis during pregnancy

Mengnan Yao; Yang Liu; Dan Jin; Wanjun Yin; Shuangshuang Ma; Ruixue Tao; Fangbiao Tao; Peng Zhu

doi:10.1016/j.envres.2020.109456

Relationship betweentemporal distribution of air pollution exposure and glucose homeostasis during pregnancy

Environ Res. 2020 Jun:185:109456. doi: 10.1016/j.envres.2020.109456. Epub 2020 Apr 3.

Authors

Mengnan Yao¹, Yang Liu², Dan Jin³, Wanjun Yin³, Shuangshuang Ma³, Ruixue Tao⁴, Fangbiao Tao², Peng Zhu⁵

Affiliations

¹ Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China. Electronic address: ymnan1001@126.com.
² Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.
³ Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.
⁴ Department of Gynecology and Obstetrics, Hefei First People's Hospital, Hefei, China.
⁵ Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China. Electronic address: pengzhu@ahmu.edu.cn.

PMID: 32278159
DOI: 10.1016/j.envres.2020.109456

Abstract

Background: Mounting evidence has demonstrated that air pollution exposure is associated with the increased prevalence of gestational diabetes mellitus (GDM). However, the long-term exposure effect and the time window of the maximum effect of these air pollutants on GDM and glucose homeostasis during pregnancy are unclear.

Methods: We conducted this study on 5427 nondiabetic pregnant women who were admitted from three hospitals in Hefei City, China, between 2015 and 2018. The data regarding the average exposure to particulate matter (PM), sulfur dioxide (SO₂), and ozone (O₃) were estimated in a fixed monitoring station in Hefei. We used logistic regression and multiple linear regression to assess the effects of air pollutants on GDM and glucose homeostasis.

Results: Of the 5427 participants, 1119 (20.6%) had GDM. We found prepregnancy exposure to air pollutants was associated with the risk of GDM in the single pollutant model [odds and 95% confidence interval (CI) of GDM for an interquartile range (IQR) increase was 1.24 (1.06-1.45) for PM_2.5, 1.42 (1.26-1.59) for PM₁₀, 1.21 (1.10-1.33) for SO₂ and1.19 (1.08-1.31) for O₃]. The risk of GDM before pregnancy was higher with long-term exposure to high-concentration pollutants compared with the risk in pregnant women who were not exposed to high-concentration pollutants (χ² = 41.52, p for trend <0.0001); the ORs and 95% CI values for the exposure times of 1, 2, and 3 months were 1.28 (0.96-1.72), 1.52 (1.06-2.19), and 1.69 (1.11-2.57), respectively. The results showed a positive effect of exposure to higher-concentration air pollutants 1 year before pregnancy on glucose homeostasis during pregnancy. The time windows of the maximum effect of PM_2.5, PM₁₀, SO₂, and O₃ on GDM were different. The time windows of the maximum effect of PM_2.5, PM₁₀, and SO₂ were 6 months, 5 months, and 1 month before the last menstrual period (LMP) and 3 months after the LMP, respectively. The time windows of the maximum effect of air pollution on glucose homeostasis indicators from the 2-h 75-g oral glucose tolerance test were similar to the abovementioned results.

Conclusions: Prepregnancy long-term air pollution exposure was associated with a higher risk of developing GDM by affecting glucose metabolism. The time window of the maximum effect of PM on GDM and glucose metabolism indicators was observed earlier than that of SO₂ and O₃.

Keywords: Glucose homeostasis; O(3); PM(2.5); Pregnancy; SO(2).

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Air Pollutants* / analysis
Air Pollutants* / toxicity
Air Pollution* / adverse effects
Air Pollution* / analysis
China / epidemiology
Cities
Diabetes, Gestational* / chemically induced
Female
Glucose
Homeostasis
Humans
Particulate Matter / analysis
Particulate Matter / toxicity
Pregnancy

Substances

Air Pollutants
Particulate Matter
Glucose