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Cord plasma insulin and in utero exposure to ambient air pollution
Narjes Madhloum1, Bram G Janssen1, Dries S Martens1
1Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium.
Insights
Exposure to particulate air pollution during pregnancy, specifically fine particulate matter (PM2.5), is linked to higher insulin levels in newborns. This early-life exposure may increase the risk of developing metabolic diseases like type 2 diabetes later in life.
Area of Science:
- Environmental Health
- Pediatrics
- Endocrinology
Background:
- Cardio-metabolic risk factors, including insulin levels, can originate in early childhood.
- Exposure to air pollution has been linked to increased insulin resistance in children.
- Early life insulin levels may serve as a marker for future metabolic disease risk.
Purpose of the Study:
- To investigate the association between prenatal exposure to air pollution and cord plasma insulin levels in newborns.
- To determine if early childhood insulin levels are linked to the origins of type 2 diabetes.
Main Methods:
- Utilized the ENVIRONAGE birth cohort (620 mother-infant pairs).
- Analyzed cord plasma insulin levels in 590 newborns.
- Estimated exposure to particulate matter (PM2.5, PM10) and nitrogen dioxide (NO2) during pregnancy using a spatiotemporal model.
Main Results:
- Cord plasma insulin levels increased by 15.8% for each standard deviation increment in PM2.5 exposure during pregnancy.
- The association was most pronounced during the second trimester of pregnancy.
- No significant association was found between cord blood insulin levels and NO2 exposure.
Conclusions:
- Prenatal exposure to particulate air pollution is associated with elevated cord plasma insulin levels at birth.
- These findings suggest that air pollution may be a risk factor for metabolic diseases like type 2 diabetes later in life.
- Early-life insulin changes due to air pollution highlight a potential public health concern.
Introduction:
Cardio-metabolic risk factors including insulin levels are at young age barely perceived as harmful, but over time these risk factors may track and lead to higher risk of metabolic syndrome. Studies showed that exposure to air pollution is associated with an increased risk of insulin resistance in childhood. We determined whether the origin of type 2 diabetes can be found in the early childhood by examining the levels of insulin in the neonatal cord blood and whether this can be considered as a disease marker for later life.
Methods:
In the ENVIRONAGE (ENVIRonmental influence ON early AGEing) birth cohort, we recruited 620 mother-infant pairs between February 2nd 2010 until August 12th 2014 at the East-Limburg Hospital in Genk, Belgium. We investigated in 590 newborns the association between cord plasma insulin levels and exposure to particulate matter (PM2.5 and PM10) and nitrogen dioxide (NO2) in various exposure windows during pregnancy. Trimester-specific air pollutant exposure levels were estimated for each mother's home address using a spatiotemporal model.
Results:
Cord plasma insulin levels averaged 33.1pmol/L (25-75th percentile: 20.1-53.5), while PM2.5 exposure during pregnancy averaged (SD) 13.7μg/m3 (2.4). Independent of maternal age, newborn's sex, birth weight, gestational age, parity, early-pregnancy BMI, ethnicity, smoking status, time of the day, maternal education, time of delivery, and season of delivery, cord plasma insulin levels increased with 15.8% (95% CI 7.8 to 24.4, p<0.0001) for each SD increment in PM2.5 levels during the entire pregnancy and was most pronounced in the 2nd trimester (13.1%, 95% CI 3.4 to 23.7, p=0.007) of pregnancy. The results for PM10 exposure were similar with those of PM2.5 exposure but we did not observe an association between cord blood insulin levels and NO2 exposure.
Conclusions:
Exposure to particulate air pollution during pregnancy is associated with increased levels of cord plasma insulin at birth. The public health relevance of this association is demonstrated by the fact that a 2.4μg/m3 (SD) increase in PM2.5 during pregnancy on cord plasma insulin levels corresponds to the effect-size of a 9kg/m2 higher early-pregnancy BMI on cord plasma. Particulate air pollution induced changes in cord plasma insulin levels during early life and might be a risk factor in the development of metabolic disease, such as glucose intolerance or type 2 diabetes, later in life.
