怀孕期间暴露于低水平空气污染和高血糖标记物:一次重复测量分析
Yan Lin1, Ruoxue Chen1, Yihui Ge1
1Nicholas School of the Environment & Duke Global Health Institute, Duke University, Durham, North Carolina 27708, United States.
Environmental science & technology
|August 27, 2024
概括
暴露于空气污染,特别是二氧化 (NO2),与孕妇血糖水平 (HbA1c) 的上升有关. 这种联系甚至在低污染水平和没有先前存在糖尿病风险因素的人中也存在.
科学领域:
- 环境健康 环境健康
- 生殖健康 生殖健康
- 内分泌学 在内分泌学.
背景情况:
- 流行病学研究表明,空气污染暴露与妊娠期糖尿病 (GDM) 风险增加之间存在联系.
- 由HbA1c水平表明的亚临床高血糖是GDM的潜在前体.
- 了解低水平空气污染对怀孕健康的影响对于公共卫生至关重要.
研究的目的:
- 调查暴露于环境空气污染物 (PM2.5和NO2) 和HbA1c水平在没有怀孕前糖尿病的孕妇中之间的关联.
- 确定孕期暴露于可能影响血糖控制的空气污染的关键窗口.
- 评估这些关联是否存在于医学上低风险怀孕人群中.
主要方法:
- 在纽约罗切斯特224名孕妇的577个样本中多次测量HbA1c.
- 使用高分辨率的时空模型,估计居民对PM2.5和NO2的暴露.
- 利用分布式滞后模型分析空气污染暴露与HbA1c之间的关系,根据怀孕阶段和风险因素进行调整.
主要成果:
- 在怀孕期间观察到HbA1c的U形轨迹 (早期:5.13%,中期:4.97%,晚期:5.43%).
- 10周NO2度 (8.0ppb) 的每个四分位数间范围增加与整体妊娠HbA1c增加0.09%和妊娠后期HbA1c增加0.18%有关.
- 在怀孕第8周到第14周之间的临界暴露窗口被确定为妊娠后期增加的HbA1c水平.
结论:
- 对环境二氧化 (NO2) 的低水平暴露与医学上低风险的孕妇的HbA1c水平增加有关.
- 这些发现表明,空气污染可能导致怀孕期间的亚临床高血糖症,独立于传统的GDM危险因素.
- 在关键的早期到中期怀孕窗口期间,有针对性的干预措施或公共卫生建议可以减轻空气污染的不良血糖影响.
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