颗粒物成分与妊娠期糖尿病的发病:确定易感暴露窗口

PM Constituents and Onset of Gestational Diabetes Mellitus: Identifying Susceptible Exposure Windows.

作者信息

Zheng Yi, Bian Jiang, Hart Jaime, Laden Francine, Soo-Tung Wen Tony, Zhao Jinying, Qin Huaizhen, Hu Hui

机构信息

Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.

Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA.

出版信息

Atmos Environ (1994). 2022 Dec 15;291. doi: 10.1016/j.atmosenv.2022.119409. Epub 2022 Sep 29.

Abstract

Fine particulate matter (PM) has been linked to gestational diabetes mellitus (GDM). However, PM is a complex mixture with large spatiotemporal heterogeneities, and women with early-onset GDM (i.e., diagnosed before 24 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 24 gestation week). We aimed to examine differential impacts of PM 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 PM and its constituents (i.e., sulfate [SO ], ammonium [NH ], nitrate [NO ], 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 PM and its constituents with GDM and its onsets. Distributed non-linear lag models were implemented to identify susceptible exposure windows. Exposures to PM, SO , NH , and BC were statistically significantly associated with higher hazards of GDM. Exposures to PM during weeks 1-12 of gestation were positively associated with GDM. Associations of early-onset GDM with PM in the 1 and 2 trimesters, SO in the 1 and 2 trimesters, and NO in the preconception and 1 trimester were considerably stronger than observations for late-onset GDM. Our findings suggest there are differential associations of PM 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.

摘要

细颗粒物(PM)与妊娠期糖尿病(GDM)有关。然而,PM是一种具有较大时空异质性的复杂混合物,与晚发型GDM(即妊娠24周及以后诊断)的女性相比,早发型GDM(即妊娠24周前诊断)的女性具有不同的母体特征,且健康结局较差的风险更高。我们旨在研究PM及其成分对早发型与晚发型GDM的不同影响,并确定相应的易感暴露窗口。我们利用了2012 - 2017年佛罗里达州全州范围内关联的电子健康记录和出生记录数据。根据孕妇的居住史,将PM及其成分(即硫酸盐[SO]、铵[NH]、硝酸盐[NO]、有机物[OM]、黑碳[BC]、矿物粉尘[DUST]和海盐[SS])的暴露在时空上与孕妇进行关联。使用Cox比例风险模型和多项逻辑回归来研究PM及其成分与GDM及其发病的关联。实施分布式非线性滞后模型以确定易感暴露窗口。PM、SO、NH和BC的暴露与GDM的较高风险在统计学上显著相关。妊娠第1 - 12周期间PM的暴露与GDM呈正相关。早发型GDM与孕早期和孕中期的PM、孕早期和孕中期的SO以及孕前和孕早期的NO的关联比晚发型GDM的观察结果要强得多。我们的研究结果表明,PM及其成分与早发型和晚发型GDM存在不同的关联,且有不同的易感暴露窗口。这项研究有助于更好地理解空气污染对GDM的影响,并考虑到其生理异质性。

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