Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Obstetrics and Gynecology, College of Medicine, Ewha Medical Research Institute, Ewha Womans University Mokdong Hospital, Seoul, Korea.
Environ Sci Pollut Res Int. 2023 Dec;30(59):123893-123906. doi: 10.1007/s11356-023-30921-x. Epub 2023 Nov 23.
We examined the association between exposure to PM, focused on individual exposure level, and metabolic dysfunction during pregnancy. APPO study (Air Pollution on Pregnancy Outcome) was a prospective, multicenter, observational cohort study conducted from January 2021 to March 2023. Individual PM concentrations were calculated using a time-weighted average model. Metabolic dysfunction during pregnancy was assessed based on a modified definition of metabolic syndrome and its components, accounting for pregnancy-specific criteria. Exposure to PM during pregnancy was associated with worsened metabolic parameters especially glucose metabolism. In comparison to participants exposed to the low PM group, those exposed to high PM levels exhibited increased odds of gestational diabetes mellitus (GDM) after adjusting for confounding variables in different adjusted models. Specifically, in model 1, the adjusted odds ratio (aOR) was 3.117 with a 95% confidence interval (CI) of 1.234-7.870; in model 2, the aOR was 3.855 with a 95% CI of 1.255-11.844; in model 3, the aOR was 3.404 with a 95% CI of 1.206-9.607; and in model 4, the aOR was 2.741 with a 95% CI of 0.712-10.547. Exposure to higher levels of PM during pregnancy was associated with a tendency to worsen metabolic dysfunction markers specifically in glucose homeostasis. Further research is needed to investigate the mechanisms underlying the effects of ambient PM on metabolic dysfunction during pregnancy.
我们研究了怀孕期间个体暴露水平与代谢功能障碍之间的关系。APPO 研究（妊娠结局与空气污染研究）是一项前瞻性、多中心、观察性队列研究，于 2021 年 1 月至 2023 年 3 月进行。个体 PM 浓度使用时间加权平均模型进行计算。代谢功能障碍在怀孕期间的评估基于代谢综合征及其组分的改良定义，并考虑了妊娠特有的标准。怀孕期间接触 PM 与代谢参数恶化尤其葡萄糖代谢恶化有关。与暴露于低 PM 组的参与者相比，在校正不同调整模型中的混杂变量后，暴露于高 PM 水平的参与者发生妊娠期糖尿病（GDM）的几率增加。具体而言，在模型 1 中，调整后的优势比（aOR）为 3.117，95%置信区间（CI）为 1.234-7.870；在模型 2 中，aOR 为 3.855，95%CI 为 1.255-11.844；在模型 3 中，aOR 为 3.404，95%CI 为 1.206-9.607；在模型 4 中，aOR 为 2.741，95%CI 为 0.712-10.547。怀孕期间接触较高水平的 PM 与代谢功能障碍标志物恶化的趋势有关，尤其是葡萄糖稳态。需要进一步研究以探讨环境 PM 对怀孕期间代谢功能障碍影响的机制。
