Ambient PM gross β-activity and glucose levels during pregnancy

Veronica A. Wang1, Tamarra James-Todd1,2, Michele R. Hacker3,2, Karen E. O’Brien3, Blair J. Wylie3, Russ Hauser2,1, Paige L. Williams2,4, Andrea Bellavia4,1, Marlee Quinn1, Thomas F. McElrath5, Stefania Papatheodorou6,2
1Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA
2Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
3Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
4Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, USA
5Division of Maternal-Fetal Medicine, Brigham & Women’s Hospital, Harvard Medical School, Boston, USA
6Harvard T.H. Chan School of Public Health, Boston, USA

Tóm tắt

Exposure to ionizing radiation has been associated with insulin resistance and type 2 diabetes. In light of recent work showing an association between ambient particulate matter (PM) gross β-activity and gestational diabetes mellitus (GDM) among pregnant women, we examined pregnancy glucose levels in relation to PM gross β-activity to better understand this pathway. Our study included 103 participants receiving prenatal care at Beth Israel Deaconess Medical Center in Boston, MA. PM gross β-activity was obtained from US Environmental Protection Agency’s RadNet program monitors, and blood glucose levels were obtained from the non-fasting glucose challenge test performed clinically as the first step of the 2-step GDM screening test. For each exposure window we examined (i.e., moving average same-day, one-week, first-trimester, and second-trimester PM gross β-activity), we fitted generalized additive models and adjusted for clinical characteristics, socio-demographic factors, temporal variables, and PM with an aerodynamic diameter ≤ 2.5 μm (PM2.5). Subgroup analyses by maternal age and by body mass index were also conducted. An interquartile range increase in average PM gross β-activity during the second trimester of pregnancy was associated with an increase of 17.5 (95% CI: 0.8, 34.3) mg/dL in glucose concentration. Associations were stronger among younger and overweight/obese participants. Our findings also suggest that the highest compared to the lowest quartile of one-week exposure was associated with 17.0 (95% CI: − 4.0, 38.0) mg/dL higher glucose levels. No associations of glucose were observed with PM gross β-activity during same-day and first-trimester exposure windows. PM2.5 was not associated with glucose levels during any exposure window in our data. Exposure to higher levels of ambient PM gross β-activity was associated with higher blood glucose levels in pregnant patients, with implications for how this novel environmental factor could impact pregnancy health.

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