Abstract
BackgroundExposure 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.MethodsOur 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.ResultsAn 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.ConclusionsExposure 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.
Highlights
Exposure to ionizing radiation has been associated with insulin resistance and type 2 diabetes
Eight participants had a glucose level above 140 mg/dL, one standard glucose challenge test (GCT) clinical cut-off for additional gestational diabetes mellitus (GDM) screening [38], and one participant was later diagnosed with GDM
Each exposure window of particulate matter (PM) gross βactivity that we examined followed the same overall pattern of higher pregnancy glucose levels with higher exposure, average exposure to PM gross β-activity over the second trimester was observed to have a larger magnitude of increase in glucose concentration than smaller exposure windows
Summary
Exposure to ionizing radiation has been associated with insulin resistance and type 2 diabetes. In addition to an increased risk of type 2 diabetes, GDM confers an increased risk of long-term adverse outcomes for offspring after delivery, including obesity and carbohydrate intolerance that can lead to increases in metabolic syndrome and cardiac disease in adult life [8]. These adverse outcomes are linked to elevated pregnancy glucose levels that do not meet the clinical threshold for gestational diabetes [9]. As such, identifying modifiable risk factors that reduce elevated pregnancy glucose levels is of great importance
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