产前空气污染暴露与新生儿脐血C肽的关联研究  

Association between prenatal air pollution exposure and neonatal cord blood C-peptide

作　　者：罗薇 张磊 江楠 许敏 许继荣 卞景凤 朱鹏[1] LUO Wei;ZHANG Lei;JIANG Nan;XU Min;XU Jirong;BIAN Jingfeng;ZHU Peng(Department of Maternal,Child&Adolescent Health,School of Public Health,Anhui Medical University,Key Laboratory of Health Education of Birth Population,Anhui Key Laboratory of Population Health and Aristogenics,Anhui Hefei 230032,China)

机构地区：[1]安徽医科大学公共卫生学院儿少卫生与妇幼保健学系,出生人口健康教育部重点实验室,人口健康与优生安徽省重点实验室,安徽合肥230032

出　　处：《中国妇幼健康研究》2023年第4期40-46,共7页Chinese Journal of Woman and Child Health Research

基　　金：国家自然科学基金(81872631、82173531);国家重点研发计划(2022YFC2702901);安徽医科大学科研提升计划(2021xkjT009)。

摘　　要：目的探讨孕妇产前空气污染物暴露与新生儿脐血C肽水平及高胰岛素血症风险的关系。方法选取2015年3月至2020年2月在合肥市3家医院招募并符合纳入排除标准的3322对母婴为研究对象,收集孕妇一般人口学特征、孕期健康状况和行为生活方式等资料,并从合肥市生态环境局官方网站获得产前PM_(2.5)、PM_(10)、CO、SO_(2)四种空气污染物的暴露水平。随访至分娩获得胎儿脐血C肽和新生儿信息,分别采用多因素线性回归和Logistic回归分析产前空气污染暴露与胎儿脐血C肽水平及高胰岛素血症的关系。结果脐血C肽平均浓度为(0.40±0.26)nmol/L。在调整了潜在混杂因素后,多因素线性回归分析显示,整个孕期空气污染物PM_(2.5)、PM_(10)、CO、SO_(2)暴露与脐血C肽水平呈正相关;以<P_(25)暴露水平为参照,整个孕期四种空气污染物≥P_(75)组的脐血C肽浓度分别增加22.3%、30.1%、28.0%和29.2%。多因素Logistic回归分析显示,PM_(2.5)、PM_(10)、CO和SO_(2)日均暴露浓度每增加10μg/m^(3)、10μg/m^(3)、0.1mg/m^(3)和1μg/m^(3),新生儿高胰岛素血症风险分别增加63%(RR=1.63,95%CI:1.43~1.86)、72%(RR=1.72,95%CI:1.52~1.95)、72%(RR=1.72,95%CI:1.52~1.94)和21%(RR=1.21,95%CI:1.17~1.26)。分层分析显示,无论孕妇是否存在GDM或孕前超重/肥胖,四种空气污染物暴露均与新生儿高胰岛素血症风险增加显著关联。结论产前空气污染物暴露与脐血C肽水平升高及新生儿高胰岛素血症风险增加有关,且这种关联独立于GDM或孕前超重/肥胖。Objective To study the relationship between air pollutants exposure during pregnancy and neonatal cord blood C-peptide level and the risk of hyperinsulinemia.Methods From March 2015 to February 2020,3 322 mother-to-child couples who were recruited in three hospitals in Hefei, Anhui province, China and met the inclusion and exclusion standards were selected as the research objects.Information on the general demographic characteristics, life behavior style and health status during pregnancy were collected, and prenatal exposure levels of PM2.5,PM10,CO and SO2were achieved from the official website of Hefei Ecological Environment Bureau.The research objects were followed up until the cord blood C-peptide level and neonatal birth information were obtained.Multivariate linear regression and Logistic regression were applied to analyze the relevance between air pollutants exposure and C-peptide level and the risk of hyperinsulinemia, respectively.Results The mean concentration of cord blood C-peptide was(0.40 ± 0.26) nmol/L.After adjusting the potential confounding factors, multivariate linear regression model results showed that the exposure of air pollutants PM2.5,PM10,CO and SO2during the whole pregnancy was positively correlated with the level of cord blood C-peptide.Compared with the air pollutants exposure level of25,the cord blood C-peptide′s concentration in the four air pollutants ≥P75group increased by 22.3%,30.1%,28.0% and 29.2%,respectively.Multivariate Logistic regression analysis showed that for each increase of 10μg/m~3,10μg/m~3,0.1mg/m~3and 1μg/m~3 of air pollutant PM2.5,PM10,CO and SO2,the increased risk of the neonatal hyperinsulinemia were 63%(RR=1.63,95%CI:1.43-1.86),72%(RR=1.72,95%CI:1.52-1.95),72%(RR=1.72,95%CI:1.52-1.94) and 21%(RR=1.21,95%CI:1.17-1.26),respectively.Stratified analysis showed that whether a pregnant woman was with GDM or pre-pregnancy overweight/obesity or not, prenatal air pollutant exposure was significantly associated with the increase of the risk of neonatal hyperinsul

关 键 词：空气污染 脐血C肽 前瞻性队列研究 产前 新生儿高胰岛素血症 

分 类 号：R174[医药卫生—妇幼卫生保健]