妊娠期夜间暴露于室外人造光与葡萄糖稳态的关系:一项前瞻性队列研究

Association between exposure to outdoor artificial light at night during pregnancy and glucose homeostasis: A prospective cohort study

妊娠期夜间暴露于室外人造光与葡萄糖稳态的关系:一项前瞻性队列研究

Authors：Zhang L, Wang H, Zu P, Li X, Ma S, Zhu Y, Xie T, Tao F, Zhu DM, Zhu P.  

Source：Environ Res

DOI:10.1016/j.envres.2024.118178

Abstract

BACKGROUND: Outdoor artificial light at night (ALAN) has been linked to an elevated risk of diabetes, but the available literature on the relationships between ALAN and glucose homeostasis in pregnancy is limited.

METHODS: A prospective cohort study of 6730 pregnant women was conducted in Hefei, China. Outdoor ALAN exposure was estimated using satellite data with individual addresses at a spatial resolution of approximately 1km, and the average ALAN intensity was calculated. Gestational diabetes mellitus (GDM) was diagnosed based on a standard 75-g oral glucose tolerance test. Multivariable linear regression and logistic regression were used to estimate the relationships between ALAN and glucose homeostasis.

RESULTS: Outdoor ALAN was associated with elevated glucose homeostasis markers in the first trimester, but not GDM risk. An increase in the interquartile range of outdoor ALAN values was related to a 0.02 (95% confidence interval [CI]: 0.00, 0.03) mmol/L higher fasting plasma glucose, a 0.42 (95% CI: 0.30, 0.54) muU/mL increase in insulin and a 0.09 (95% CI: 0.07, 0.12) increase in homeostatic model assessment of insulin resistance (HOMA-IR) during the first trimester. Subgroup analyses showed that the associations between outdoor ALAN exposure and fasting plasma glucose, insulin, and HOMA-IR were more pronounced among pregnant women who conceived in summer and autumn.

CONCLUSIONS: The results provided evidence that brighter outdoor ALAN in the first trimester was related to elevated glucose intolerance in pregnancy, especially in pregnant women conceived in summer and autumn, and effective strategies are needed to prevent and manage light pollution.

摘要

背景：夜间室外人造光（ALAN）与糖尿病风险升高有关，但关于 ALAN 与妊娠期葡萄糖稳态之间关系的现有文献有限。

方法：在中国合肥市对 6730 名孕妇进行了前瞻性队列研究。户外的使用卫星数据估计ALAN暴露量，其空间分辨率约为1km，并计算了平均ALAN强度。妊娠期糖尿病（GDM）是根据标准的 75 克口服葡萄糖耐量试验诊断的。采用多因素线性回归和logistic回归来估计ALAN与葡萄糖稳态的关系。

结果：室外ALAN与妊娠早期的葡萄糖稳态标志物升高相关，但与GDM风险无关。室外ALAN值的四分位距增加与空腹血糖升高0.02（95%CI：0.00,0.03）mmol/L，胰岛素增加0.42（95%CI：0.30,0.54）μU/mL和胰岛素抵抗稳态模型评估（HOMA-IR ）增加0.09（95%CI：0.07,0.12）有关。亚组分析显示，在夏季和秋季受孕的孕妇中，室外ALAN暴露与空腹血糖、胰岛素和HOMA-IR之间的关联更为明显。

结论：研究结果表明，妊娠早期较亮的室外ALAN与妊娠期葡萄糖耐受不良升高有关，尤其是夏秋季孕孕妇，需要有效的策略来预防和管理光污染。