Anti-inflammatory diet mitigate cardiovascular risks due to particulate matter exposure in women during pregnancy: A perspective cohort study from China

抗炎饮食可减轻妊娠期妇女颗粒物暴露引起的心血管风险：一项来自中国的前瞻性队列研究

Authors: Ping Zu, Lei Zhang, Kun Zhang, Liping He, Yujie Fan, Chenxi Zhou, Yunlong Chen, Ying Zhang, Ruixue Tao, Xianxia Chen, Peng Zhu.

Source: Environ Res.2024 Oct 3;263(Pt 2):120104. 

doi: 10.1016/j.envres.2024.120104. 

Abstract

Background: Particulate matter (PM) exposure during pregnancy may increase cardiovascular risk (CVR). However, the specific time windows of exposure contributing to this association and the potential biological mechanisms underlying it remain unclear.

Objective: To determine the sensitive time window for CVR related to PM exposure. We investigated whether levels of inflammatory biomarkers mediate the relationship between PM exposure and CVR, and examined the potential impact of an anti-inflammatory diet on this association.

Methods: From 2015 to 2021, 9294 pregnant women from three Hefei hospitals were included. We used a 1 × 1 km satellite dataset to assess PM₁, PM_2.5, and PM₁₀ exposure. High-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) were measured as inflammatory biomarkers. The empirical dietary inflammatory pattern (EDIP) score, based on a validated food frequency questionnaire. The CVR score was calculated using five clinical metrics based on American Heart Association criteria.

Results: We found a significant association between PM exposure and increased CVR score, especially during the 2nd to 8th weeks of the first trimester. For every increase of 10-μg/m3of PM₁, PM_2.5, and PM₁₀, there was an associated increase in CVR of 0.51 (95%CI: 0.21, 082), 0.25 (95% CI: 0.11 to 0.39), and 0.29 (95% CI: 0.09 to 0.37), respectively. Mediation analysis revealed that the proportion of the association between PM₁, PM_2.5, and PM₁₀ exposure and CVR mediated by inflammatory biomarkers was 24.3%, 22.4%, and 20.1%, respectively. Stratified analyses showed no positive correlation between PM exposure and CVR in the anti-inflammatory diet (low EDIP) group. The β coefficients were 0.52 for PM₁(95% CI: -0.06 to 1.11), 0.31 for PM_2.5(95% CI: -0.04 to 0.79), and 0.25 for PM₁₀ (95% CI: -0.03 to 0.54).

Conclusions: PM exposure, particularly during weeks 2-8 of pregnancy, correlates with CVR, partly mediated by levels of inflammatory biomarkers. An anti-inflammatory diet mitigates CVR associated with PM exposure.

Keywords:  Anti-inflammatory diet; Cardiovascular risk; Inflammatory biomarkers; Particulate matter; Prospective cohort study.

摘要

背景： 怀孕期间颗粒物（PM）暴露可能会增加心血管风险（CVR）。然而，导致这种关联的暴露的具体时间窗口及其潜在的生物学机制仍不清楚。

目的： 确定与PM暴露相关的CVR敏感时间窗口。我们调查了炎症生物标志物水平是否介导PM暴露与CVR之间的关系，并研究了抗炎饮食对这种关联的潜在影响。

方法： 纳入 2015年至202年合肥市3家医院的9 294例孕妇。我们使用 1 × 1 公里的卫星数据集来评估 PM₁、PM_2.5和 PM₁₀暴露。高敏C反应蛋白（hs-CRP）、白细胞介素-6 （IL-6）和肿瘤坏死因子-α（TNF-α）作为炎症生物标志物进行测量。经验饮食炎症模式（EDIP）评分，基于经过验证的食物频率问卷。CVR 评分是根据美国心脏协会标准使用五个临床指标计算的。

结果： 我们发现PM暴露与CVR评分升高之间存在显著相关性，尤其是在妊娠早期的第2至8周。每增加10 μg/m³ PM_1、PM_2.5和 PM₁₀，CVR 的相关增加分别为 0.51 （95% CI： 0.21， 082）、0.25 （95% CI： 0.11 至 0.39）和 0.29 （95% CI： 0.09 ，0.37）。中介分析显示，PM_1、PM_2.5和 PM₁₀炎症生物标志物介导的暴露和 CVR 分别为 24.3% 、 22.4% 和 20.1%。分层分析显示，抗炎饮食（低 EDIP）组 PM 暴露与 CVR 之间没有正相关。PM₁的β系数为0.521（95% CI：-0.06～1.11），PM_2.5为0.312.5（95% CI：-0.04～0.79），PM₁₀为 0.2510（95% CI：-0.03～0.54）。

结论： PM 暴露，特别是在妊娠2～8 周，与CVR相关，部分由炎症生物标志物水平介导。抗炎饮食可减轻与PM暴露相关的CVR。

关键词： 抗炎饮食；心血管风险；炎症生物标志物；颗粒物；前瞻性队列研究。