关注孕妇葡萄糖稳态受损，加强夜间户外人造光管理

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 6,730 pregnant women was conducted in Hefei, China. Outdoor ALAN exposure was estimated using satellite data with individual addresses at a spatial resolution of approximately 1 km, 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) μU/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.

Keywords: Artificial light at night; Glucose homeostasis; GDM; Insulin; HOMA-IR; Cohort study 

摘要

背景

夜间户外人造光(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联的现有文献仍然有限。

方法

在中国合肥对实施了一项包含6730名孕妇的前瞻性队列研究。利用空间分辨率约为1公里的单个地址的卫星数据估计室外ALAN暴露，并计算平均ALAN强度。妊娠期糖尿病(GDM)的诊断是基于标准的75 g口服葡萄糖耐量试验。采用多元线性回归和logistic回归估计ALAN与葡萄糖稳态之间的关联。

结果

在妊娠早期，室外ALAN与葡萄糖稳态标志物升高有关，但与GDM风险无关。室外ALAN值每增加一个IQR与妊娠早期空腹血糖升高0.02(95% CI: 0.00, 0.03) mmol/L、胰岛素升高0.42 (95% CI: 0.30, 0.54) μU/mL、胰岛素抵抗指数(HOMA-IR)升高0.09 (95% CI: 0.07, 0.12)相关。亚组分析显示，在夏秋季怀孕的孕妇中，室外ALAN暴露与空腹血糖、胰岛素和HOMA-IR之间的关联更为显著。

结论

结果提示，妊娠早期室外更强的ALAN与妊娠期葡萄糖稳态受损有关，尤其是对夏秋季受孕的孕妇，需要采取有效的策略来预防和管理光污染。

关键词:夜间人工照明; 葡萄糖稳态; 妊娠期糖尿病; 胰岛素; 胰岛素抵抗指数; 队列研究