抗炎饮食可保护孕期颗粒物暴露引起的心血管健康风险

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

抗炎饮食可保护孕期颗粒物暴露引起的心血管健康风险

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

Source: Environmental Research.

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. 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, PM2.5, 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/m3 of PM1, PM2.5, 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, PM2.5, 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 PM2.5 (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.

摘要

背景：怀孕期间接触细颗粒物（PM）可能增加心血管风（CVR）。然而，关于PM暴露对孕期心血管健康影响的研究仍然有限，尤其是关键暴露时间窗以及潜在的生物学机制尚不明确。

方法：本研究基于合肥母婴健康队列（MIH-Hefei）数据，共纳入了9294名孕妇（2015-2021年）。利用卫星数据估算了孕妇暴露于PM₁、PM_2.5和PM₁₀的水平，检测了孕妇血清中3种炎症生物标志物（hs-CRP、IL-6、TNF-α）的水平。根据食物频率问卷计算了经验性膳食炎症模式（EDIP）的评分，采用美国心脏协会制定的评分标准评估心血管健康风险。

结果：研究发现，在孕早期，PM₁暴露与CVR评分呈正相关（β = 0.51，95% CI: 0.21, 0.82），在孕中期（β = 0.16，95% CI: -0.36–0.68）和孕晚期（β = 0.09，95% CI: -0.42, 0.21）相关性减弱。PM_2.5和PM₁₀的暴露水平也与心血管风险评分呈类似的关联。孕早期是PM暴露对心血管健康风险影响的关键窗口期，PM₁影响关键期在第1-6周、PM_2.5、PM₁₀影响关键期在第2-6周。中介分析发现，PM₁、PM_2.5和PM₁₀暴露与 CVR之间关联中由炎症标志物介导的比例分别为24.3%、22.4%和20.1%。分层分层分析结果显示，在低EDIP组（遵循抗炎饮食模式的孕妇），PM暴露与炎症标志物的关联显著性消失（β = 0.52，95% CI: -0.06, 1.11）；同样，在低EDIP组中，PM暴露与心血管风险之间亦未观察到显著关联（β = 2.75，95% CI: -2.68, 8.27）。

结论：怀孕期间，尤其是在第2至第8周，颗粒物暴露会增加心血管健康风险。该关联部分通过炎症生物标志物介导。抗炎饮食可能通过抑制慢性炎症，有助于降低孕期颗粒物暴露对心血管健康的潜在风险。