妊娠早期PM_(2.5)多重环境暴露对孕妇甲状腺激素水平的影响

Effect of multiple environmental exposure to PM_(2.5) in early pregnancy on thyroid hormone levels in pregnant women

目的 了解妊娠早期不同环境下细颗粒物(fine particulate matter,PM_(2.5))暴露与母体甲状腺激素水平之间的关系。方法 2023年5—6月,使用新疆维吾尔自治区博尔塔拉蒙古自治州逐日PM_(2.5)数据,通过Arcgis 10.8中克里金插值工具计算新疆145名母婴队列孕妇妊娠早期住址周围PM_(2.5)暴露浓度,再通过室内、外颗粒物浓度比值(I/0值)计算室内妊娠早期PM_(2.5)暴露浓度,最后按照不同环境暴露时间计算多重环境下妊娠早期PM_(2.5)暴露浓度,使用广义线性模型分析不同环境下妊娠早期PM_(2.5)暴露浓度与队列孕妇甲状腺激素水平之间的关系。结果 145名孕妇妊娠早期日均室外环境PM_(2.5)暴露浓度[M(P_(25),P_(75))]为37(27,39)μg/m^(3),日均室内环境PM_(2.5)暴露浓度为23(18,27)μg/m^(3);多重环境日均暴露量(average daily dose,ADD)最高PM_(2.5)暴露浓度为30(24,33)μg/m^(3),日均ADD最低PM_(2.5)暴露浓度为25(20,29)μg/m^(3)。145名孕妇血清游离甲状腺素(free thyroxine,FT4)水平为13.2(12.0,14.4)pmol/L,血清游离三碘甲状腺素(serum free triiodothyronine,FT3)水平为4.5(4.1,4.8)pmol/L,促甲状腺激素(thyroid stimulating hormone,TSH)水平为2.13(1.02,2.13)μIU/mL。妊娠早期日均室外、室内、ADD(最高)、ADD(最低)环境PM_(2.5)暴露浓度均与孕期FT4水平存在相关性,OR(95%CI)分别为0.967(0.954~0.979)、0.969(0.957~0.980)、0.969(0.959~0.980)、0.969(0.957~0.980)(均P<0.05)。结论 室外、室内、多重环境下PM_(2.5)妊娠早期暴露均与孕期FT4存在相关性,孕早期处于胎儿甲状腺尚未发育的特殊阶段,需重点关注母体甲状腺激素水平稳态失衡。

Objective To study the relationship between fine particulate matter(PM_(2.5)) exposure and maternal thyroid hormone levels in different environments during early pregnancy.Methods Using daily PM_(2.5)data from Bortala Mongolian Autonomous Prefecture of Xinjiang Uygur Autonomous Region,the PM_(2.5)exposure concentration around the early pregnancy address of 145 maternal infant queue pregnant women in Xinjiang was calculated using the Kriging interpolation tool in Arcgis 10.8.The indoor PM_(2.5)exposure concentration in the early pregnancy was calculated using the ratio of indoor and outdoor particulate matter concentration(I/0 value).The PM_(2.5)exposure concentration in multiple environments was calculated based on different environmental exposure times,and using a generalized linear model to analyze the relationship between PM_(2.5)exposure concentration in early pregnancy and thyroid hormone levels in cohort pregnant women under different environments.Results The average daily outdoor exposure concentration of PM_(2.5)in early pregnancy of 145 pregnant women M(P_(25),P_(75)) was 37(27,39)μg/m^(3),the daily average indoor exposure concentration of PM_(2.5)was 23(18,27)μg/m^(3).The maximum exposure concentration of PM_(2.5)in the average daily dose(ADD) of multiple environments was 30(24,33)μg/m^(3),the minimum exposure concentration of PM_(2.5)was 25(20,29)μg/m^(3).145 pregnant women had free thyroxine(FT4) levels of 13.2(12.0,14.4)pmol/L,serum free triiodothyronine(FT3) level was 4.5(4.1,4.8)pmol/L,thyroid stimulating hormone(TSH) level was 2.13(1.02,2.13)μIU/mL.The daily average outdoor,indoor,ADD(highest),and ADD(lowest) environmental PM_(2.5)exposure concentrations in early pregnancy were all correlated with FT4 levels during pregnancy,with OR(95%CI) of 0.967(0.954-0.979),0.969(0.957-0.980),0.969(0.959-0.980) and 0.969(0.957-0.980),respectively(all P<0.05).Conclusion Exposure to PM_(2.5)in outdoor,indoor,and multiple environments during early pregnancy is correlated with FT4 during pregnancy.Early pregnancy is a special stage where the fetal thyroid gland has not yet developed,and should pay special attention to the imbalance of maternal thyroid hormone levels.