Background

Growing evidence indicates that air pollution is capable of disrupting the immune system and therefore, might be associated with an onset of Type 1 diabetes (T1D).

Objectives

We explored possible links of T1D with ambient exposures in the population of southern Israel, characterized by hot and dry climate and frequent dust storms.

Methods

We conducted a matched nested case-control study where exposure to environmental pollutants during gestation in T1D cases was compared to that of healthy children. Up to 10 controls were matched to every case by age, gender and ethnicity, in all 362 cases and 3512 controls. Measurements of pollutants' concentrations, nitrogen dioxide (NO₂), sulphur dioxide (SO₂), ozone (O₃) and particulate matter of size less than 10 and 2.5 μm in diameter (PM₁₀ and PM_2.5), as well as the mean daily measurements of meteorological conditions were obtained from the local monitoring stations. The association between T1D and pollution, solar radiation (SR), temperature and relative humidity was adjusted for socioeconomic status, temperature, maternal age and pre-gestational maternal DM, using conditional logistic regression. The environmental exposures were presented as indicators of quartiles averaged over whole pregnancy and by trimesters.

Results

Exposure to ozone and solar radiation during gestation were both associated with the T1D in offspring, although at borderline significance. Compared to the lowest quartile, the odds ratio (OR) for exposure to 3rd and 4th quartile of O₃ was equal 1.61 (95%CI: 0.95; 2.73) and 1.45 (95%CI: 0.83; 2.53), respectively. Likewise, the ORs for exposure to SR were equal 1.83 (95%CI: 0.92; 3.64), 2.54 (95%CI: 1.21; 5.29) and 2.06 (95%CI: 0.95; 4.45) for to 2nd, 3rd and 4th quartiles, respectively. Exposure to SO₂ followed a dose-response pattern, but was not statistically significant. Other environmental factors were not independently related to T1D. Analysis of exposures one year prior to the disease onset indicated a positive association between T1D and SR.

Conclusions

We showed that exposure to high ozone levels and solar radiation during gestation might be related to the T1D. More scientific evidence needs to accumulate to support the study findings.

中文翻译：

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妊娠期空气污染和气象条件以及后代的1型糖尿病

背景

越来越多的证据表明，空气污染能够破坏免疫系统，因此可能与1型糖尿病（T1D）的发作有关。

目标

我们探索了以色列南部人口中T1D与周围环境暴露的可能联系，这些地区的特征是炎热干燥的气候和频繁的沙尘暴。

方法

我们进行了一项匹配的嵌套病例对照研究，该研究将T1D病例在妊娠期间暴露于环境污染物的情况与健康儿童的暴露进行了比较。在所有362例病例和3512例对照中，按年龄，性别和种族分类的每例病例最多匹配10例对照。测量污染物的浓度，二氧化氮（NO ₂），二氧化硫（SO ₂），臭氧（O ₃）和直径小于10和2.5μm的颗粒物（PM ₁₀和PM _2.5）），以及从当地监测站获得的气象条件的每日平均测量值。使用条件Logistic回归对T1D与污染，太阳辐射（SR），温度和相对湿度之间的关系进行了社会经济状况，温度，孕产妇年龄和孕前孕产妇DM的调整。将环境暴露作为整个妊娠和三个月平均四分位数的指标。

结果

妊娠期间暴露于臭氧和太阳辐射均与后代的T1D有关，尽管这具有重要意义。与最低四分位数相比，暴露于O _3的第三和第四四分位数的比值比（OR）分别等于1.61（95％CI：0.95; 2.73）和1.45（95％CI：0.83; 2.53）。同样，对于第二，第三和第四四分位数，暴露于SR的OR等于1.83（95％CI：0.92; 3.64），2.54（95％CI：1.21; 5.29）和2.06（95％CI：0.95; 4.45） ， 分别。SO _2的暴露遵循剂量反应模式，但无统计学意义。其他环境因素与T1D无关。疾病发作前一年的暴露分析表明，T1D与SR之间呈正相关。

结论

我们发现妊娠期间暴露于高水平的臭氧和太阳辐射可能与T1D有关。需要积累更多的科学证据来支持研究结果。