Effects of PM2.5 constituents on gestational diabetes mellitus in Chinese pregnant women: The potential modifying role of vitamin B12

Chen Li; Dongfang Zhang; Xiang Li; Yibin Zhang; Guangbin Sun; Hongyu Zhou; Rui Xi; Haoyang Yuan; Liwen Zhang; Xumei Zhang; Shuying Li; Qiang Zhang; Xueli Yang

doi:10.1016/j.envres.2025.122003

Effects of PM_2.5 constituents on gestational diabetes mellitus in Chinese pregnant women: The potential modifying role of vitamin B₁₂

Environ Res. 2025 May 29:282:122003. doi: 10.1016/j.envres.2025.122003. Online ahead of print.

Authors

Chen Li¹, Dongfang Zhang¹, Xiang Li¹, Yibin Zhang¹, Guangbin Sun¹, Hongyu Zhou¹, Rui Xi¹, Haoyang Yuan¹, Liwen Zhang¹, Xumei Zhang², Shuying Li³, Qiang Zhang⁴, Xueli Yang⁵

Affiliations

¹ Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China.
² Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China; Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.
³ Department of Endocrinology, Tianjin Xiqing Hospital, Tianjin, China; Tianjin Metabolic Disease Hospital, Tianjin Medical University, Tianjin, China.
⁴ Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China. Electronic address: qiangzhang@tmu.edu.cn.
⁵ Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China. Electronic address: yangxueli2019@tmu.edu.cn.

PMID: 40449579
DOI: 10.1016/j.envres.2025.122003

Abstract

Associations of PM_2.5 and its constituents with gestational diabetes mellitus (GDM) are still unclear, and little is known about the impact of vitamin B₁₂. The Gene-Environment-Nutrient-Epigenetics interaction on Maternal and Children health study (GENEMaC) cohort was conducted during 2017-2018 in Tianjin, China, and 1396 eligible women were included in the final analysis. Spatiotemporal models were used to estimate PM_2.5 exposure levels and its constituents, including sulfate (SO₄²^-), ammonium (NH₄⁺), nitrate (NO₃^-), organic matter (OM), black carbon (BC). Logistic regression and distributed lag non-linear model (DLNM) were used to assess each pollutant-GDM association. Weighted quantile sum (WQS) regression was conducted to assess the extent of contributions of pollutants co-exposure to GDM. The logistic regression showed that exposures to PM_2.5, NO₃^-, and NH₄⁺ during the 2nd trimester of pregnancy increased the risk of GDM. DLNM analyses observed a lag exposure-response relationship for each constituent, while BC exposed in the 2nd trimester was displayed as the top contributor in the WQS model. The joint effects of constituents exposure (high versus low) and serum B₁₂ (tertiles) on GDM were further evaluated, and the highest risks of GDM were consistently observed in the low B₁₂ level and high pollution groups for SO₄²^-, NO₃^-, and NH₄⁺. These findings provide evidence of the impact of PM_2.5 components on GDM and highlight the susceptibility of pregnant women with low B₁₂ levels to air pollution.

Keywords: Birth cohort; Gestational diabetes mellitus; PM(2.5) constituents exposure; Vitamin B(12).