Preliminary Results Concerning Investigation of Air Pollution Effect in Western Macedonia on Fasting Blood Glucose During Pregnancy

  • Itziou A. Laboratory of Clinical Biochemistry, Department of Midwifery, School of Health and Welfare, Technological Educational Institute of Western Macedonia, 50200, Ptolemaida, Greece
Keywords: pollution, biomarkers, pregnancy, fasting blood glucose.


Pregnancy is very crucial period in a woman’s life. Several changes occur in her body in order to supply the best to the fetus. During pregnancy glucose metabolism undergoes specific adaptations, including increased hepatic glucose production in the fasting state and maternal peripheral insulin resistance, so that glucose is always supplied to the fetus. PM pollution has recently been suggested as an emerging risk factor for glucose control disorders including impaired glucose regulation, or even diabetes. The aim of the present study was to investigate changes in fasting glucose in pregnant women, associated with changes in exposure to ambient air pollution. 50 pregnant women residents of Kozani, Western Macedonia, Greece participated in the study. The results of the study showed increased levels of fasting blood glucose in most women. Moreover, according to simple linear correlation (Pearson’s test), PM2.5 levels were associated with increased fasting blood glucose. The statistically significant correlation between atmospheric pollution and glucose levels found in the present preliminary study shows a possible role of pollution as a risk factor for second semester glucemia during pregnancy. Therefore future work is considered necessary in order to clarify this possible connection.


Tsikritzis LI, Fotakis M, Tzimkas N, Kolovos N, Tsikritzi R (2008). “Distribution and correlation of the natural radionuclides in a coal mine of the West Macedonia Lignite Center (Greece).” J Environ Radioact. 99(2):230-7

Tsikritzis, L.I., Ganatsios, S., Duliu, O., Kavouridis, K., Sawidis, T (2002). “Trace elements distribution in soil in areas of lignite power plants of western Macedonia.” Journal of Trace and Microprobe Techniques 20 (2), 269.

Germani M.S., Zoller W.H. (1988). “Vapor-phase concentrations of arsenic, selenium, bromide, iodine and mercury in the stack of a coal fired power plant” Envir. Sci. Technol., 22, 1079-1085

Kauppinen E.I., Pakkanen T.A (1990). “Coal Combustion Aerosols: A Field Study.” Environmental Science and Technology 24, 12, 1811-1818.

Tsikritzis L.I (2003). “Study of the bioaccumulation of heavy metals and radionuclides of plants in West Macedonia.” Ph.D. thesis, Aristotle University of Thessaloniki, pp. 4-10, 69, 143 (in Greek).

Greek Public Power Corporation PPC, Division of Mines (2002). Annual report 2002. PPC, Athens.

Fleisch, A.F., Gold, D.R., Rifas-Shiman, S.L., Koutrakis, P., Schwartz, J.D., Kloog, I. (2014). “Air pollution exposure and abnormal glucose tolerance during pregnancy: the project Viva cohort.” Environ. Health Perspect. 122, 378 –383.

Sichletidis L, Tsiotsios I, Gavriilidis A, Chloros D, Gioulekas D, Kottakis I, Pataka A (2005). “The effects of environmental pollution on the respiratory system of children in western Macedonia, Greece.” J Investig Allergol Clin Immunol. 2005;15(2):117-23.

Wang G, Jiang R, Zhao Z, Song W (2013). “Effects of ozone and fie particulate matter (PM 2.5) on rat system inflammation and cardiac function.” Toxicol Lett 217(1):23–33.

Lee PC, Talbott EO, Roberts JM, Catov JM, Sharma RK, Ritz B (2011). “Particulate air pollution exposure and C-reactive protein during early pregnancy.” Epidemiology 22(4):524–531.

Esposito K, Petrizzo M, Maiorino MI, Bellastella G, Giugliano D. (2016). Particulate matter pollutants and risk of type 2 diabetes: a time for concern? Endocrine 51:32–37.

Andersen ZJ, Raaschou-Nielsen O, Ketzel M, Jensen SS, Hvidberg M, Loft S (2012). “Diabetes incidence and long-term exposure to air pollution: a cohort study.” Diabetes Care 35(1), 92–98.

Coogan, P.F., White, L.F., Jerrett, M., Brook, R.D., Su, J.G., Seto, E., et al. (2012). “Air pollution and incidence of hypertension and diabetes mellitus in black women living in Los Angeles.” Circulation 125, 767 –772

Eze, I.C., Schaffner, E., Fischer, E., Schikowski, T., Adam, M., Imboden, M. (2014). “Longterm air pollution exposure and diabetes in a population-based Swiss cohort.” Environ. Int. 70, 95 –105.

Desoye G., and Nolan C.J. (2016). “The fetal glucose steal: an underappreciated phenomenon in diabetic pregnancy.” Diabetologia 59:1089–1094

Catalano PM (2014) “Trying to understand gestational diabetes.” Diabet Med 31:273–281

American Diabetes Association. 2008. Standards of medical care in diabetes—2008. Diabetes Care 31(suppl 1), S12–S54.

Kratz A, Ferraro M, Sluss PM, Lewandrowski KB (2004) “Laboratory reference values” N Engl J Med.;351(15):1548-15632. PMID:15470219

Genuth S, et al. Follow-up report on the diagnosis of diabetes mellitus (2003). “Expert Committee on the Diagnosis and Classification of Diabetes Mellitus”.Diabetes Care. Nov;26(11):3160-7. PMID:14578255

International Association of Diabetes and Pregnancy Study Groups Consensus Panel.

Sun Q, Yue P, Deiuliis JA, Lumeng CN, Kampfrath T, Mikolaj MB (2009). “Ambient air pollution exaggerates adipose inflammation and insulin resistance in a mouse model of diet-induced obesity.” Circulation 119:538–546.

Chen L, Zhou Y, Li S, Williams G, Kan H, Marks GB, Morawska L, Abramson MJ, Chen S, Yao T, Qin T, Wu S, Guo Y (2016). “Air pollution and fasting blood glucose: A longitudinal study in China.” Sci Total Environ. 15;541:750-755.

Fleisch AF, Kloog I, Luttmann-Gibson H, Gold DR, Oken E, Schwartz JD (2016). “Air pollution exposure and gestational diabetes mellitus among pregnant women in Massachusetts: a cohort study.” Environ Health. 24;15:40.

Peng C, Bind MC, Colicino E, Kloog I, Byun HM, Cantone L, Trevisi L, Zhong J, Brennan K, Dereix AE, Vokonas PS, Coull BA, Schwartz JD, Baccarelli AA (2016). “Particulate Air Pollution and Fasting Blood Glucose in Nondiabetic Individuals: Associations and Epigenetic Mediation in the Normative Aging Study, 2000-2011.” Environ Health Perspect 124(11):1715-1721.

Malmqvist E, Jakobsson K, Tinnerberg H, Rignell-Hydbom A, Rylander L (2013). “Gestational diabetes and preeclampsia in association with air pollution at levels below current air quality guidelines.” Environ Health Perspect. 121(4):488-93.

Xu X, Liu C, Xu Z, Tzan K, Zhong M, Wang A (2011). “Long-term exposure to ambient fie particulate pollution induces insulin resistance and mitochondrial alteration in adipose tissue.” Toxicol Sci 124(1):88–98.

Zheng X, Zhu S, Chang S, Cao Y, Dong J, Li J, Long R, Zhou Y (2013). “Protective effects of chronic resveratrol treatment on vascular inflammatory injury in steptozotocin-induced type 2 diabetic rats: role of NF-kappa B signaling.” Eur J Pharmacol. 720(1-3):147-57.

Sacks DA, Hadden DR, Maresh M, Deerochanawong C, Dyer AR, Metzger BE (2012). “Frequency of gestational diabetes mellitus at collaborating centers based on IADPSG consensus panel-recommended criteria: the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study.” Diabetes Care 35(3):526–528.

Buchanan TA, Xiang AH. (2005). “Gestational diabetes mellitus”. J Clin Invest.115(3), 485– 91.

Hu H, Ha S, Henderson BH, Warner TD, Roth J, Kan H (2015). “Association of Atmospheric Particulate Matter and Ozone with Gestational Diabetes Mellitus.” Environ Health Perspect. 2015;123(9):853– 9

Robledo CA, Mendola P, Yeung E, Mannisto T, Sundaram R, Liu D (2015). “Preconception and early pregnancy air pollution exposures and risk of gestational diabetes mellitus.” Environ Res. 2015;137:316– 22.

Gold DR. (2008). “Vulnerability to cardiovascular effects of air pollution in people with diabetes.” Curr Diab Rep 8(5):333–335.

Ighodaro O.M (2018). “Molecular pathways associated with oxidative stress in diabetes mellitus.” Biomedicine & Pharmacotherapy, 108, 656-662.

Pope CA III, Dockery DW (2006). “Health effects of fie particulate air pollution: lines that connect.” J Air Waste Manag Assoc. 56:709–742.

Terzano C, Di Stefano F, Conti V, Graziani E, Petroianni A (2010). “Air pollution ultrafie particles: toxicity beyond the lung.” Eur Rev Med Pharmacol Sci 14:809–821.

Hapo Study Cooperative Research Group, Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U (2008). “Hyperglycemia and adverse pregnancy outcomes.” N Engl J Med 358(19):1991–2002.

Hillier TA, Pedula KL, Schmidt MM, Mullen JA, Charles MA, Pettitt DJ (2007). “Childhood obesity and metabolic imprinting: the ongoing effects of maternal hyperglycemia.” Diabetes Care 30(9):2287–2292.