Diabetes enhances vulnerability to particulate air pollution - Associated impairment in vascular reactivity and endothelial function
Diabetes enhances vulnerability to particulate air pollution - Associated impairment in vascular reactivity and endothelial function
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DOI：
10.1161/circulationaha.104.517110
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发表时间：
2005-06-07
期刊：
影响因子：
37.8
通讯作者：
Schwartz, J
中科院分区：
文献类型：
--
作者：
O'Neill, MS;Veves, A;Schwartz, J
背景-流行病学研究表明，糖尿病患者容易受到与暴露于颗粒空气污染相关的心血管健康影响。糖尿病患者内皮和血管功能受损，可能与心血管风险增加有关。我们研究了是否内皮依赖性和非依赖性血管反应性与颗粒暴露在个人和没有diabetes.Methods和Results-Study受试者为270名波士顿居民。我们测量了24小时平均环境空气污染水平（细颗粒物[PM2.5]、颗粒数、黑碳和硫酸盐[SO 42-]），距离患者检查部位约500 m。评价了污染物浓度与血管反应性的关系。线性回归拟合肱动脉直径（流量介导和硝酸甘油介导）的百分比变化，颗粒污染物指数，表观温度，季节，年龄，种族，性别，吸烟史和体重指数作为预测因子。模型适用于所有受试者，然后按诊断的糖尿病与糖尿病风险分层。所有4个颗粒指标的6天移动平均值与糖尿病患者的血管反应性降低相关，但与风险患者无关。在糖尿病患者中，SO 42-的四分位数范围增加与血流介导（-10.7%; 95% CI，-17.3至-3.5）和硝酸甘油介导（-5.4%; 95% CI，-10.5至-0.1）的血管反应性降低相关。黑碳增加与血流介导的血管反应性降低相关（-12.6%; 95%CI，-21.7至-2.4），PM2.5与硝酸甘油介导的反应性相关（-7.6%; 95%CI，-12.8至-2.1）。II型糖尿病的影响比I型糖尿病强。结论糖尿病易受燃煤电厂和交通相关颗粒物的影响。
Background-Epidemiological studies suggest that people with diabetes are vulnerable to cardiovascular health effects associated with exposure to particle air pollution. Endothelial and vascular function is impaired in diabetes and may be related to increased cardiovascular risk. We examined whether endothelium-dependent and -independent vascular reactivity was associated with particle exposure in individuals with and without diabetes.Methods and Results-Study subjects were 270 greater-Boston residents. We measured 24-hour average ambient levels of air pollution ( fine particles [PM2.5], particle number, black carbon, and sulfates [SO42-]) approximate to 500 m from the patient examination site. Pollutant concentrations were evaluated for associations with vascular reactivity. Linear regressions were fit to the percent change in brachial artery diameter ( flow mediated and nitroglycerin mediated), with the particulate pollutant index, apparent temperature, season, age, race, sex, smoking history, and body mass index as predictors. Models were fit to all subjects and then stratified by diagnosed diabetes versus at risk for diabetes. Six-day moving averages of all 4 particle metrics were associated with decreased vascular reactivity among patients with diabetes but not those at risk. Interquartile range increases in SO42- were associated with decreased flow-mediated (-10.7%; 95% CI, -17.3 to -3.5) and nitroglycerin-mediated (-5.4%; 95% CI, -10.5 to -0.1) vascular reactivity among those with diabetes. Black carbon increases were associated with decreased flow-mediated vascular reactivity ( -12.6%; 95% CI, -21.7 to -2.4), and PM2.5 was associated with nitroglycerin-mediated reactivity ( -7.6%; 95% CI, -12.8 to -2.1). Effects were stronger in type II than type I diabetes.Conclusions-Diabetes confers vulnerability to particles associated with coal-burning power plants and traffic.