PM2.5 and Diabetes and Hypertension Incidence in the Black Women's Health Study.
PM2.5 and Diabetes and Hypertension Incidence in the Black Women's Health Study.
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DOI：
10.1097/ede.0000000000000418
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发表时间：
2016-03
期刊：
影响因子：
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通讯作者：
Jerrett M
中科院分区：
文献类型：
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作者：
Coogan PF;White LF;Yu J;Burnett RT;Seto E;Brook RD;Palmer JR;Rosenberg L;Jerrett M
临床研究表明，接触细颗粒物（PM2.5）会增加胰岛素抵抗和血压。 PM2.5 暴露与 2 型糖尿病或高血压发病率之间关系的流行病学证据并不一致。我们使用 Cox 比例风险模型，利用黑人女性健康研究的数据，计算了居住在美国 56 个大都市区的一大群非洲裔美国女性与接触 PM2.5 相关的 2 型糖尿病和高血压事件的风险比 (HR) 和 95% 置信区间 (CI)。通过结合土地利用回归和贝叶斯最大熵技术的混合模型，对所有住宅区的污染物水平进行了后续评估。 1995年至2011年间，发生糖尿病4387例，高血压9570例。在控制年龄、问卷周期和都会地区的模型中，每四分位数范围的 PM2.5 (2.9 μg/m3) 与糖尿病（HR = 1.13，95% CI 1.04–1.24）和高血压（HR = 1.06，95% CI 1.00–1.12）呈正相关。然而，糖尿病的多变量 HR 为 0.99 (95% CI 0.90–1.09)，高血压的多变量 HR 为 0.99 (95% CI 0.93–1.06)。某些亚组的 HR 有所增加，例如体重指数<25 kg/m2 的女性患糖尿病的 HR 为 1.36 (95% CI 0.91–2.04)。我们的结果几乎没有支持 PM2.5 与高血压发病率之间的关联。总体队列的结果并不支持空气污染与糖尿病发病率之间的关联，但瘦女性的发病率有所增加。
Clinical studies have shown that exposure to fine particulate matter (PM2.5) can increase insulin resistance and blood pressure. The epidemiologic evidence for an association of PM2.5 exposure with the incidence of type 2 diabetes or hypertension is inconsistent. We used Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CI) for incident type 2 diabetes and hypertension associated with exposure to PM2.5 in a large cohort of African American women living in 56 metropolitan areas across the U.S., using data from the Black Women’s Health Study. Pollutant levels were estimated at all residential locations over follow-up with a hybrid model incorporating land use regression and Bayesian Maximum Entropy techniques. During 1995 to 2011, 4387 cases of diabetes and 9570 cases of hypertension occurred. In models controlling for age, questionnaire cycle, and metro area there were positive associations with diabetes (HR = 1.13, 95% CI 1.04–1.24) and hypertension (HR = 1.06, 95% CI 1.00–1.12) per interquartile range of PM2.5 (2.9 μg/m3). Multivariable HRs, however, were 0.99 (95% CI 0.90–1.09) for diabetes and 0.99 (95% CI 0.93–1.06) for hypertension. HRs were increased in some subgroups, e.g, 1.36 (95% CI 0.91–2.04) for diabetes among women with body mass index<25 kg/m2. Our results provide little support for an association of PM2.5 with hypertension incidence. Results from the overall cohort do not support an association of air pollution with diabetes incidence, but there was a suggestive increase in lean women.