CARDIOVASCULAR EFFECTS OF AIR POLLUTION IN DIABETES

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This is a longitudinal prospective repeated measures panel study looking to see if air pollution affects the cardiovascular system and if it affects the cardiovascular system of people with diabetes or who are at risk for diabetes more than people without diabetes. This study will also look to see if traffic-related particle pollution affects the cardiovascular system more than other kinds of pollution. The study is not randomized and there is no intervention. The relation between air pollution and the response variables will be analyzed using a hierarchical mixed model to incorporate the repeated measures design and allow examination of effect modification. In epidemiological studies, people with diabetes have been observed to be especially sensitive to the effects of ambient airborne particles, especially with regard to cardiovascular outcomes. Understanding why this is true may provide insight into the mechanisms of particle toxicity. To assess these hypotheses requires access to stable population of diabetic subjects that can be followed prospectively and matched to detailed daily measurements of ambient particulate pollution concentrations. In a population of 75 participants (25 with diabetes, 25 with metabolic syndrome, 25 without diabetes) examined at 5 repeated visits, the main aims of the study are to test the following hypothesis: 1) Basal arterial tone (diameter), brachial artery reactivity, radial artery pulse wave, markers of sub-clinical inflammation, and cardiovascular risk are adversely affected by particulate air pollution. 2) Subjects with type 2 diabetes, and subjects with metabolic syndrome placing them at high risk for diabetes are more sensitive to air-pollution related changes in these indicators of cardiovascular health than subjects with diabetes. 3) The association with air pollution is primarily due to traffic related particles, as measured by black carbon and particle number density. Between 4/1/06 and 3/31/07 14 subjects have enrolled in the study. This study is actively recruiting and enrolling subjects. There were no unexpected safety issues in the study. There is no preliminary data to share at this time.