Household Air Pollution, Adiposity, and Cardiorenal Disease Risk in Children

摘要 儿童肥胖症是一个主要的公共健康威胁，其发病率正以惊人的速度增长 国际吧目前，22.4%的儿童和青少年肥胖，约1670万， 儿童人群中所有年龄组的肥胖率都在增加。肥胖儿童 更有可能被诊断出患有几种主要疾病（高血压，高脂血症， 冠状动脉疾病和糖尿病）。肥胖症每年的医疗费用估计- 相关疾病是一个惊人的1902亿美元或近21%的年度医疗支出， 美国的家庭空气污染（HAP）是一个术语，描述了健康和 固体燃料不完全燃烧产生的污染物对环境的影响， 木材、煤炭、木炭、动物粪便、作物废料在露天火上或在 通风不良的家庭和释放悬浮颗粒物（PM）。研究较少 研究家庭空气污染（包括PM2.5）在心血管风险中的作用 儿童肥胖症的症状心血管健康的一个重要组成部分是一个昼夜变化， 血压，其中夜间水平比白天值低约20%。的 儿童期无夜间血压下降可能是早期疾病的重要指标 我们的团队最近发表的证据表明，儿童肥胖与 不沾水。这里提出的具体项目将检验这一假设， 家庭空气污染通过炎症增加肥胖儿童的心血管风险- 昼夜血压调节的相关中断。该项目将招募10-18岁的患者， 家庭空气质量与高血压危险因素之间的关系。的试点研究 确定高效颗粒物（HEPA）过滤装置对空气质量的影响 还将测量这些患者的暴露和健康风险。这项研究涉及一个 通过了解和识别环境暴露， 农村儿童的脆弱高危群体，以开发新的治疗方法，以提高他们的 健康

ABSTRACT Childhood obesity is a major public health threat with rates increasing at an alarming rate worldwide. Currently 22.4% of children and adolescents are obese, approximately 16.7 million, with rates of obesity increasing in all age groups in the pediatric population. Obese children are more likely to be diagnosed with several major morbidities (hypertension, hyperlipidemia, coronary artery disease, and diabetes). The estimated annual health care costs of obesity- related illness are a staggering $190.2 billion or nearly 21% of annual medical spending in the United States. Household air pollution (HAP) is a term that describes the health and environmental impacts of pollutants produced from incomplete combustion of solid fuels such as wood, coal, charcoal, animal dung, crop wastes burnt on open fires or wood-burning stoves in poorly ventilated homes and releases suspended particulate matter (PM). There are few studies examining the role of household air pollution including PM2.5 in cardiovascular risk in the setting of pediatric obesity. An important component of cardiovascular health is a diurnal variation of blood pressure, where nocturnal levels are approximately 20% lower than daytime values. The absence of nocturnal BP-dipping in childhood may be an important indicator of early disease risks and our team has recently published evidence that childhood obesity is associated with non-dipping. The specific project proposed here will test the hypothesis that exposure to household air pollution increases cardiovascular risk in obese children through an inflammation- related disruption in diurnal BP regulation. This project will recruit patients aged 10-18 to define relationships between at-home air quality and hypertension risk factors. A pilot study to determine the impact of high efficacy particulate matter (HEPA) filtration units on air quality exposure and health risks will be measured in these patients as well. This research addresses a significant public health issue by understanding and identifying environmental exposures in a vulnerable high-risk group of rural children in order to develop new treatments to improve their health.