Air pollution and incidence of hypertension and diabetes mellitus in black women living in Los Angeles.
Air pollution and incidence of hypertension and diabetes mellitus in black women living in Los Angeles.
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DOI：
10.1161/circulationaha.111.052753
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发表时间：
2012-02-14
期刊：
影响因子：
37.8
通讯作者：
Rosenberg L
中科院分区：
文献类型：
--
作者：
Coogan PF;White LF;Jerrett M;Brook RD;Su JG;Seto E;Burnett R;Palmer JR;Rosenberg L
有证据表明，与短期接触相比，多年来长期接触空气污染物会带来更高的心血管发病和死亡风险。一种解释是，长期累积的不利影响会导致慢性疾病的发生。初步流行病学和临床证据表明，空气污染可能导致高血压和2型糖尿病的发生。我们使用 Cox 比例风险模型来评估居住在洛杉矶的一群非裔美国女性中与接触细颗粒物 (PM2.5) 和氮氧化物 (NOx) 相关的高血压和糖尿病的发病率比 (IRR) 和 95% 置信区间 (CI)。使用土地利用回归模型（NOx）和监测站测量值（PM2.5）插值来估计参与者居住地址的污染物水平。 1995年至2005年的随访中，发生高血压病例531例，糖尿病病例183例。当单独分析污染物时，PM2.5 每增加 10 μg/m3，高血压的 IRR 为 1.48 (95% CI 0.95-2.31)，NOx 四分位距 (12.4 ppb) 的 IRR 为 1.14 (95% CI 1.03-1.25)。糖尿病相应的 IRR 为 1.63 (95% CI 0.78-3.44) 和 1.25 (95% CI 1.07-1.46)。当两种污染物包含在同一模型中时，两种结果的 PM2.5 的 IRR 均减弱，而 NOx 的 IRR 基本不变。我们的研究结果表明，接触空气污染物，尤其是与交通相关的污染物，可能会增加患 2 型糖尿病和高血压的风险。
Evidence suggests that longer-term exposure to air pollutants over years confers higher risks of cardiovascular morbidity and mortality than shorter term exposure. One explanation is that cumulative adverse effects that develop over longer durations lead to the genesis of chronic disease. Preliminary epidemiological and clinical evidence suggest that air pollution may contribute to the development hypertension and type 2 diabetes. We used Cox proportional hazards models to assess incidence rate ratios (IRRs) and 95% confidence intervals (CI) for incident hypertension and diabetes associated with exposure to fine particulate matter (PM2.5) and nitrogen oxides (NOx) in a cohort of African American women living in Los Angeles. Pollutant levels were estimated at participant residential addresses with land use regression models (NOx) and interpolation from monitoring station measurements (PM2.5). Over follow-up from 1995-2005, 531 incident cases of hypertension and 183 incident cases of diabetes occurred. When pollutants were analyzed separately, the IRR for hypertension for a 10 μg/m3 increase in PM2.5 was 1.48 (95% CI 0.95-2.31) and the IRR for the interquartile range (12.4 parts per billion) of NOx was 1.14 (95% CI 1.03-1.25). The corresponding IRRs for diabetes were 1.63 (95% CI 0.78-3.44) and 1.25 (95% CI 1.07-1.46). When both pollutants were included in the same model, the IRRs for PM2.5 were attenuated and the IRRs for NOx were essentially unchanged for both outcomes. Our results suggest that exposure to air pollutants, especially traffic-related pollutants, may increase the risk of type 2 diabetes and possibly of hypertension.