The interaction of diet, air pollution, and cardiovascular disease in NHANES.

描述(由申请人提供)：长期和短期暴露于环境空气污染物，特别是颗粒物(PM)，与心血管疾病(CVD)有关。许多因素，如年龄和既往疾病，加剧了PM对心血管的不利影响然而，目前尚不清楚空气污染对心血管的不利影响是否会被饮食和生活方式因素改变。这是一个重要的问题，因为很大一部分普通人群暴露于PM，而心血管疾病是美国的主要死亡原因，占美国总死亡人数的25.4%。我们有一个绝佳的机会，通过利用国家健康和营养检查调查(NHANES)III研究来弥补这一研究差距，该研究是一个久负盛名的、具有全国代表性的队列研究，包含关于饮食和生活方式因素、血液生物标志物和环境空气污染的详细信息。主要的假设是，饮食可以改变空气污染对心血管疾病发病率和死亡率的不利影响。肥胖和高饱和脂肪摄入量是公认的与代谢综合征相关的饮食和生活方式因素，代谢综合征是心血管疾病的已知危险因素。在美国，代谢综合征的患病率有上升的趋势，这可能会导致未来心血管疾病风险因素的增加(Ford等人，2004~Johnson等人，2009)。最近的研究表明，空气污染暴露与心血管疾病中间生物标志物水平的增加有关，包括代谢综合征(Chen，2008)，暴露于高水平PM的个人的血液胆固醇、血压和C反应蛋白水平的增加表明因此，假设环境空气污染物暴露与心血管疾病死亡率之间的不利关系在肥胖者、高饱和脂肪消费者和胰岛素抵抗者(即患有代谢综合征的人)中更强。这一假设将在NHANES III研究队列中的18,149名美国男性和女性中进行检验，他们是在1988-1994年间登记的。来自5、10和20英里范围内最近监测仪的室外PM浓度和气体污染物浓度已与每个参与者的住址联系在一起。在研究基线时获得有关血液生物标记物、人体测量和饮食摄入量的信息，并对所有受试者进行长达20年的跟踪调查，直到确定死亡和心血管疾病死亡率。这些数据将被用来探索这样的假设，即暴露在环境空气污染物(特别是PM)中与死亡率增加以及心血管疾病中间生物标志物的不利变化有关，并且这些关系会被肥胖和从饱和脂肪中摄取卡路里所改变。 与公共健康相关：我们已经组建了一个由空气污染、营养和遗传学研究人员组成的跨学科团队，以验证我们的假设，即环境空气污染对心血管系统的不利影响会被营养因素改变。我们将使用独特的NHANES III数据集来模拟空气污染和饮食对心脏健康的长期影响，包括死亡率。成功的结果将为改善饮食造成的空气污染对心脏影响的潜在途径提供信息。

DESCRIPTION (provided by applicant): Long-term and short-term exposures to ambient air pollutants, particularly particulate matter (PM), have been linked to cardiovascular disease (CVD). A number of factors, such as age and pre-existing disease, exacerbate the adverse cardiovascular effects of PM. Yet, it remains unclear whether the adverse cardiovascular effects of air pollution could be modified by diet and lifestyle factors. This is an important question because a large proportion of the general population is exposed to PM and CVD is the leading cause of death in US, accounting for 25.4% of the total deaths in the United States. We have an excellent opportunity to address this research gap by utilizing the National Health and Nutrition Examination Survey (NHANES) III Study, a well-established, nationally representative cohort, with detailed information on diet and lifestyle factors, blood biomarkers, and ambient air pollution. The main hypothesis is that diet can modify the adverse effect of air pollution on CVD morbidity and mortality. Obesity and high saturated fat intake are well established dietary and lifestyle factors associated with metabolic syndrome, a known risk factor for CVD. There is an increasing trend in the prevalence of metabolic syndrome in the U.S., and this may lead to future increases in CVD risk factors (Ford et al., 2004~ Johnson et al., 2009). Recent studies suggest that air pollution exposure is associated with increased levels of intermediate biomarkers of CVD, including metabolic syndrome (Chen, 2008), indicated by increased levels of blood cholesterols, blood pressure, and C-reactive protein in individuals exposed to high levels of PM. Therefore, it is hypothesized that the adverse relationships between ambient air pollutant exposure and CVD mortality are stronger in obese subjects, high saturated fat consumers, and insulin resistant people (i.e., individuals with metabolic syndrome). This hypothesis will be examined in 18,149 U.S. men and women in the NHANES III study cohort, who were enrolled in 1988-1994. Outdoor concentrations of PM and gaseous pollutants concentrations from nearest monitors within 5, 10, and 20 miles have been linked to each participant's residential address. Information on blood biomarkers, anthropometry, and dietary intake was obtained at study baseline and all subjects were followed up to 20 years until death and CVD mortality ascertained. These data will be used to explore the hypothesis that exposure to ambient air pollutant (in particular, PM) is associated with increased mortality as well as adverse changes in intermediate biomarkers of CVD and that these relationships are modified by adiposity and intake of calories from saturated fat. PUBLIC HEALTH RELEVANCE: We have assembled an interdisciplinary team of air pollution, nutrition, and genetics researchers to test our hypothesis that the adverse effects of ambient air pollution on the cardiovascular system are modified by nutrition factors. We will use the unique NHANES III data set to model the interaction of air pollution and diet on long term cardiac health effects, including mortality. Successful results will provide information on potential avenues for effect modification of the cardiac effects of air pollution by diet.