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

摘要 儿童肥胖是一个主要的公共健康威胁，儿童肥胖率正以惊人的速度增长 全世界。目前22.4%的儿童和青少年患有肥胖症，约1670万人， 儿童人口中所有年龄段的肥胖率都在上升。肥胖的儿童 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)。肥胖症每年的估计医疗费用- 相关疾病高达1902亿美元，占美国年度医疗支出的近21% 美国。家庭空气污染(HAP)是一个用来描述人们的健康和 固体燃料不完全燃烧产生的污染物对环境的影响 木材，煤，木炭，动物粪便，农作物废弃物在明火上燃烧或在 通风不良的房屋会释放悬浮颗粒物(PM)。很少有研究。 检查包括PM2.5在内的家庭空气污染在心血管风险中的作用 儿童肥胖症。心血管健康的一个重要组成部分是每天变化的 血压，夜间血压水平大约比白天低20%。这个 儿童时期没有夜间血压下降可能是早期疾病的一个重要指标 风险和我们的团队最近发表的证据表明，儿童肥胖与 不浸泡。这里提出的具体项目将检验暴露于 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岁的患者来定义 居家空气质量与高血压危险因素的关系。一项初步研究 确定高效颗粒物(HEPA)过滤装置对空气质量的影响 暴露和健康风险也将在这些患者中进行测量。这项研究针对的是 通过了解和确定环境暴露于 为农村弱势高危儿童群体开发新的治疗方法，以改善他们的 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.