Chen Jiu-Chiuan, Cavallari Jennifer M, Stone Peter H, Christiani David C
Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill, North Carolina, USA.
Environ Health Perspect. 2007 Jul;115(7):1002-6. doi: 10.1289/ehp.9609.
Increasing evidence suggests that obesity may impart greater susceptibility to adverse effects of air pollution. Particulate matter, especially PM(2.5) (particulate matter with aero-dynamic diameter </=2.5 microm), is associated with increased cardiac events and reduction of heart rate variability (HRV).
Our goal was to investigate whether particle-mediated autonomic modulation is aggravated in obese individuals.
We examined PM(2.5)-mediated acute effects on HRV and heart rate (HR) using 10 24-hr and 13 48-hr ambulatory electrocardiogram recordings collected from 18 boilermakers (39.5 +/- 9.1 years of age) exposed to high levels of metal particulates. Average HR and 5-min HRV [SDNN: standard deviation of normal-to-normal intervals (NN); rMSSD: square-root of mean squared-differences of successive NN intervals; HF: high-frequency power 0.15-0.4 Hz] and personal PM(2.5) exposures were continuously monitored. Subjects with body mass index >/= 30 kg/m(2) were classified as obese. Mixed-effect models were used for statistical analyses.
Half (50%) of the study subjects were obese. After adjustment for confounders, each 1-mg/m(3) increase in 4-hr moving average PM(2.5) was associated with HR increase of 5.9 bpm [95% confidence interval (CI), 4.2 to 7.7] and with 5-min HRV reduction by 6.5% (95% CI, 1.9 to 11.3%) for SDNN, 1.7% (95% CI, -4.9 to 8.4%) for rMSSD, and 8.8% (95% CI, -3.8 to 21.3%) for HF. Obese individuals had greater PM(2.5)-mediated HRV reductions (2- to 3-fold differences) than nonobese individuals, and had more PM(2.5)-mediated HR increases (9-bpm vs. 4-bpm increase in HR for each 1-mg/m(3) increase in PM(2.5); p < 0.001).
Our study revealed greater autonomic cardiac responses to metal particulates in obese workers, supporting the hypothesis that obesity may impart greater susceptibility to acute cardiovascular effects of fine particles.
越来越多的证据表明,肥胖可能使人更容易受到空气污染不良影响的侵害。颗粒物,尤其是PM(2.5)(空气动力学直径≤2.5微米的颗粒物),与心脏事件增加和心率变异性(HRV)降低有关。
我们的目标是研究在肥胖个体中,颗粒物介导的自主神经调节是否会加剧。
我们使用从18名接触高浓度金属颗粒物的锅炉制造工人(年龄39.5±9.1岁)收集的10份24小时动态心电图记录和13份48小时动态心电图记录,研究PM(2.5)对HRV和心率(HR)的急性影响。持续监测平均心率、5分钟HRV[SDNN:正常到正常间期(NN)的标准差;rMSSD:连续NN间期平方差的平方根;HF:0.15 - 0.4赫兹的高频功率]以及个人PM(2.5)暴露情况。体重指数≥30kg/m²的受试者被归类为肥胖。采用混合效应模型进行统计分析。
一半(50%)的研究对象为肥胖者。在对混杂因素进行调整后,4小时移动平均PM(2.5)每增加1mg/m³与心率增加[95%置信区间(CI),4.2至7.7]5.9次/分钟以及5分钟HRV降低相关,对于SDNN降低6.5%(95%CI,1.9至11.3%),对于rMSSD降低1.7%(95%CI,-4.9至8.4%),对于HF降低8.8%(95%CI,-3.8至21.3%)。肥胖个体比非肥胖个体有更大的PM(2.5)介导的HRV降低(相差2至3倍),并且有更多的PM(2.5)介导的心率增加(PM(2.5)每增加1mg/m³,心率增加9次/分钟,而非肥胖个体为4次/分钟;p<0.001)。
我们的研究揭示了肥胖工人对金属颗粒物有更大的心脏自主神经反应,支持了肥胖可能使人更容易受到细颗粒物急性心血管影响的假说。