School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, & Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China.
School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, & Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, Shanghai, China.
Environ Int. 2015 Jul;80:19-25. doi: 10.1016/j.envint.2015.03.003. Epub 2015 Mar 31.
Little is known regarding how the size distribution of particulate matter (PM) air pollution influences its effect on blood pressure (BP), especially among patients with diabetes. The objective of this study was to explore the short-term associations between size-fractionated PM and BP among diabetes patients. We scheduled 6 repeated BP examinations every 2 weeks from 13 April 2013 to 30 June 2013 in a panel of 35 type 2 diabetes mellitus patients recruited from an urban community in Shanghai, China. We measured real-time PM concentrations in the size range of 0.25 to 10 μm. We used linear mixed-effect models to examine the short-term association of size-fractionated PM and BP after controlling for individual characteristics, mean temperature, relative humidity, day of the week, years with diabetes and use of antihypertensive medication. The association with systolic BP and pulse pressure strengthened with decreasing diameter. The size fractions with the strongest associations were 0.25 to 0.40 μm for number concentrations and ≤ 2.5 μm for mass concentrations. Furthermore, these effects occurred immediately even after 0-2h and lasted for up to 48 h following exposure. An interquartile range increase in 24-h average number concentrations of PM0.25-0.40 was associated with increases of 3.61 mmHg in systolic BP and 2.96 mmHg in pulse pressure. Females, patients younger than 65 years of age and patients without antihypertensive treatment were more susceptible to these effects. Our results revealed important size and temporal patterns of PM in elevating BP among diabetes patients in China.
关于颗粒物（PM）空气污染的粒径分布如何影响其对血压（BP）的影响，人们知之甚少，尤其是在糖尿病患者中。本研究旨在探讨糖尿病患者中不同粒径的 PM 与 BP 之间的短期关联。我们从中国上海一个城市社区招募了 35 名 2 型糖尿病患者，在 2013 年 4 月 13 日至 6 月 30 日期间，每两周安排 6 次重复血压检查。我们测量了粒径范围在 0.25 到 10μm 的实时 PM 浓度。我们使用线性混合效应模型，在控制个体特征、平均温度、相对湿度、星期几、糖尿病患病年限和使用降压药物后，检查了不同粒径的 PM 与 BP 的短期关联。与收缩压和脉压的关联随着直径的减小而增强。与数量浓度相关的最强关联粒径范围为 0.25 到 0.40μm，与质量浓度相关的最强关联粒径范围为≤2.5μm。此外，即使在暴露后 0-2 小时，这些影响也会立即发生，并持续长达 48 小时。24 小时平均 PM0.25-0.40 数量浓度的中值增加 1 个四分位间距与收缩压升高 3.61mmHg 和脉压升高 2.96mmHg 有关。女性、年龄小于 65 岁的患者和未接受降压治疗的患者更容易受到这些影响。我们的研究结果揭示了中国糖尿病患者中 PM 升高 BP 的重要粒径和时间模式。
