Wilker Elissa H, Preis Sarah R, Beiser Alexa S, Wolf Philip A, Au Rhoda, Kloog Itai, Li Wenyuan, Schwartz Joel, Koutrakis Petros, DeCarli Charles, Seshadri Sudha, Mittleman Murray A
From the Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (E.H.W., M.A.M.); Exposure, Epidemiology and Risk Program, Department of Environmental Health (E.H.W., J.S., P.K.) and Department of Epidemiology (W.L., J.S., M.A.M.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Biostatistics, School of Public Health (S.R.P., A.S.B., R.A.) and Department of Neurology, School of Medicine (A.S.B., P.A.W., S.S.), Boston University, MA; Framingham Heart Study, MA (S.R.P., A.S.B., P.A.W., S.S.); Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer Sheva, Israel (I.K.); and Department of Neurology and Center for Neuroscience, University of California, Davis (C.D.).
Stroke. 2015 May;46(5):1161-6. doi: 10.1161/STROKEAHA.114.008348.
Long-term exposure to ambient air pollution is associated with cerebrovascular disease and cognitive impairment, but whether it is related to structural changes in the brain is not clear. We examined the associations between residential long-term exposure to ambient air pollution and markers of brain aging using magnetic resonance imaging.
Framingham Offspring Study participants who attended the seventh examination were at least 60 years old and free of dementia and stroke were included. We evaluated associations between exposures (fine particulate matter [PM2.5] and residential proximity to major roadways) and measures of total cerebral brain volume, hippocampal volume, white matter hyperintensity volume (log-transformed and extensive white matter hyperintensity volume for age), and covert brain infarcts. Models were adjusted for age, clinical covariates, indicators of socioeconomic position, and temporal trends.
A 2-μg/m(3) increase in PM2.5 was associated with -0.32% (95% confidence interval, -0.59 to -0.05) smaller total cerebral brain volume and 1.46 (95% confidence interval, 1.10 to 1.94) higher odds of covert brain infarcts. Living further away from a major roadway was associated with 0.10 (95% confidence interval, 0.01 to 0.19) greater log-transformed white matter hyperintensity volume for an interquartile range difference in distance, but no clear pattern of association was observed for extensive white matter.
Exposure to elevated levels of PM2.5 was associated with smaller total cerebral brain volume, a marker of age-associated brain atrophy, and with higher odds of covert brain infarcts. These findings suggest that air pollution is associated with insidious effects on structural brain aging even in dementia- and stroke-free persons.
长期暴露于环境空气污染与脑血管疾病及认知障碍相关,但它是否与大脑结构变化有关尚不清楚。我们使用磁共振成像检查了长期居住暴露于环境空气污染与脑老化标志物之间的关联。
纳入参加第七次检查的弗雷明汉后代研究参与者,他们年龄至少60岁,且无痴呆和中风。我们评估了暴露因素(细颗粒物[PM2.5]以及住宅与主要道路的距离)与全脑总体积、海马体体积、白质高信号体积(经对数转换并根据年龄调整的广泛白质高信号体积)和隐匿性脑梗死测量指标之间的关联。模型对年龄、临床协变量、社会经济地位指标和时间趋势进行了调整。
PM2.5每增加2μg/m³,与全脑总体积减小0.32%(95%置信区间,-0.59至-0.05)以及隐匿性脑梗死几率增加1.46(95%置信区间,1.10至1.94)相关。对于四分位间距的距离差异,居住在离主要道路更远的地方与经对数转换的白质高信号体积增加0.10(95%置信区间,0.01至0.19)相关,但对于广泛白质未观察到明确的关联模式。
暴露于高水平的PM2.5与全脑总体积减小相关,全脑总体积是与年龄相关的脑萎缩的一个标志物,并且与隐匿性脑梗死的较高几率相关。这些发现表明,即使在无痴呆和中风的人群中,空气污染也与对大脑结构老化的潜在影响有关。