Michikawa Takehiro, Okamura Tomonori, Nitta Hiroshi, Nishiwaki Yuji, Takebayashi Toru, Ueda Kayo, Kadota Aya, Fujiyoshi Akira, Ohkubo Takayoshi, Ueshima Hirotsugu, Okayama Akira, Miura Katsuyuki
Environmental Epidemiology Section, Centre for Environmental Health Sciences, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan; Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Environ Pollut. 2016 Jun;213:460-467. doi: 10.1016/j.envpol.2016.02.051. Epub 2016 Mar 8.
A suggestive mechanism behind the association between particulate matter and cardiovascular disease is inflammatory response. Earlier population-based studies investigating the association between particulate matter and inflammatory biological markers, in particular C-reactive protein (CRP), showed inconsistent results. In addition, evidence from the Asian population, in which CRP levels are typically lower than those observed in Western populations, was sparse. We examined the cross-sectional association between short- and long-term exposure to particulate matter and inflammatory markers, including high-sensitivity CRP (hs-CRP) and white blood cell (WBC) count, in a representative population of Japanese community dwellers (NIPPON DATA2010). We analysed data from 2360 participants (1002 men and 1358 women), aged 20 years or older, who resided in 300 randomly selected districts (222 public health centre areas) throughout Japan. We used background concentrations of suspended particulate matter (SPM, defined as particles with a 100% cut-off level at 10 μm aerodynamic diameter) and co-pollutants within the public health centre area. A logistic regression model was applied to estimate odds ratios (ORs) of elevated hs-CRP (> 0.3 mg/dl) or WBC (> 9000/μl). Since smoking is an important confounding factor, we firstly included this in the models, and additionally conducted the analyses after excluding current smokers. The one-month average concentration of SPM was positively associated with hs-CRP (OR per 10 μg/m(3) increase in SPM = 1.42, 95% confidence interval = 1.00-2.04), and high exposure to SPM on the day of blood draw was associated with increased WBC count, after excluding current smokers (OR = 1.13, 1.01-1.28). Similar association patterns were observed for ozone. In conclusion, exposure to particulate matter was associated with inflammatory markers in the general Japanese population. Systemic inflammation may play a role in the link between particulate matter and cardiovascular disease.
颗粒物与心血管疾病之间关联背后的一种可能机制是炎症反应。早期基于人群的研究调查了颗粒物与炎症生物标志物，特别是C反应蛋白（CRP）之间的关联，结果并不一致。此外，来自亚洲人群（其CRP水平通常低于西方人群）的证据很少。我们在日本社区居民的代表性人群（NIPPON DATA2010）中，研究了短期和长期接触颗粒物与炎症标志物之间的横断面关联，这些炎症标志物包括高敏CRP（hs-CRP）和白细胞（WBC）计数。我们分析了来自2360名参与者（1002名男性和1358名女性）的数据，这些参与者年龄在20岁及以上，居住在日本各地随机选择的300个地区（222个公共卫生中心区域）。我们使用了公共卫生中心区域内悬浮颗粒物（SPM，定义为空气动力学直径在10μm处截断水平为100%的颗粒）和共污染物的背景浓度。应用逻辑回归模型来估计hs-CRP升高（>0.3mg/dl）或WBC升高（>9000/μl）的比值比（OR）。由于吸烟是一个重要的混杂因素，我们首先将其纳入模型，此外在排除当前吸烟者后进行了分析。在排除当前吸烟者后，SPM的一个月平均浓度与hs-CRP呈正相关（SPM每增加10μg/m³，OR = 1.42，95%置信区间 = 1.00 - 2.04），并且采血当天高暴露于SPM与WBC计数增加有关（OR = 1.13，1.01 - 1.28）。对于臭氧也观察到了类似的关联模式。总之，在日本普通人群中，接触颗粒物与炎症标志物有关。全身炎症可能在颗粒物与心血管疾病之间的联系中起作用。
