Khafaie Morteza Abdullatif, Salvi Sundeep Santosh, Yajnik Chittaranjan Sakerlal, Ojha Ajay, Khafaie Behzad, Gore Sharad Damodar
Environmental Technologies Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Department of Public Health, Faculty of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Environ Sci Pollut Res Int. 2017 Jun;24(18):15538-15546. doi: 10.1007/s11356-017-9148-5. Epub 2017 May 17.
Diabetics may be more vulnerable to the harmful effects of ambient air pollutants than healthy individuals. But, the risk factors that lead to susceptibility to air pollution in diabetics have not yet been identified. We examined the effect of exposure to ambient PM on chronic symptoms and the pulmonary function tests (PFT) in diabetic and non-diabetic subjects. Also, to investigate possible determinants of susceptibility, we recruited 400 type 2 diabetic and 465 healthy subjects who were investigated for chronic respiratory symptoms (CRSs) and then underwent measurement of forced vital capacity (FVC) and forced expiratory volume 1 (FEV1) according to standard protocol. Percent predicted FEV1 and FVC (FEV1% and FVC%, respectively) for each subject were calculated. Particulate matter (PM) concentrations at residence place of subjects were estimated using AERMOD dispersion model. The association between PM and CRSs was explored using logistic regression. We also used linear regression models controlling for potential confounders to study the association between chronic exposure to PM and FEV1% and FVC%. Prevalence of current wheezing, allergy symptom, chest tightness, FEV1/FVC <70%, and physician-diagnosed asthma and COPD was significantly higher among diabetic subjects than non-diabetics. There was no significant difference between percent predicted value of PFT among diabetic and non-diabetic subjects (P < 0.05). We estimated that 1 SD increase in PM concentration was associated with a greater risk of having dyspnea by 1.50-fold (95% CI, 1.12-2.01). Higher exposure to PM concentration was also significantly associated with lower FVC%. The size of effect for 1 SD μg/m (=98.38) increase in PM concentration was 3.71% (95% CI, 0.48-4.99) decrease in FVC%. In addition, we indicated that strength of these associations was higher in overweight, smoker, and aged persons. We demonstrated a possible contribution of air pollution to reduced lung function independent of diabetes status. This study suggests that decline in exposure may significantly reduce disease manifestation as dyspnea and impaired lung function. We conduct that higher BMI, smoking, and older age were associated with higher levels of air pollution effects.
糖尿病患者可能比健康个体更容易受到环境空气污染物的有害影响。但是，导致糖尿病患者易受空气污染影响的风险因素尚未确定。我们研究了暴露于环境细颗粒物（PM）对糖尿病和非糖尿病受试者慢性症状及肺功能测试（PFT）的影响。此外，为了调查易感性的可能决定因素，我们招募了400名2型糖尿病患者和465名健康受试者，对他们进行慢性呼吸道症状（CRS）调查，然后根据标准方案测量用力肺活量（FVC）和第1秒用力呼气容积（FEV1）。计算每个受试者的预计FEV1和FVC百分比（分别为FEV1%和FVC%）。使用AERMOD扩散模型估计受试者居住地点的颗粒物（PM）浓度。使用逻辑回归探索PM与CRS之间的关联。我们还使用线性回归模型控制潜在混杂因素，以研究长期暴露于PM与FEV1%和FVC%之间的关联。糖尿病受试者中当前喘息、过敏症状、胸闷、FEV1/FVC<70%以及医生诊断的哮喘和慢性阻塞性肺疾病（COPD）的患病率显著高于非糖尿病受试者。糖尿病和非糖尿病受试者之间PFT的预计值百分比没有显著差异（P<0.05）。我们估计PM浓度每增加1个标准差，出现呼吸困难的风险就会增加1.50倍（95%置信区间，1.12 - 2.01）。更高的PM浓度暴露也与更低的FVC%显著相关。PM浓度每增加1个标准差μg/m（=98.38），FVC%下降的幅度为3.71%（95%置信区间，0.48 - 4.99）。此外，我们指出这些关联在超重、吸烟者和老年人中更强。我们证明了空气污染对肺功能降低有独立于糖尿病状态的可能影响。这项研究表明，减少暴露可能会显著降低如呼吸困难和肺功能受损等疾病表现。我们认为较高的体重指数（BMI）、吸烟和年龄较大与更高水平的空气污染影响相关。
