颗粒物暴露与应激激素水平：空气净化的随机、双盲、交叉试验。
Particulate Matter Exposure and Stress Hormone Levels: A Randomized, Double-Blind, Crossover Trial of Air Purification.
机构信息
From School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China (H.L., J.C., R.C., Z.Z., Z.Y., H.K.); Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, China (J.C., R.C., Z.Y., L.W., J.C.); Department of Genetics and Genomics Sciences, Icahn School of Medicine at Mount Sinai, New York, NY (K.H.); The Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY (K.H.); Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University, China (K.H.); Department of Environmental Health, School of Public Health, Boston University, MA (P.L.K.); Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing (H.C.); and Key Laboratory of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, China (H.K.).
出版信息
Circulation. 2017 Aug 15;136(7):618-627. doi: 10.1161/CIRCULATIONAHA.116.026796.
BACKGROUND
Exposure to ambient particulate matter (PM) is associated with a number of adverse health outcomes, but potential mechanisms are largely unknown. Metabolomics represents a powerful approach to study global metabolic changes in response to environmental exposures. We therefore conducted this study to investigate changes in serum metabolites in response to the reduction of PM exposure among healthy college students.
METHODS
We conducted a randomized, double-blind crossover trial in 55 healthy college students in Shanghai, China. Real and sham air purifiers were placed in participants' dormitories in random order for 9 days with a 12-day washout period. Serum metabolites were quantified by using gas chromatography-mass spectrometry and ultrahigh performance liquid chromatography-mass spectrometry. Between-treatment differences in metabolites were examined using orthogonal partial least square-discriminant analysis and mixed-effect models. Secondary outcomes include blood pressure, corticotropin-releasing hormone, adrenocorticotropic hormone, insulin resistance, and biomarkers of oxidative stress and inflammation.
RESULTS
The average personal exposure to PMs with aerodynamic diameters ≤2.5 μm was 24.3 μg/m during the real purification and 53.1 μg/m during the sham purification. Metabolomics analysis showed that higher exposure to PMs with aerodynamic diameters ≤2.5 μm led to significant increases in cortisol, cortisone, epinephrine, and norepinephrine. Between-treatment differences were also observed for glucose, amino acids, fatty acids, and lipids. We found significantly higher blood pressure, hormones, insulin resistance, and biomarkers of oxidative stress and inflammation among individuals exposed to higher PMs with aerodynamic diameters ≤2.5 μm.
CONCLUSIONS
This study suggests that higher PM may induce metabolic alterations that are consistent with activations of the hypothalamus-pituitary-adrenal and sympathetic-adrenal-medullary axes, adding potential mechanistic insights into the adverse health outcomes associated with PM. Furthermore, our study demonstrated short-term reductions in stress hormone following indoor air purification.
CLINICAL TRIAL REGISTRATION
URL: http://www.clinicaltrials.gov. Unique identifier: NCT02712333.
背景
暴露于环境细颗粒物（PM）与许多不良健康后果有关，但潜在机制在很大程度上尚不清楚。代谢组学代表了一种研究环境暴露引起的整体代谢变化的有力方法。因此，我们进行了这项研究，以调查健康大学生 PM 暴露减少时血清代谢物的变化。
方法
我们在中国上海的 55 名健康大学生中进行了一项随机、双盲交叉试验。真实和模拟空气净化器以随机顺序放置在参与者的宿舍中，为期 9 天，洗脱期为 12 天。通过气相色谱-质谱和超高效液相色谱-质谱定量血清代谢物。使用正交偏最小二乘判别分析和混合效应模型检查代谢物的治疗间差异。次要结局包括血压、促肾上腺皮质激素释放激素、促肾上腺皮质激素、胰岛素抵抗以及氧化应激和炎症的生物标志物。
结果
真实净化时个人暴露于空气动力学直径≤2.5μm 的 PM 的平均水平为 24.3μg/m，模拟净化时为 53.1μg/m。代谢组学分析表明，较高的空气动力学直径≤2.5μm 的 PM 暴露会导致皮质醇、皮质酮、肾上腺素和去甲肾上腺素显著增加。治疗间差异也观察到葡萄糖、氨基酸、脂肪酸和脂质。我们发现，暴露于空气动力学直径≤2.5μm 的较高 PM 的个体的血压、激素、胰岛素抵抗以及氧化应激和炎症的生物标志物显著升高。
结论
这项研究表明，较高的 PM 可能会引起代谢改变，这些改变与下丘脑-垂体-肾上腺和交感肾上腺髓质轴的激活一致，为 PM 相关不良健康后果提供了潜在的机制见解。此外，我们的研究表明，室内空气净化后应激激素水平短期下降。
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