1 Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
2 California Office of Environmental Health Hazard Assessment, Oakland, California.
J Womens Health (Larchmt). 2019 Jun;28(6):802-811. doi: 10.1089/jwh.2018.7182. Epub 2019 Feb 7.
This article aims to examine the association between long-term ambient air pollution and progression of subclinical atherosclerosis with 2-year follow-up among midlife women from the Study of Women's Health Across the Nation (SWAN). Carotid duplex ultrasonography was performed in participants from a SWAN ancillary study carried out at the Pittsburgh and Chicago sites. Mean and maximum carotid intima-media thickness (CIMT) and plaque burden were assessed throughout the common, bulb, and internal carotid artery. The yearly mean exposure to PM (particulate matter) and ozone was generated based on monitors within 20 km of the participants' home. The effect of air pollutants during follow-up on progression of CIMT was estimated using linear mixed-effects models, and the effect on progression of plaque presence and plaque index, a measure of extent of plaque, was evaluated using logistic regression. This study included 417 (257 White and 160 Black) women with a mean age of 51 years at baseline. A 1 μg/m higher yearly mean exposure to PM during follow-up was associated with a 4.28 (95% confidence interval [CI]: 0.02-8.54) μm/year increase in maximum CIMT, after adjusting for socioeconomic and traditional cardiovascular disease (CVD) risk factors. Exposure to PM contributed to a 30% (95% CI: 3%-65%) higher odds of plaque index progression adjusting for socioeconomic factors only. PM independently contributed to progression of subclinical atherosclerosis, among women transitioning through menopause, a time of increasing CVD risk. Yet no significant associations between ozone and subclinical atherosclerosis were observed.
本文旨在探讨长期环境空气污染与中年女性亚临床动脉粥样硬化进展之间的关联，随访时间为 2 年。参与者来自 SWAN 辅助研究，该研究在匹兹堡和芝加哥进行了颈动脉双功能超声检查。在颈总、颈球和颈内动脉全程评估平均和最大颈动脉内膜中层厚度（CIMT）和斑块负荷。根据参与者家附近 20 公里范围内的监测器，生成每年平均 PM（颗粒物）和臭氧暴露量。使用线性混合效应模型估计随访期间空气污染物对 CIMT 进展的影响，使用逻辑回归评估对斑块存在和斑块指数（斑块程度的衡量指标）进展的影响。该研究纳入了 417 名（257 名白人，160 名黑人）平均年龄为 51 岁的女性。在调整了社会经济和传统心血管疾病（CVD）风险因素后，随访期间每年平均 PM 暴露增加 1μg/m，与最大 CIMT 每年增加 4.28μm/年（95%置信区间：0.02-8.54）相关。仅调整社会经济因素，PM 暴露使斑块指数进展的几率增加 30%（95%置信区间：3%-65%）。PM 独立促进了处于绝经过渡时期女性亚临床动脉粥样硬化的进展，这是 CVD 风险增加的时期。然而，臭氧与亚临床动脉粥样硬化之间没有观察到显著关联。
