大气细颗粒物（PM2.5）污染对中国现代化进程中动脉粥样硬化的影响：来自 CATHAY 研究的报告。

The impact of particulate matter air pollution (PM2.5) on atherosclerosis in modernizing China: a report from the CATHAY study.

机构信息

Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong SAR.

Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR.

出版信息

Int J Epidemiol. 2021 May 17;50(2):578-588. doi: 10.1093/ije/dyaa235.

DOI:10.1093/ije/dyaa235

PMID:33349857

Abstract

BACKGROUND

Air pollution has been associated with an increase in cardiovascular diseases incidence. To evaluate whether air pollution can accelerate atherogenic processes, we assessed the effects of air pollution on important surrogate markers of atherosclerosis [brachial flow-mediated dilation (FMD) and carotid intima-media thickness (IMT)].

METHODS

A total of 1656 Han Chinese (mean age 46.0 + 11.2 years; male 47%) in Hong Kong, Macau, Pun Yu, Yu County and the 3-Gorges Territories (Yangtze River) were studied between 1996 and 2007 [Chinese Atherosclerosis in the Aged and Young Project (the CATHAY Study)]. Cardiovascular risk profiles were evaluated. Particulate matter with an aerodynamic diameter <2.5 µm (PM2.5) parameters were computed from satellite sensors. Brachial FMD and carotid IMT were measured by ultrasound.

RESULTS

Health parameters [age, gender, body mass index, waist : hip ratio (WHR) and glucose)] were similar in lowest and highest PM2.5 exposure tertiles, systolic and diastolic blood pressures and triglycerides were higher (P < 0.001) and low-density cholesterol (LDL-C) was lower in the top PM2.5 tertile (P < 0.001). Brachial FMD [7.84 ± 1.77, 95% confidence interval (CI) 7.59-8.10%, vs 8.50 ± 2.52, 95% CI 8.23-8.77%, P < 0.0001) was significantly lower and carotid IMT (0.68 ± 0.13 mm, 95% CI 0.67-0.69 mm vs 0.63 mm ± 0.15 mm 95% CI 0.62-0.64 mm; P < 0.0001) was significantly thicker in the top PM2.5 tertile compared with the lowest tertile. On multiple regression, FMD was inversely related to PM2.5 (beta = 0.134, P = 0.015) independent of gender, age and blood pressure (model R2 = 0.156, F-value = 7.6, P < 0.0001). Carotid IMT was significantly correlated with PM2.5 exposure (beta = 0.381, P < 0.0001) independent of age, location, gender, WHR, blood pressure and LDL-C (model R2 = 0.408, F-value = 51.4, P-value <0.0001).

CONCLUSIONS

Air pollution is strongly associated with markers of early atherosclerosis, suggesting a potential target for preventive intervention.

摘要

背景

空气污染与心血管疾病发病率的增加有关。为了评估空气污染是否会加速动脉粥样硬化过程，我们评估了空气污染对动脉粥样硬化重要替代标志物[肱动脉血流介导的扩张（FMD）和颈动脉内膜-中层厚度（IMT）]的影响。

方法

1996 年至 2007 年，在中国香港、澳门、番禺、玉县和三峡地区（长江）共研究了 1656 名汉族人（平均年龄 46.0+11.2 岁；男性 47%）[中国老年和年轻人群动脉粥样硬化研究（CATHAY 研究）]。评估了心血管风险状况。通过卫星传感器计算出空气动力学直径<2.5 µm（PM2.5）的颗粒物参数。肱动脉 FMD 和颈动脉 IMT 通过超声测量。

结果

健康参数[年龄、性别、体重指数、腰围：臀围比（WHR）和血糖]在 PM2.5 暴露最低和最高三分位组中相似，收缩压和舒张压以及甘油三酯更高（P<0.001），而 LDL-C 在 PM2.5 最高三分位组中更低（P<0.001）。肱动脉 FMD[7.84+1.77，95%置信区间（CI）7.59-8.10%，vs 8.50+2.52，95%CI 8.23-8.77%，P<0.0001]明显较低，颈动脉 IMT[0.68+0.13mm，95%CI 0.67-0.69mm vs 0.63mm+0.15mm 95%CI 0.62-0.64mm；P<0.0001]在 PM2.5 最高三分位组中明显较厚。多元回归分析显示，FMD 与 PM2.5 呈负相关（β=0.134，P=0.015），独立于性别、年龄和血压（模型 R2=0.156，F 值=7.6，P<0.0001）。颈动脉 IMT 与 PM2.5 暴露显著相关（β=0.381，P<0.0001），独立于年龄、位置、性别、WHR、血压和 LDL-C（模型 R2=0.408，F 值=51.4，P 值<0.0001）。