Peralta Adjani A, Schwartz Joel, Gold Diane R, Coull Brent, Koutrakis Petros
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
Environ Res. 2021 Apr;195:110827. doi: 10.1016/j.envres.2021.110827. Epub 2021 Feb 4.
Several studies have found associations between increases in QT interval length, a marker of cardiac electrical instability, and short-term fine particulate matter (PM) exposures. To our knowledge, this is the first study to examine the association between specific PM metal components and QT interval length.
We measured heart-rate corrected QT interval (QTc) duration among 630 participants in the Normative Aging Study (NAS) based in Eastern Massachusetts between 2000 and 2011. We utilized time-varying linear mixed-effects regressions with a random intercept for each participant to analyze associations between QTc interval and moving averages (0-7 day moving averages) of 24-h mean concentrations of PM metal components (vanadium, nickel, copper, zinc and lead) measured at the Harvard Supersite monitoring station. Models were adjusted for daily PM mass estimated at a 1 km × 1 km grid cell from a previously validated prediction model and other covariates. Bayesian kernel machine regression (BKMR) was utilized to assess the overall joint effect of the PM metal components.
We found consistent results with higher lead (Pb) associated with significant higher QTc intervals for both the multi-pollutant and the two pollutant (PM mass and a PM component) models across the moving averages. The greatest effect of lead on QTc interval was detected for the 4-day moving average lead exposure. In the multi-pollutant model, each 2.72 ng/m increase in daily lead levels for a 4-day moving average was associated with a 7.91 ms (95% CI: 3.63, 12.18) increase in QTc interval. In the two-pollutant models with PM mass and lead, each 2.72 ng/m increase in daily lead levels for a 4-day moving average was associated with an 8.50 ms (95% CI: 4.59, 12.41) increase in QTc interval. We found that 4-day moving average of copper has a negative association with QTc interval when compared to the other PM metal components. In the multi-pollutant model, each 1.81 ng/m increase in daily copper levels for a 4-day moving average was associated with an -3.89 ms (95% CI: -6.98, -0.79) increase in QTc interval. Copper's essential function inside the human body could mediate its cardiotoxicity on cardiac conductivity and explain why we found that copper in comparison to the other metals was less harmful for QTc interval.
Exposure to metals contained in PM are associated with acute changes in ventricular repolarization as indicated by QT interval characteristics.
多项研究发现，心脏电不稳定标志物QT间期长度增加与短期细颗粒物（PM）暴露之间存在关联。据我们所知，这是第一项研究特定PM金属成分与QT间期长度之间关联的研究。
我们在2000年至2011年期间，对马萨诸塞州东部规范衰老研究（NAS）中的630名参与者测量了心率校正QT间期（QTc）时长。我们使用具有随机截距的时变线性混合效应回归，对每位参与者分析QTc间期与在哈佛超级站点监测站测量的PM金属成分（钒、镍、铜、锌和铅）24小时平均浓度的移动平均值（0 - 7天移动平均值）之间的关联。模型针对根据先前验证的预测模型在1千米×1千米网格单元估算的每日PM质量以及其他协变量进行了调整。采用贝叶斯核机器回归（BKMR）来评估PM金属成分的总体联合效应。
我们发现，在移动平均值范围内，对于多污染物模型和两种污染物（PM质量和一种PM成分）模型，铅（Pb）含量越高，QTc间期显著越长，结果一致。在4天移动平均铅暴露中检测到铅对QTc间期的最大影响。在多污染物模型中，4天移动平均每日铅水平每增加2.72纳克/立方米，与QTc间期增加7.91毫秒（95%置信区间：3.63，12.18）相关。在包含PM质量和铅的两种污染物模型中，4天移动平均每日铅水平每增加2.72纳克/立方米，与QTc间期增加8.50毫秒（95%置信区间：4.59，12.41）相关。我们发现，与其他PM金属成分相比，铜的4天移动平均值与QTc间期呈负相关。在多污染物模型中，4天移动平均每日铜水平每增加1.81纳克/立方米，与QTc间期增加 - 3.89毫秒（95%置信区间： - 6.98， - 0.79）相关。铜在人体内的基本功能可能介导其对心脏电导率的心脏毒性，并解释了为什么我们发现与其他金属相比，铜对QTc间期的危害较小。
如QT间期特征所示，暴露于PM中所含金属与心室复极化的急性变化有关。
