短期暴露于大气污染与凝血生物标志物之间的关联：系统评价和荟萃分析。
Association between short-term exposure to ambient air pollution and biomarkers of coagulation: A systematic review and meta-analysis.
机构信息
Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China; Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi, China.
Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China.
出版信息
Environ Res. 2022 Dec;215(Pt 1):114210. doi: 10.1016/j.envres.2022.114210. Epub 2022 Aug 27.
Ambient air pollution is one of the major global risk factors for cardiovascular health, and coagulation changes have been proposed to mediate this risk. Plasminogen activator inhibitor-1 (PAI-1), von Willebrand factor (vWF), soluble P-selectin (sP-selectin) and tissue plasminogen activator (t-PA) are major coagulation biomarkers. However, there has been no systematic meta-analysis to summarize associations of ambient air pollution with these coagulation biomarkers. To assess the overall associations between ambient particulate matter (PM, PM), ozone (O), nitrogen dioxide (NO), carbon monoxide (CO) and major coagulation biomarkers including PAI-1, vWF, sP-selectin and t-PA based on the existing epidemiological research. We performed a systematic literature search of publications reporting the associations of ambient air pollutants (PM, PM, O, NO and CO) with coagulation biomarkers (PAI-1, vWF, sP-selectin and t-PA) in PubMed, Web of Science, EMBASE, and Scopus databases as of April 5, 2022. Then, we performed a random-effect meta-analysis, which included 27 articles, and then identified the potential sources of heterogeneity. The pooled percent changes of coagulation biomarkers per 10 μg/m increase in short-term exposure to ambient PM were 2.43% (95% CI: 0.59%, 4.29%) in PAI-1, 1.08% (95% CI: 0.21%, 1.96%) in vWF and 1.14% (95% CI: 0.59%, 1.68%) in sP-selectin, respectively. We also found significant associations of short-term exposure to ambient O with PAI-1 (1.62%, 95% CI: 0.01%, 3.25%), sP-selectin (9.59%, 95% CI:2.78%, 16.86%) and t-PA (0.45%, 95% CI: 0.02%, 0.88%), respectively. Short-term exposures to ambient PM, NO and CO were not significantly associated with changes in coagulation biomarkers. In conclusion, short-term exposures to PM and O are associated with significant increases in coagulation biomarkers, suggesting an activated coagulation state upon air pollution exposure.
大气污染是影响心血管健康的主要全球风险因素之一，凝血变化被认为是其介导因素。纤溶酶原激活物抑制剂-1（PAI-1）、血管性血友病因子（vWF）、可溶性 P 选择素（sP-selectin）和组织型纤溶酶原激活物（t-PA）是主要的凝血生物标志物。然而，目前还没有系统的荟萃分析来总结大气污染与这些凝血生物标志物之间的关联。本研究旨在评估现有流行病学研究中大气颗粒物（PM、PM）、臭氧（O）、二氧化氮（NO）、一氧化碳（CO）与主要凝血生物标志物（PAI-1、vWF、sP-selectin 和 t-PA）之间的总体关联。我们在 PubMed、Web of Science、EMBASE 和 Scopus 数据库中进行了系统的文献检索，检索了截至 2022 年 4 月 5 日报道大气污染物（PM、PM、O、NO 和 CO）与凝血生物标志物（PAI-1、vWF、sP-selectin 和 t-PA）之间关联的出版物。然后，我们进行了随机效应荟萃分析，其中包括 27 篇文章，并确定了异质性的潜在来源。大气 PM 短期暴露每增加 10μg/m 时，PAI-1、vWF 和 sP-selectin 的凝血生物标志物的平均百分比变化分别为 2.43%（95%CI：0.59%，4.29%）、1.08%（95%CI：0.21%，1.96%）和 1.14%（95%CI：0.59%，1.68%）。我们还发现，大气 O 的短期暴露与 PAI-1（1.62%，95%CI：0.01%，3.25%）、sP-selectin（9.59%，95%CI：2.78%，16.86%）和 t-PA（0.45%，95%CI：0.02%，0.88%）的相关性显著。大气 PM、NO 和 CO 的短期暴露与凝血生物标志物的变化没有显著关联。总之，PM 和 O 的短期暴露与凝血生物标志物的显著增加相关，提示在空气污染暴露时存在激活的凝血状态。
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