儿童和青少年产前及产后颗粒物暴露与血压：系统评价和荟萃分析
Pre- and postnatal particulate matter exposure and blood pressure in children and adolescents: A systematic review and meta-analysis.
作者信息
Liu Yufan, Li Yan, Xu Hailin, Zhao Xinying, Zhu Yawen, Zhao Bosen, Yao Qing, Duan Huawei, Guo Caixia, Li Yanbo
机构信息
Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China.
Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China; Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, China.
出版信息
Environ Res. 2023 Apr 15;223:115373. doi: 10.1016/j.envres.2023.115373. Epub 2023 Jan 31.
BACKGROUND
Early life is a susceptible period of air pollution-related adverse health effects. Hypertension in children might be life-threatening without prevention or treatment. Nevertheless, the causative association between environmental factors and childhood hypertension was limited. In the light of particulate matter (PM) as an environmental risk factor for cardiovascular diseases, this study investigated the association of pre- and postnatal PM exposure with blood pressure (BP) and hypertension among children and adolescents.
METHOD
Four electronic databases were searched for related epidemiological studies published up to September 13, 2022. Stata 14.0 was applied to examine the heterogeneity among the studies and evaluate the combined effect sizes per 10 μg/m increase of PM by selecting the corresponding models. Besides, subgroup analysis, sensitivity analysis, and publication bias test were also conducted.
RESULTS
Prenatal PM exposure was correlated with increased diastolic blood pressure (DBP) in offspring [1.14 mmHg (95% CI: 0.12, 2.17)]. For short-term postnatal exposure effects, PM (7-day average) was significantly associated with systolic blood pressure (SBP) [0.20 mmHg (95% CI: 0.16, 0.23)] and DBP [0.49 mmHg (95% CI: 0.45, 0.53)]; and also, PM (7-day average) was significantly associated with SBP [0.14 mmHg (95% CI: 0.12, 0.16)]. For long-term postnatal exposure effects, positive associations were manifested in SBP with PM [β = 0.44, 95% CI: 0.40, 0.48] and PM [β = 0.35, 95% CI: 0.19, 0.51]; DBP with PM [β = 0.45, 95% CI: 0.42, 0.49], PM [β = 0.31, 95% CI: 0.27, 0.35] and PM [β = 0.32, 95% CI: 0.19, 0.45]; and hypertension with PM [OR = 1.43, 95% CI: 1.40, 1.46], PM [OR = 1.65, 95% CI: 1.29, 2.11] and PM [OR = 1.26, 95% CI: 1.09, 1.45].
CONCLUSION
Both prenatal and postnatal exposure to PM can increase BP, contributing to a higher prevalence of hypertension in children and adolescents.
背景
生命早期是空气污染相关不良健康影响的易感期。儿童高血压若不预防或治疗可能危及生命。然而，环境因素与儿童高血压之间的因果关联有限。鉴于颗粒物（PM）是心血管疾病的环境风险因素，本研究调查了产前和产后PM暴露与儿童及青少年血压（BP）和高血压之间的关联。
方法
检索了四个电子数据库，以查找截至2022年9月13日发表的相关流行病学研究。应用Stata 14.0检查研究间的异质性，并通过选择相应模型评估PM每增加10μg/m时的合并效应量。此外，还进行了亚组分析、敏感性分析和发表偏倚测试。
结果
产前PM暴露与后代舒张压（DBP）升高相关[1.14mmHg（95%CI：0.12，2.17）]。对于产后短期暴露效应，PM（7天平均值）与收缩压（SBP）[0.20mmHg（95%CI：0.16，0.23）]和DBP[0.49mmHg（95%CI：0.45，0.53）]显著相关；并且，PM（7天平均值）与SBP[0.14mmHg（95%CI：0.12，0.16）]也显著相关。对于产后长期暴露效应，SBP与PM[β = 0.44，95%CI：0.40，0.48]和PM[β = 0.35，95%CI：0.19，0.51]呈正相关；DBP与PM[β = 0.45，95%CI：0.42，0.49]、PM[β = 0.31，95%CI：0.27，0.35]和PM[β = 0.32，95%CI：0.19，0.45]呈正相关；高血压与PM[OR = 1.43，95%CI：1.40，1.46]、PM[OR = 1.65，95%CI：1.29，2.11]和PM[OR = 1.26，95%CI：1.09，1.45]呈正相关。
结论
产前和产后暴露于PM均可升高血压，导致儿童及青少年高血压患病率升高。
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