Department of Cardiology, Renmin Hospital of Wuhan University.
Institute of Model Animal, Wuhan University.
J Atheroscler Thromb. 2023 Nov 1;30(11):1552-1567. doi: 10.5551/jat.64062. Epub 2023 Apr 8.
To date, PM-associated vascular damage in metabolic abnormalities has remained controversial. We knew little about the vascular damage of PM constituents. Thus, this study aimed to investigate the relationship between long-term exposure to PM and its constituents and vascular damage in metabolic abnormalities.
A total of 124,387 participants with metabolic abnormalities (defined as at least one metabolic disorder, such as obesity, elevated blood pressure, elevated triglyceride level, elevated fasting glucose level, or low HDL cholesterol level) were recruited in this study from 11 representative centers in China between January 2011 and December 2017. PM and its constituents (black carbon [BC], organic matter [OM], sulfate [SO], nitrate [NO], and ammonium salts [NH]) were extracted. Elevated brachial-ankle pulse wave velocity (baPWV) (≥ 1,400 cm/s) and declined ankle-brachial index (ABI) (＜0.9) indicated vascular damage. Multivariable logistic regression and Quantile g-Computation models were utilized to explore the impact on outcomes.
Of the 124,387 participants (median age, 49 years), 87,870 (70.64%) were men. One-year lag exposure to PM and its constituents was significantly associated with vascular damage in single pollutant models. The adjusted odds ratios (OR) for each 1-µg/m increase in PM was 1.013 (95% CI, 1.012-1.015) and 1.031 (95% CI, 1.025-1.037) for elevated baPWV and decreased ABI, respectively. PM constituents were also associated with vascular damage in multi-pollutant models. Among the PM constituents, BC (47.17%), SO (33.59%), and NH (19.23%) have the highest contribution to elevated baPWV and NO (47.89%) and BC (23.50%) to declined ABI.
Chronic exposure to PM and PM constituents was related to vascular damage in the abnormal metabolic population in China. The heterogeneous contribution of different PM constituents to vessel bed damage is worthy of attention when developing targeted strategies.
迄今为止，与 PM 相关的血管损伤在代谢异常中的作用仍存在争议。我们对 PM 成分的血管损伤知之甚少。因此，本研究旨在探讨长期暴露于 PM 及其成分与代谢异常患者的血管损伤之间的关系。
本研究共纳入了 124387 例代谢异常患者（定义为至少存在一种代谢紊乱，如肥胖、血压升高、甘油三酯水平升高、空腹血糖水平升高或高密度脂蛋白胆固醇水平降低），这些患者来自于中国 11 个有代表性的中心，于 2011 年 1 月至 2017 年 12 月入组。提取 PM 及其成分（黑碳[BC]、有机物[OM]、硫酸盐[SO]、硝酸盐[NO]和铵盐[NH]）。肱踝脉搏波速度（baPWV）升高（≥1400cm/s）和踝臂指数（ABI）降低（＜0.9）表明存在血管损伤。多变量逻辑回归和分位数 g 计算模型用于探讨其对结果的影响。
在 124387 名参与者中（中位年龄 49 岁），87870 名（70.64%）为男性。单污染物模型中，PM 及成分的 1 年滞后暴露与血管损伤显著相关。PM 每增加 1μg/m，baPWV 升高的调整比值比（OR）为 1.013（95%可信区间[CI]：1.012-1.015），ABI 降低的调整 OR 为 1.031（95% CI：1.025-1.037）。多污染物模型中，PM 成分也与血管损伤相关。在 PM 成分中，BC（47.17%）、SO（33.59%）和 NH（19.23%）对 baPWV 升高的贡献最大，NO（47.89%）和 BC（23.50%）对 ABI 降低的贡献最大。
在中国代谢异常人群中，慢性暴露于 PM 及其成分与血管损伤有关。不同 PM 成分对血管床损伤的异质性贡献值得关注，在制定有针对性的策略时应予以考虑。
