Department of Internal Medicine, School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, the Netherlands.
School of Mental Health and Neuroscience, University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.
Environ Health. 2024 Sep 4;23(1):70. doi: 10.1186/s12940-024-01110-1.
Epidemiological and toxicological studies indicate that increased exposure to air pollutants can lead to neurodegenerative diseases. To further confirm this relationship, we evaluated the association between exposure to ambient air pollutants and corneal nerve measures as a surrogate for neurodegeneration, using corneal confocal microscopy.
We used population-based observational cross-sectional data from The Maastricht Study including N = 3635 participants (mean age 59.3 years, 51.6% were women, and 19.9% had type 2 diabetes) living in the Maastricht area. Using the Geoscience and hEalth Cohort COnsortium (GECCO) data we linked the yearly average exposure levels of ambient air pollutants at home address-level [particulate matter with diameters of ≤ 2.5 µm (PM2.5), and ≤ 10.0 µm (PM10), nitrogen dioxide (NO2), and elemental carbon (EC)]. We used linear regression analysis to study the associations between Z-score for ambient air pollutants concentrations (PM, PM, NO, and EC) and Z-score for individual corneal nerve measures (corneal nerve bifurcation density, corneal nerve density, corneal nerve length, and fractal dimension).
After adjustment for potential confounders (age, sex, level of education, glucose metabolism status, corneal confocal microscopy lag time, inclusion year of participants, smoking status, and alcohol consumption), higher Z-scores for PM and PM were associated with lower Z-scores for corneal nerve bifurcation density, nerve density, nerve length, and nerve fractal dimension [stβ (95% CI): PM -0.10 (-0.14; -0.05), -0.04 (-0.09; 0.01), -0.11 (-0.16; -0.06), -0.20 (-0.24; -0.15); and PM -0.08 (-0.13; -0.03), -0.04 (-0.09; 0.01), -0.08 (-0.13; -0.04), -0.17 (-0.21; -0.12)], respectively. No associations were found between NO and EC and corneal nerve measures.
Our population-based study demonstrated that exposure to higher levels of PM and PM are associated with higher levels of corneal neurodegeneration, estimated from lower corneal nerve measures. Our results suggest that air pollution may be a determinant for neurodegeneration assessed in the cornea and may impact the ocular surface health as well.
流行病学和毒理学研究表明，接触更多的空气污染物可能导致神经退行性疾病。为了进一步证实这种关系，我们使用角膜共聚焦显微镜评估了环境空气污染物暴露与角膜神经测量值之间的关联，角膜神经测量值可作为神经退行性变的替代指标。
我们使用基于人群的横断面观察性研究 Maastricht 研究的数据，该研究包括 3635 名参与者（平均年龄 59.3 岁，51.6%为女性，19.9%患有 2 型糖尿病），他们居住在马斯特里赫特地区。我们使用地球科学和健康队列联盟（GECCO）的数据，将家庭住址层面的环境空气污染物年平均暴露水平（直径≤2.5 µm 的颗粒物（PM2.5）和≤10 µm 的颗粒物（PM10）、二氧化氮（NO2）和元素碳（EC））与参与者进行关联。我们使用线性回归分析来研究环境空气污染物浓度 Z 分数（PM、PM、NO 和 EC）与个体角膜神经测量值 Z 分数（角膜神经分支密度、角膜神经密度、角膜神经长度和分形维数）之间的关系。
在调整了潜在混杂因素（年龄、性别、教育水平、葡萄糖代谢状态、角膜共聚焦显微镜滞后时间、参与者纳入年份、吸烟状况和饮酒量）后，PM 和 PM 的 Z 分数较高与角膜神经分支密度、神经密度、神经长度和神经分形维数的 Z 分数较低相关[标准化β（95%置信区间）：PM -0.10（-0.14；-0.05），-0.04（-0.09；0.01），-0.11（-0.16；-0.06），-0.20（-0.24；-0.15）；PM -0.08（-0.13；-0.03），-0.04（-0.09；0.01），-0.08（-0.13；-0.04），-0.17（-0.21；-0.12）]。NO 和 EC 与角膜神经测量值之间没有关联。
我们的基于人群的研究表明，PM 和 PM 暴露水平较高与角膜神经退行性变程度较高相关，这可以通过较低的角膜神经测量值来评估。我们的结果表明，空气污染可能是角膜神经退行性变的决定因素，并可能影响眼表健康。
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