Diabetes enhances vulnerability to particulate air pollution - Associated impairment in vascular reactivity and endothelial function

被引:359
作者
O'Neill, MS
Veves, A
Zanobetti, A
Sarnat, JA
Gold, DR
Economides, PA
Horton, ES
Schwartz, J
机构
[1] Harvard Univ, Sch Publ Hlth, Dept Environm Hlth, Boston, MA 02115 USA
[2] Harvard Univ, Sch Med, Channing Lab, Boston, MA 02115 USA
[3] Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA
[4] Joslin Diabet Ctr, Boston, MA 02215 USA
关键词
diabetes mellitus; endothelium; epidemiology; pollution; vasculature;
D O I
10.1161/CIRCULATIONAHA.104.517110
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background-Epidemiological studies suggest that people with diabetes are vulnerable to cardiovascular health effects associated with exposure to particle air pollution. Endothelial and vascular function is impaired in diabetes and may be related to increased cardiovascular risk. We examined whether endothelium-dependent and -independent vascular reactivity was associated with particle exposure in individuals with and without diabetes. Methods and Results-Study subjects were 270 greater-Boston residents. We measured 24-hour average ambient levels of air pollution ( fine particles [PM2.5], particle number, black carbon, and sulfates [SO42-]) approximate to 500 m from the patient examination site. Pollutant concentrations were evaluated for associations with vascular reactivity. Linear regressions were fit to the percent change in brachial artery diameter ( flow mediated and nitroglycerin mediated), with the particulate pollutant index, apparent temperature, season, age, race, sex, smoking history, and body mass index as predictors. Models were fit to all subjects and then stratified by diagnosed diabetes versus at risk for diabetes. Six-day moving averages of all 4 particle metrics were associated with decreased vascular reactivity among patients with diabetes but not those at risk. Interquartile range increases in SO42- were associated with decreased flow-mediated (-10.7%; 95% CI, -17.3 to -3.5) and nitroglycerin-mediated (-5.4%; 95% CI, -10.5 to -0.1) vascular reactivity among those with diabetes. Black carbon increases were associated with decreased flow-mediated vascular reactivity ( -12.6%; 95% CI, -21.7 to -2.4), and PM2.5 was associated with nitroglycerin-mediated reactivity ( -7.6%; 95% CI, -12.8 to -2.1). Effects were stronger in type II than type I diabetes. Conclusions-Diabetes confers vulnerability to particles associated with coal-burning power plants and traffic.
引用
收藏
页码:2913 / 2920
页数:8
相关论文
共 59 条
[1]   Long-term follow-up of patients with mild coronary artery disease and endothelial dysfunction [J].
Al Suwaidi, J ;
Hamasaki, S ;
Higano, ST ;
Nishimura, RA ;
Holmes, DR ;
Lerman, A .
CIRCULATION, 2000, 101 (09) :948-954
[2]   CLOSE RELATION OF ENDOTHELIAL FUNCTION IN THE HUMAN CORONARY AND PERIPHERAL CIRCULATIONS [J].
ANDERSON, TJ ;
UEHATA, A ;
GERHARD, MD ;
MEREDITH, IT ;
KNAB, S ;
DELAGRANGE, D ;
LIEBERMAN, EH ;
GANZ, P ;
CREAGER, MA ;
YEUNG, AC ;
SELWYN, AP .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1995, 26 (05) :1235-1241
[3]   Short term associations between outdoor air pollution and mortality in London 1992-4 [J].
Bremner, SA ;
Anderson, HR ;
Atkinson, RW ;
McMichael, AJ ;
Strachan, DP ;
Bland, JM ;
Bower, JS .
OCCUPATIONAL AND ENVIRONMENTAL MEDICINE, 1999, 56 (04) :237-244
[4]   Air pollution: The "heart" of the problem [J].
Brook, RD ;
Brook, JR ;
Rajagopalan, S .
CURRENT HYPERTENSION REPORTS, 2003, 5 (01) :32-39
[5]   Inhalation of fine particulate air pollution and ozone causes acute arterial vasoconstriction in healthy adults [J].
Brook, RD ;
Brook, JR ;
Urch, B ;
Vincent, R ;
Rajagopalan, S ;
Silverman, F .
CIRCULATION, 2002, 105 (13) :1534-1536
[6]   Effects of particulate and gaseous air pollution on cardiorespiratory hospitalizations [J].
Burnett, RT ;
Smith-Doiron, M ;
Stieb, D ;
Cakmak, S ;
Brook, JR .
ARCHIVES OF ENVIRONMENTAL HEALTH, 1999, 54 (02) :130-139
[7]   Spatial variation in particulate concentrations within metropolitan Philadelphia [J].
Burton, RM ;
Suh, HH ;
Koutrakis, P .
ENVIRONMENTAL SCIENCE & TECHNOLOGY, 1996, 30 (02) :400-407
[8]   Microvascular and macrovascular reactivity is reduced in subjects at risk for type 2 diabetes [J].
Caballero, AE ;
Arora, S ;
Saouaf, R ;
Lim, SC ;
Smakowski, P ;
Park, JY ;
King, GL ;
LoGerfo, FW ;
Horton, ES ;
Veves, A .
DIABETES, 1999, 48 (09) :1856-1862
[9]   The effects of troglitazone, an insulin-sensitizing agent, on the endothelial function in early and late type 2 diabetes: A placebo-controlled randomized clinical trial [J].
Caballero, AE ;
Saouaf, R ;
Lim, SC ;
Hamdy, O ;
Abou-Elenin, K ;
O'Connor, C ;
LoGerfo, FW ;
Horton, ES ;
Veves, A .
METABOLISM-CLINICAL AND EXPERIMENTAL, 2003, 52 (02) :173-180
[10]   Increased activity of endogenous endothelin in patients with type II diabetes mellitus [J].
Cardillo, C ;
Campia, U ;
Bryant, MB ;
Panza, JA .
CIRCULATION, 2002, 106 (14) :1783-1787