大气PM_(2.5)持续高暴露对中老年人群心血管代谢风险的影响  

Impact of persistent high ambient fine particulate matters exposure on cardiometabolic risk factors among middle-aged and elderly people

作　　者：石婉荧 陈晨[1] 曹亚强 张翼[1] 崔倩 赵峰[1] 王蛟男 方建龙[1] 唐宋 李湉湉[1,2] 施小明 SHI Wan-ying;CHEN Chen;CAO Ya-qiang;ZHANG Yi;CUI Qian;ZHAO Feng;WANG Jiao-nan;FANG Jian-long;TANG Song;LI Tian-tian;SHI Xiao-ming(China CDC Key Laboratory of Environment and Population Health,National Institute of Environmental Health,Chinese Center for Disease Control and Prevention,Beijing 100021,China;School of Public Health,Nanjing Medical University,Nanjing 211166,China;School of Ecology and Environment,Inner Mongolian University,Hohhot 010021,China)

机构地区：[1]中国疾病预防控制中心环境与人群健康重点实验室,中国疾病预防控制中心环境与健康相关产品安全所,北京100021 [2]南京医科大学公共卫生学院,南京211166 [3]内蒙古大学生态与环境学院,呼和浩特010021

出　　处：《中华疾病控制杂志》2021年第10期1120-1125,1168,共7页Chinese Journal of Disease Control & Prevention

基　　金：国家自然科学基金(81573247);国家重点研发计划(2016YFC0206500);大气重污染成因与治理攻关项目(DQGG0401)。

摘　　要：目的探索京津冀及周边地区大气中细颗粒物(fine particulate matters,PM2.5)持续高暴露对中老年人群心血管代谢风险的影响。方法于2017年4月9日—2019年3月31日在京津冀及周边共6个省、市开展横断面调查,选择40~<90岁社区中老年人作为研究对象,共计2415名。通过问卷调查获取居民个人基本情况、社会经济状况和生活方式等信息,通过体格检查以获得腰围、血压、FPG、TG和HDL-C水平,根据2005年国际糖尿病联盟发布的共识声明定义代谢风险因素聚集。以PM2.5日均浓度≥75μg/m^(3)、≥各县、区参与调查当天PM2.5日均浓度的P90及不同持续时间(≥2 d和≥3 d)定义PM2.5高暴露情景和持续状态。采用Logistic回归分析模型分析大气PM2.5持续高暴露对人群心血管代谢风险聚集的影响。结果大气PM2.5持续高暴露与人群代谢风险聚集风险存在关联,尤其是PM2.5浓度≥P90且持续2 d、3 d以上时可观察到具有统计学意义的结果,人群代谢风险因素聚集影响的OR(95%CI)值分别为1.58(1.00~2.50)和2.57(1.27~5.22)。其中FPG上升、TG水平上升是较为敏感的代谢风险因素。亚组分析结果显示,PM2.5持续高暴露对男性和<65岁人群代谢风险的影响更强。结论京津冀及周边地区大气PM2.5持续高浓度暴露可增加中老年人群心血管代谢风险。Objective To explore the effects of persistent high exposure of fine particulate matters(PM_(2.5))on cardiometabolic risk factors among middle-aged and older people in Beijing-Tianjin-Hebei and surrounding regions.Methods A cross-sectional survey was conducted from April 9 th,2017 to March 31 st,2019 in 6 Provinces in Beijing-Tianjin-Hebei and the surrounding areas.A total of 2415 middle-aged and elderly people aged 40 to 89 years were recruited as the research participants.Questionnaire survey was conducted to obtain the basic information,socioeconomic and lifestyle of the participants.Physical examination was carried out to obtain waist circumference,levels of fasting blood glucose,blood pressure,triglycerides and high-density lipoprotein cholesterol.According to the consensus statement from the International Diabetes Federation in 2005,the co-prevalence of cardiometabolic risk factors was defined.Daily mean PM_(2.5) concentrations≥75μg/m^(3),≥90 th percentile of daily mean PM_(2.5) concentrations in each County during the survey year and various durations(≥2 d or≥3 d)were used to define PM_(2.5) high exposure scenarios and persistent states.Logistic regression model was used to analyze the effects of persistent high exposure of PM_(2.5) on co-prevalence of cardiometabolic risk factors.Results Persistent high exposure of PM_(2.5) was significantly associated with the co-prevalence of cardiometabolic factors,especially when extreme pollution scenario was defined by P90 and lasted for more than 2 days and 3 days,OR value(95%CI)of elevated risk of co-prevalence of cardiometabolic factors were 1.58(1.00-2.50)and 2.57(1.27-5.22),respectively.The increase of blood glucose and triglyceride level were more sensitive metabolic risk factors.Moreover,subgroup analysis showed that persistent high PM_(2.5) exposure had a more substantial impact on cardiometabolic risks in males and people under 65 years.Conclusions Persistent high exposure of PM_(2.5) in Beijing-Tianjin-Hebei and surrounding regions in China can si

关 键 词：细颗粒物 重污染 心血管代谢风险因素 

分 类 号：R122.2[医药卫生—环境卫生学] R181[医药卫生—公共卫生与预防医学]