短期环境空气污染物暴露与动脉僵硬度的关联及肥胖的效应修饰作用分析  

Association between short-term ambient air pollution exposure and arterial stiffness and effect modification of obesity

作　　者：谭音希 彭和香 郑一 王斯悦 武轶群[2,3] 秦雪英 李劲[2,3] 吴涛 陈大方[2,3] 王梦莹 胡永华[2,3] Tan Yinxi;Peng Hexiang;Zheng Yi;Wang Siyue;Wu Yiqun;Qin Xueying;Li Jin;Wu Tao;Chen Dafang;Wang Mengying;Hu Yonghua(Department of Nutrition and Food Hygiene,School of Public Health,Peking University,Beijing 100191,China;Department of Epidemiology and Biostatistics,School of Public Health,Peking University,Beijing 100191,China;Key Laboratory of Epidemiology of Major Diseases(Peking University),Ministry of Education,Beijing 100191,China)

机构地区：[1]北京大学公共卫生学院营养与食品卫生学系,北京100191 [2]北京大学公共卫生学院流行病与卫生统计学系,北京100191 [3]重大疾病流行病学教育部重点实验室(北京大学),北京100191

出　　处：《中华流行病学杂志》2024年第12期1639-1648,共10页Chinese Journal of Epidemiology

基　　金：国家自然科学基金(82204135,81230066,81102177,82473716);北京市自然科学基金(7232237);中国疾病预防控制中心环境与人群健康重点实验室开放基金(2022-CKL-02)。

摘　　要：目的探索短期环境空气污染物暴露与动脉僵硬度相关指标之间的关联,并探索肥胖是否对上述关联存在效应修饰作用。方法基于北京房山家系队列基线资料开展分析。采用研究对象参与调查当天的空气污染物浓度的24 h均值作为污染指标,采用广义加性高斯模型估计短期各项空气污染物(PM_(2.5)、PM_(10)、SO_(2)、NO_(2)、CO)暴露与颈总动脉内膜厚度(CIMT)、脉搏波传导速度(BAPWV)、脉压(PP)和踝肱指数(ABI)的关联。将各项空气污染物和BMI、腰臀比的交叉项纳入模型以检验交互作用,并开展分层分析进一步探索其对短期各项空气污染物暴露与CIMT、BAPWV、PP、ABI关联的影响。结果共纳入4211名研究对象进行分析。研究对象年龄为(58.9±8.7)岁,其中2268名(53.9%)为女性。模型调整社会人口学、生活行为方式、用药史等混杂因素。结果显示,PM_(2.5)(β=2.912×10^(-4),95%CI:1.424×10^(-4)~4.400×10^(-4),P<0.001)、CO(β=0.027,95%CI:0.011~0.043,P<0.001)、SO_(2)(β=2.070×10-3,95%CI:7.060×10^(-4)~3.430×10-3,P=0.003)、NO_(2)(β=3.650×10^(-4),95%CI:2.340×10-5~7.060×10^(-4),P=0.036)4种污染浓度增加与CIMT水平升高有关。PM_(10)(β=0.018,95%CI:0.002~0.033,P=0.028)浓度增加与PP水平升高有关。研究未发现短期空气污染物暴露与ABI、BAPWV水平存在关联。腰臀比对短期PM_(2.5)(交互作用P=0.015)、NO_(2)(交互作用P=0.008)、CO(交互作用P=0.044)暴露与CIMT的关联存在效应修饰作用;对短期PM_(2.5)(交互作用P=0.002)、NO_(2)(交互作用P=0.010)、CO(交互作用P=0.029)、PM_(10)(交互作用P<0.001)暴露与PP的关联存在效应修饰作用,腰臀比较低的人群中空气污染物浓度升高相关的CIMT、PP升高更显著。结论短期暴露于多种空气污染物与CIMT、PP等动脉僵硬度指标存在关联,腰臀比对此关联存在效应修饰作用,较低腰臀比可能会增强空气污染物暴露与指标的关联。Objective To assess the association between short-term ambient air pollution exposure and arterial stiffness and whether obesity modifies these associations.Methods A cross-sectional study was conducted based on Fangshan family cohort in Beijing.The 24 hours average air pollutant levels on the day cohort participants took baseline survey were calculated as short-term air pollution.A generalized additive model(GAM)with Gaussian links was used to estimate changes in typical carotid artery intima-media thickness(CIMT),brachial-ankle pulse wave velocity(BAPWV),pulse pressure(PP)and ankle-branchial index(ABI)after short-term exposure to each air pollution(PM_(2.5),PM_(10),SO_(2),NO_(2),CO).The cross-product terms of each air pollution,body mass index(BMI),and waist-to-hip ratio were included in the GAM model to test the interaction.Further,they conducted a stratified analysis to test their effects on the relationship between short-term exposure to each air pollution and the arterial stiffness indicators.Results A total of 4211 individuals were included in the analysis.Individuals'age was(58.9±8.7)years,of which 2268(53.9%)were female.Several covariates,including sociodemographic factors,lifestyle behaviors,and history of drugs,were included in the analysis.The results of the GAM analysis showed that an increase in PM_(2.5)(β=2.912×10^(-4),95%CI:1.424×10^(-4)-4.400×10^(-4),P<0.001),CO(β=0.027,95%CI:0.011-0.043,P<0.001),SO_(2)(β=2.070×10-3,95%CI:7.060×10^(-4)-3.430×10-3,P=0.003),and NO_(2)(β=3.650×10^(-4),95%CI:2.340×10-5-7.060×10^(-4),P=0.036)were associated with an increase in CIMT,while an increase in PM_(10)(β=0.018,95%CI:0.002-0.033,P=0.028)was associated with an increase in PP in the study population.Besides,the waist-to-hip ratio had an effect-modification on the correlation of short-term exposure of PM_(2.5)(interaction P=0.015),NO_(2)(interaction P=0.008),and CO(interaction P=0.044)with CIMT,and the correlation between short-term exposure of PM_(2.5)(interaction P=0.002),NO_(2)(interaction P=0.01

关 键 词：空气污染物 动脉硬化 交互作用 

分 类 号：X51[环境科学与工程—环境工程] R589.2[医药卫生—内分泌]