大气PM<sub>2.5</sub>持续高暴露对中老年人群心血管代谢风险的影响

石婉荧; 陈晨; 曹亚强; 张翼; 崔倩; 赵峰; 王蛟男; 方建龙; 唐宋; 李湉湉; 施小明

doi:10.16462/j.cnki.zhjbkz.2021.10.002

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

doi: 10.16462/j.cnki.zhjbkz.2021.10.002

石婉荧¹,
陈晨¹,
曹亚强^{1, 2},
张翼¹,
崔倩^{1, 3},
赵峰¹,
王蛟男^{1, 2},
方建龙¹,
唐宋^{1, 2},
李湉湉^{1, 2},
施小明^{1, 2, ,}

1.
100021 北京，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
2.
211166 南京，南京医科大学公共卫生学院
3.
010021 呼和浩特，内蒙古大学生态与环境学院

基金项目:

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

详细信息

通讯作者:
施小明，E-mail: shixm@chinacdc.cn

中图分类号: R122.2;R181
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- 被引次数: 0
出版历程
- 收稿日期: 2021-06-08
- 修回日期: 2021-08-02
- 网络出版日期: 2021-11-17
- 刊出日期: 2021-10-10

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

SHI Wan-ying¹,
CHEN Chen¹,
CAO Ya-qiang^{1, 2},
ZHANG Yi¹,
CUI Qian^{1, 3},
ZHAO Feng¹,
WANG Jiao-nan^{1, 2},
FANG Jian-long¹,
TANG Song^{1, 2},
LI Tian-tian^{1, 2},
SHI Xiao-ming^{1, 2
, ,}

1.
China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
2.
School of Public Health, Nanjing Medical University, Nanjing 211166, China
3.
School of Ecology and Environment, Inner Mongolian University, Hohhot 010021, China

Funds:

National Natural Science Foundation of China 81573247

National Key Research and Development Program of China 2016YFC0206500

National research program for key issues in air pollution control DQGG0401

More Information

Corresponding author: SHI Xiao-ming, E-mail: shixm@chinacdc.cn

摘要

摘要: 目的探索京津冀及周边地区大气中细颗粒物(fine particulate matters, PM_2.5)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2 415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PM_2.5日均浓度≥75 μg/m³、≥各县、区参与调查当天PM_2.5日均浓度的P₉₀及不同持续时间(≥2 d和≥3 d)定义PM_2.5高暴露情景和持续状态。采用Logistic回归分析模型分析大气PM_2.5持续高暴露对人群心血管代谢风险聚集的影响。结果大气PM_2.5持续高暴露与人群代谢风险聚集风险存在关联，尤其是PM_2.5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，PM_2.5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PM_2.5持续高浓度暴露可增加中老年人群心血管代谢风险。
- 细颗粒物 /
- 重污染 /
- 心血管代谢风险因素
Abstract: 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 9th, 2017 to March 31st, 2019 in 6 Provinces in Beijing-Tianjin-Hebei and the surrounding areas. A total of 2 415 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 ≥75 μg/m³, ≥90th 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 significantly increase cardiometabolic risks in middle-aged and older people.
- Fine particulate matter /
- Heavy pollution /
- Cardiometabolic risk factors

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表 1 研究对象的基本特征描述[n(%)]

Table 1. Description of the basic characteristics of the study participants [n(%)]

特征	代谢风险因素聚集		合计	t/χ²值	P值
特征	否	是	合计	t/χ²值	P值
年龄[(x±s)，岁]	57.1±13.1	62.2±12.7	61.3±12.9	7.313	＜0.001
性别				0.031	0.859
男	202(49.5)	984(49.0)	1 186(49.1)
女	206(50.5)	1 023(51.0)	1 229(50.9)
受教育程度				20.212	＜0.001
小学及以下	111(27.2)	729(36.3)	840(34.8)
初中/高中	221(54.2)	1 039(51.8)	1 260(52.2)
大专及以上	76(18.6)	239(11.9)	315(13.0)
家庭年收入(万元)				25.312	＜0.001
1~＜3	184(45.1)	1 138(56.7)	1 322(54.7)
3~＜10	180(31.9)	580(28.9)	710(29.4)
≥10	94(23.0)	289(14.4)	383(15.9)
吸烟				0.569	0.505
否	328(80.4)	1 580(78.7)	1 908(79.0)
是	80(19.6)	427(21.3)	507(21.0)
饮酒				1.277	0.290
否	313(76.7)	1 486(74.0)	1 799(74.5)
是	95(23.3)	521(26.0)	616(25.5)
合计	408(16.9)	2 007(83.1)	2 415(100.0)

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表 2 研究期间气象因素和大气污染物的统计学描述

Table 2. Statistical descriptions of meteorological factors and air pollutants during the study period

变量	x±s	P₂₅	M	P₇₅	次数(次)	总天数(d)	平均每次持续天数(d)
气象因素
温度(℃)	6.3±9.4	2.1	5.2	9.1
相对湿度(%)	55.4±18.5	41.0	57.0	69.0
大气污染物
PM_2.5(μg/m³)	52.5±46.4	16.6	44.2	82.5
PM_2.5持续高暴露情景
≥75 μg/m³					623	623	1.0
≥75 μg/m³，持续≥2 d					157	504	3.2
≥75 μg/m³，持续≥3 d					91	370	4.1
≥P₉₀					242	242	1.0
≥P₉₀，持续≥2 d					64	168	2.6
≥P₉₀，持续≥3 d					25	90	3.6

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表 3 大气PM_2.5持续高暴露对心血管代谢风险因素聚集的多因素Logistic回归分析

Table 3. Multivariate Logistic regression analysis of persistent high exposure of ambient PM_2.5 on co-prevalence of cardiometabolic risk factors

变量	OR值	95% CI值	P值
PM_2.5浓度(μg/m³)	1.04	1.01~1.08	0.019
PM_2.5持续高暴露情景
≥75 μg/m³	1.09	0.83~1.42	0.553
≥75 μg/m³，持续≥2 d	1.02	0.76~1.37	0.899
≥75 μg/m³，持续≥3 d	0.95	0.70~1.30	0.751
≥P₉₀	1.32	0.89~1.95	0.164
≥P₉₀，持续≥2 d	1.58	1.00~2.50	0.049
≥P₉₀，持续≥3 d	2.57	1.27~5.22	0.009

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表 4 大气PM_2.5持续高暴露情景对多种心血管代谢风险因素的多因素Logistic回归分析

Table 4. Multivariate Logistic regression analysis of persistent high exposure of ambient PM_2.5 on various cardiometabolic risk factors

分组	风险因素聚集	血压升高	腹型肥胖	血糖升高	TG升高	HDL-C降低
全人群	2.57(1.27~5.22) ^a	1.12(0.73~1.73)	1.27(0.79~2.04)	2.62(1.70~4.02) ^a	1.49(1.02~2.18) ^a	1.36(0.82~2.26)
性别组
男性	2.96(1.03~8.48) ^a	0.95(0.49~1.82)	1.37(0.73~2.57)	3.20(1.64~6.25) ^a	1.42(0.80~2.50)	2.08(1.09~3.96) ^a
女性	2.20(0.83~5.79)	1.25(0.69~2.26)	1.05(0.50~2.19)	2.21(1.25~3.93) ^a	1.58(0.94~2.65)	1.14(0.64~2.01)
年龄(岁)
＜65	1.99(0.82~4.84)	1.14(0.62~2.09)	1.56(0.75~3.24)	3.37(1.72~6.61) ^a	1.33(0.76~2.35)	1.96(1.08~3.55) ^a
≥65	3.17(0.94~10.7)	1.01(0.53~1.94)	1.00(0.52~1.92)	1.94(1.09~3.43) ^a	1.63(0.97~2.75)	1.10(0.58~2.08)
注：PM_2.5持续高暴露情景定义为浓度≥P₉₀，持续时间≥3 d；模型调整年龄、性别、家庭年收入、受教育程度、吸烟状况、饮酒状况、日均温度、日均相对湿度；^a P＜0.05。

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特征	代谢风险因素聚集		合计	t/χ²值	P值
特征	否	是	合计	t/χ²值	P值
年龄[(x±s)，岁]	57.1±13.1	62.2±12.7	61.3±12.9	7.313	＜0.001
性别				0.031	0.859
男	202(49.5)	984(49.0)	1 186(49.1)
女	206(50.5)	1 023(51.0)	1 229(50.9)
受教育程度				20.212	＜0.001
小学及以下	111(27.2)	729(36.3)	840(34.8)
初中/高中	221(54.2)	1 039(51.8)	1 260(52.2)
大专及以上	76(18.6)	239(11.9)	315(13.0)
家庭年收入(万元)				25.312	＜0.001
1~＜3	184(45.1)	1 138(56.7)	1 322(54.7)
3~＜10	180(31.9)	580(28.9)	710(29.4)
≥10	94(23.0)	289(14.4)	383(15.9)
吸烟				0.569	0.505
否	328(80.4)	1 580(78.7)	1 908(79.0)
是	80(19.6)	427(21.3)	507(21.0)
饮酒				1.277	0.290
否	313(76.7)	1 486(74.0)	1 799(74.5)
是	95(23.3)	521(26.0)	616(25.5)
合计	408(16.9)	2 007(83.1)	2 415(100.0)

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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

doi: 10.16462/j.cnki.zhjbkz.2021.10.002

通讯作者:
施小明，E-mail: shixm@chinacdc.cn

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

Corresponding author: SHI Xiao-ming, E-mail: shixm@chinacdc.cn

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大气PM2.5持续高暴露对中老年人群心血管代谢风险的影响

doi: 10.16462/j.cnki.zhjbkz.2021.10.002

通讯作者: 施小明，E-mail: shixm@chinacdc.cn

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

Corresponding author: SHI Xiao-ming, E-mail: shixm@chinacdc.cn

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出版历程

目录

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

通讯作者:
施小明，E-mail: shixm@chinacdc.cn