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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

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. 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[J]. 中华疾病控制杂志, 2021, 25(10): 1120-1125, 1168. doi: 10.16462/j.cnki.zhjbkz.2021.10.002
引用本文: 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. 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[J]. 中华疾病控制杂志, 2021, 25(10): 1120-1125, 1168. doi: 10.16462/j.cnki.zhjbkz.2021.10.002
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. Impact of persistent high ambient fine particulate matters exposure on cardiometabolic risk factors among middle-aged and elderly people[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2021, 25(10): 1120-1125, 1168. doi: 10.16462/j.cnki.zhjbkz.2021.10.002
Citation: 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. Impact of persistent high ambient fine particulate matters exposure on cardiometabolic risk factors among middle-aged and elderly people[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2021, 25(10): 1120-1125, 1168. doi: 10.16462/j.cnki.zhjbkz.2021.10.002

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
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

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

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
  • 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PM2.5日均浓度≥75 μg/m3、≥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。
  • 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 P
    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)
    下载: 导出CSV

    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
      PM2.5(μg/m3) 52.5±46.4 16.6 44.2 82.5
    PM2.5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
    下载: 导出CSV

    表  3  大气PM2.5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 PM2.5 on co-prevalence of cardiometabolic risk factors

    变量 OR 95% CI P
    PM2.5浓度(μg/m3) 1.04 1.01~1.08 0.019
    PM2.5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
    下载: 导出CSV

    表  4  大气PM2.5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 PM2.5 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:PM2.5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。
    下载: 导出CSV
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  • 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

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