短期空气污染物暴露与代谢综合征患者内皮功能相关性分析

Short-term exposure to individual air pollutants associated with endothelial function in patients with metabolic syndrome

目的 评估代谢综合征患者空气污染与内皮功能的相关性。方法 纳入2013年1月~2013年7月在北京协和医院心血管内科门诊就诊的代谢综合征患者61例，平均年龄62.41±9.12岁，对所有受试者采用Endopat2000进行充血反应指数（RHI）的内皮功能测定。获取所有受试者居住详细地址信息及其经纬度和北京市同时期35个空气质量监测点的空气污染物数据，通过ArcGIS10.0软件将北京市网格化（分辨率为0.05°，≈5.5 km）获取受试者居住地址的污染物暴露水平作为个体化暴露水平。并从中国气象局获取同时期日平均温度、相对湿度和气压。结果 研究期间所有受试者个体化大气污染物，包括吸入直径＜2.5μm或＜10μm的颗粒物（PM2.5、PM10）、二氧化氮（NO2）、二氧化硫（SO2）、一氧化碳（CO）、臭氧（O3），日均浓度分别为78.2、129.6、52.9、25.0、1.2和59.1μg/m3。多元线性模型分析结果表明前15 d累积PM2.5和PM10每增加10 μg/m3，RHI分别下降0.87和0.72（P均＜0.05），然而并未发现气体污染物与RHI的相关性（P＞0.05）。结论 颗粒物污染与代谢综合征患者亚急性内皮功能受损相关，该机制可能部分解释空气污染所致心血管疾病发生和死亡风险的增加。

Objective The cross-sectional study was conducted to detect the relationship of air pollutants withendothelial function. Methods There were 61 patients aged 62 years with metabolic syndrome enrolled in the studyduring Jan 26, 2013 to Jul 4, 2013. Endothelial function was performed by Endopat 2000 for all subjects, expressedas reactive hyperemia index (RHI). The detailed residential addresses have been obtained, which were used to modelthe individual concentration of the air pollutants by ArcGIS10.1 software based on the data of air pollutants from35 fixed monitoring sites in Beijing, China. In addition, we got meteorological data from the China MeteorologicalAdministration for the whole study period. Results The mean of individual air pollutants for all subjects was 78.2 μg/m3 for PM2.5, 129.6 μg/m3 for PM10, 52.9 μg/m3 for nitrogen dioxide (NO2), 25.0 μg/m3 for sulfur dioxide (SO2), 1.2μg/m3 for nitric oxide (CO) and 59.1 μg/m3 for ozone (O3) during Feb 2, 2013 to Jul 4, 2013. Multiple linear analysishas shown that decrease by 0.87 and 0.72 in RHI were associated with each 10μg/m3 increase in PM2.5 and PM10 for 15-day moving average (all P<0.05). No significant association was found RHI and gaseous air pollutants (all P>0.05).Conclusion Particulate air pollutants were associated with sub-acute impaired endothelial function in patients withmetabolic syndrome. The way could, in part, account for the increases in cardiovascular disease morbidity and mortalityseen in prior studies.