大气颗粒物对成年居民患心血管疾病的影响及植被覆盖的效应修饰研究

Effects of atmospheric particulate matter on the prevalence of cardiovascular diseases in adult res⁃idents and effect modification of vegetation coverage

目的评估城市大气颗粒物(particulate matter,PM)对成年居民患心血管疾病(car⁃diovascular disease,CVD)的影响及植被覆盖的效应修饰研究。方法2015年在蚌埠市抽取4000名成年居民,使用问卷调查和居民体检获得基本信息。通过卫星反演技术,获得参与者家庭所在1 km缓冲区的大气PM浓度,应用logistic回归分析模型分析PM与患CVD的关联。通过分层分析,探讨年龄、性别、BMI和植被覆盖对这种关联的潜在作用。结果最终纳入3190名对象,其中CVD患者1080例。亚微米颗粒物(submicrometer particles,PM1)、细颗粒物(fine particulate mat⁃ter,PM2.5)、可吸入颗粒物(inhalable particles,PM10)不同组之间患病率差异均有统计学意义(均有P<0.05)。植被覆盖指标归一化植被指数(normalized difference vegetation index,NDVI)、增强型植被指数(enhanced vegetation index,EVI)、土壤调整植被指数(soil adjusted vegetation index,SAVI)不同组之间患病率差异有统计学差异(均有P<0.05)。logistic回归分析模型分析显示:调整协变量后,PM2.5高浓度组患病风险为低浓度组的1.352倍(OR=1.352,95%CI:1.078~1.696)。PM1、PM10与CVD的调整模型差异无统计学意义(均有P>0.05)。分层分析显示:PM2.5与植被覆盖的交互作用差异均有统计学意义(均有P<0.05),在植被覆盖处于较低水平时,PM2.5与CVD患病风险的关联更强。结论PM污染越严重,CVD患病风险可能越高。植被覆盖可能缓解了PM污染与CVD之间的关联。

Objective To evaluate the effects of atmospheric particulate matter on the preva⁃lence of cardiovascular diseases in adult residents and effect modification of vegetation coverage.Methods A total of 4000 adult residents were selected in Bengbu City in 2015.The basic information was obtained through a questionnaire survey and residents’physical examination.The concentration of atmospheric particulate matter(PM)in the 1 km buffer zone where the participants’homes were loca⁃ted was obtained through satellite retrieval technology.Logistic regression was used to analyze the associ⁃ation between PM and CVD.Stratified analyzes were performed to explore the potential confounding effect of age,sex,BMI,and the vegetation cover rate.Results Among the 3190 subjects included,1080 were CVD patients.There were statistical differences in the prevalence of CVD among submi⁃crometer particles(PM1),fine particulate matter(PM2.5),and inhalable particles(PM10)groups(all P<0.05).There were statistically differences in the prevalence of CVD among normalized differ⁃ence vegetation index(NDVI),enhanced vegetation index(EVI),soil adjusted vegetation index(SA⁃VI)(all P<0.05).Logistic regression results showed that after adjusting covariates,the risk of the PM2.5⁃high concentration group was 1.352 times that of the low concentration group(OR=1.352,95%CI:1.078-1.696).There was no statistically significant difference between the adjusted models of PM1 and PM10(all P>0.05).Stratified analysis showed that the interaction between PM2.5 and vegeta⁃tion coverage was statistically significant(all P<0.05).And the association between PM2.5 and the risk of cardiovascular disease was stronger when the vegetation coverage was at a lower level compared to higher level.Conclusions The more serious the atmospheric PM pollution,the higher the risk of CVD could be.Vegetation cover may moderate the association between PM pollution and CVD.