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Diabetes Care:空气污染或参与糖尿病血管并发症

2012-12-05 高晓方译 Diabetes Care

  一项研究表明,在印度2型糖尿病患者中空气污染可能促发全身性炎症反应,可能在糖尿病血管并发症中起一定作用。论文于2012年11月19日在线发表于《糖尿病护理》(Diabetes Care)杂志。   此项横断面研究在2型糖尿病患者中对每日系列大气污染数据和血浆C反应蛋白(CRP)浓度进行了相关性评估。对年龄、性别、体质指数(BMI)、血红蛋白、空腹血糖、抗炎活性药物治疗、季节、温度和

空气污染

  一项研究表明,在印度2型糖尿病患者中空气污染可能促发全身性炎症反应,可能在糖尿病血管并发症中起一定作用。论文于2012年11月19日在线发表于《糖尿病护理》(Diabetes Care)杂志。

  此项横断面研究在2型糖尿病患者中对每日系列大气污染数据和血浆C反应蛋白(CRP)浓度进行了相关性评估。对年龄、性别、体质指数(BMI)、血红蛋白、空腹血糖、抗炎活性药物治疗、季节、温度和相对湿度进行校正后,在延迟0~7天和抽血前多跨度时间点评估空气污染对CRP浓度的影响。

  结果显示,中位CRP浓度为3.59 mg/L。抽血前一天(lag1)空气中SO2和氮氧化物(NOx)每升高1个标准差时,CRP浓度即显著升高。在lag2时间点时上述效应更为显著,并在其后出现进行性减退。多日平均SO2(最长30天)和NOx(最长7天)升高亦与之具有显著相关性。除夏季外,颗粒物≤10 µm(PM10)与CRP浓度无显著相关性。在糖尿病持续时间较短以及未接受他汀类和噻唑烷二酮类治疗的患者中相关性显著升高。



OBJECTIVE 
To study the association between ambient air pollutants and serum C-reactive protein (CRP) concentration in 1,392 type 2 diabetic patients in Pune, India.
RESEARCH DESIGN AND METHODS 
A cross-sectional study was conducted that linked daily time series of ambient air pollution data (obtained from central monitoring sites) and plasma CRP concentration in type 2 diabetic patients from the Wellcome Trust Genetic (WellGen) Study, recruited between March 2005 and May 2007. Air pollution effects on CRP concentration were investigated with delays (lags) of 0–7 days and multiday averaging spans of 7, 14, and 30 days before blood collection adjusted for age, sex, BMI, hemoglobin, fasting plasma glucose, treatment with agents with anti-inflammatory action, season, air temperature, and relative humidity.
RESULTS 
Median CRP concentration was 3.49 mg/L. For 1 SD increase in SO2 and oxides of nitrogen (NOx) concentrations in ambient air, a day before blood collection (lag1), we observed a significant increase in CRP (9.34 and 7.77%, respectively). The effect was higher with lag2 (12.42% for SO2 and 11.60% for NOx) and wore off progressively thereafter. We also found a significant association with multiday averaging times of up to 30 and 7 days for SO2 and NOx, respectively. No significant associations were found between particulate matter with an aerodynamic profile ≤10 µm (PM10) and CRP concentration except in summer. The association was significantly higher among patients with a shorter duration of diabetes, and in those not on statin and thiazolidinedione treatment.
CONCLUSION 
We demonstrate, for the first time, a possible contribution of ambient air pollution to systemic inflammation in Indian type 2 diabetic patients. This may have implications for vascular complications of diabetes.    

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    2013-04-29 丁鹏鹏
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