Background

There has been no investigation to date of adults with metabolic syndrome examining the association of short and long-term exposure to fine particulate matter (PM_2.5) air pollution with cardiovascular-disease related inflammatory marker (WBC and CRP) levels in a nationally representative sample. The goal of this study is to assess the susceptibility of adults with metabolic syndrome to PM_2.5 exposure as suggested by increased cardiovascular-disease related inflammatory marker levels.

Methods

A cross sectional analysis of adult National Health and Nutrition Examination Survey (NHANES) participants (2000–2008) was carried out with linkage of CDC WONDER meteorological data and downscaler modeled USEPA air pollution data for census tracts in the continental United States.

Participants were non-pregnant NHANES adults (2000–2008) with complete data for evaluating presence of metabolic syndrome and laboratory data on WBC and CRP. Exposures studied included short (lags 0–3 days and their averages), long-term (30 and 60 day moving and annual averages) PM_2.5 exposure levels at the census tract level in the continental United States. The main outcomes included CRP and WBC levels the day of NHANES study visit analyzed using multiple linear regression, adjusting for age, gender, race, education, smoking status, history of any cardiovascular disease, maximum apparent temperature and ozone level, for participants with and without metabolic syndrome.

Results

A total of 7134 NHANES participants (35% with metabolic syndrome) met the inclusion criteria. After adjusting for confounders, we observed a significant effect of PM_2.5 acutely at lag day 0 on CRP level; a 10 µg/m³ rise in lag day 0 PM_2.5 level was associated with a 10.1% increase (95% CI: 2.2–18.6%) in CRP levels for participants with metabolic syndrome. For those without metabolic syndrome, the change in CRP was −1.3% (95% CI −8.8%, 6.8%). There were no significant associations for WBC count.

In this first national study of the effect of PM_2.5 air pollution on levels of cardiovascular-disease related inflammatory markers in adults with metabolic syndrome, CRP levels were found to be significantly increased in those with this condition with increased fine particulate matter levels at lag day 0. With one third of US adults with metabolic syndrome, the health impact of PM_2.5 in this sensitive population may be significant.

中文翻译：

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在患有代谢综合征的美国NHANES成人中，与心血管疾病以及急性和慢性暴露于细颗粒物空气污染（PM _2.5）有关的全身性炎症标志物

背景

迄今为止，尚无关于代谢综合征成人的研究，该研究以全国代表性的样本来研究短期和长期暴露于细颗粒物（PM _2.5）空气污染与心血管疾病相关的炎症标志物（WBC和CRP）水平之间的关系。 。这项研究的目的是评估心血管综合征相关炎症标记物水平升高所表明的患有代谢综合征的成年人对PM _2.5暴露的敏感性。

方法

结合CDC WONDER气象数据和按比例缩小的USEPA空气污染数据（针对美国大陆地区的人口普查数据），对成人国家健康和营养检查调查（NHANES）参与者（2000–2008）进行了横断面分析。

参加者为未怀孕的NHANES成人（2000-2008年），其具有评估代谢综合征的完整数据以及有关WBC和CRP的实验室数据。暴露研究了短（0-3滞后天，它们的平均值）在内，长期（30和60日均线及全年平均值）PM _2.5在美国大陆人口普查水平的暴露水平。主要结果包括NHANES研究访问当天的CRP和WBC水平，使用多元线性回归分析，针对年龄，性别，种族，教育，吸烟状况，任何心血管疾病史，最高表观温度和臭氧水平进行了调整，以校正年龄，性别和没有代谢综合症。

结果

共有7134名NHANES参与者（35％患有代谢综合征）符合纳入标准。调整混杂因素后，我们观察到在滞后第0天，PM _2.5对CRP水平有显着影响。滞后一天0 PM _2.5水平升高10 µg / m ³与代谢综合征参与者的CRP水平升高10.1％（95％CI：2.2-18.6％）相关。对于没有代谢综合征的患者，CRP的变化为-1.3％（95％CI -8.8％，6.8％）。WBC计数没有显着关联。

在这项关于PM _2.5空气污染对代谢综合征成人的心血管疾病相关炎症标志物水平影响的首次国家研究中，发现在这种情况下，CRP水平显着升高，且滞后日的细颗粒物水平升高0.在三分之一的美国成年人患有代谢综合征的情况下，PM _2.5对这一敏感人群的健康影响可能很大。