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Air Pollution and Progression of Atherosclerosis in Different Vessel Beds—Results from a Prospective Cohort Study in the Ruhr Area, Germany
Environmental Health Perspectives ( IF 10.4 ) Pub Date : 2020-10-5 , DOI: 10.1289/ehp7077
Frauke Hennig 1 , Marie Henrike Geisel 2, 3 , Hagen Kälsch 4, 5 , Sarah Lucht 1 , Amir Abbas Mahabadi 6 , Susanne Moebus 7 , Raimund Erbel 2 , Nils Lehmann 2 , Karl-Heinz Jöckel 2 , André Scherag 3, 8 , Barbara Hoffmann 1 ,
Affiliation  

Abstract

Objectives:

Due to inconsistent epidemiological evidence on health effects of air pollution on progression of atherosclerosis, we investigated several air pollutants and their effects on progression of atherosclerosis, using carotid intima media thickness (cIMT), coronary calcification (CAC), and thoracic aortic calcification (TAC).

Methods:

We used baseline (2000–2003) and 5-y follow-up (2006–2008) data from the German Heinz Nixdorf Recall cohort study, including 4,814 middle-aged adults. Residence-based long-term air pollution exposure, including particulate matter (PM) with aerodynamic diameter 2.5μm (PM2.5), (PM10), and nitrogen dioxide (NO2) was assessed using chemistry transport and land use regression (LUR) models. cIMT was quantified as side-specific median IMT assessed from standardized ultrasound images. CAC and TAC were quantified by computed tomography using the Agatston score. Development (yes/no) and progression of atherosclerosis (change in cIMT and annual growth rate for CAC/TAC) were analyzed with logistic and linear regression models, adjusting for age, sex, lifestyle variables, socioeconomic status, and traffic noise.

Results:

While no clear associations were observed in the full study sample (mean age 59.1 (±7.6) y; 53% female), most air pollutants were marginally associated with progression of atherosclerosis in participants with no or low baseline atherosclerotic burden. Most consistently for CAC, e.g., a 1.5μg/m3 higher exposure to PM2.5 (LUR) yielded an estimated odds ratio of 1.19 [95% confidence interval (CI): 1.03, 1.39] for progression of CAC and an increased annual growth rate of 2% (95% CI: 1%, 4%).

Conclusion:

Our study suggests that development and progression of subclinical atherosclerosis is associated with long-term air pollution in middle-aged participants with no or minor atherosclerotic burden at baseline, while overall no consistent associations are observed. https://doi.org/10.1289/EHP7077



中文翻译:

空气污染和不同血管床中动脉粥样硬化的进展-德国鲁尔区一项前瞻性队列研究的结果

摘要

目标:

由于关于空气污染对动脉粥样硬化进展的健康影响的流行病学证据不一致,我们使用颈动脉内膜中层厚度(cIMT),冠状动脉钙化(CAC)和胸主动脉钙化(TAC)研究了几种空气污染物及其对动脉粥样硬化进展的影响)。

方法:

我们使用了德国Heinz Nixdorf Recall队列研究的基线(2000-2003年)和5年随访(2006-2008年)数据,包括4,814名中年成年人。基于居住地的长期空气污染暴露,包括空气动力学直径的颗粒物(PM)2.5μ下午2.5),(下午10)和二氧化氮(没有2)是使用化学迁移和土地利用回归(LUR)模型进行评估的。cIMT被量化为根据标准化超声图像评估的侧特异性中位IMT。使用Agatston评分通过计算机断层扫描对CAC和TAC进行定量。使用逻辑和线性回归模型分析了动脉粥样硬化的发展(是/否)和动脉粥样硬化的进展(cIMT的变化和CAC / TAC的年增长率),并针对年龄,性别,生活方式变量,社会经济状况和交通噪声进行了调整。

结果:

虽然在整个研究样本中未观察到明显的关联(平均年龄59.1(±7.6)y; 53%的女性),在无或低基线动脉粥样硬化负担的受试者中,大多数空气污染物与动脉粥样硬化的进展程度相关。对于CAC最一致,例如1.5μG/3 暴露于 下午2.5 (LUR)估计CAC进展的赔率比为1.19 [95%置信区间(CI):1.03,1.39],年增长率为2%(95%CI:1%,4%)。

结论:

我们的研究表明,亚临床动脉粥样硬化的发生和发展与基线时无或有较小动脉粥样硬化负担的中年参与者的长期空气污染有关,而总体上未观察到一致的关联。https://doi.org/10.1289/EHP7077

更新日期:2020-10-06
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