Authors | O'Neill MS, Veves A, Zanobetti A, Sarnat JA, Gold DR, Economides PA, Horton ES, Schwartz J. | |
Title | Diabetes
enhances vulnerability to particulate air pollution-associated impairment
in vascular reactivity and endothelial function. |
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Full source | Circulation. 2005 Jun 7;111(22):2913-20. Epub 2005 May 31. | |
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Abstract | BACKGROUND:
Epidemiological studies suggest that people with diabetes are vulnerable
to cardiovascular health effects associated with exposure to particle air
pollution. Endothelial and vascular function is impaired in diabetes and
may be related to increased cardiovascular risk. We examined whether endothelium-dependent
and -independent vascular reactivity was associated with particle exposure
in individuals with and without diabetes. METHODS AND RESULTS: Study subjects
were 270 greater-Boston residents. We measured 24-hour average ambient levels
of air pollution (fine particles [PM2.5], particle number, black carbon,
and sulfates [SO4(2-)]) approximately 500 m from the patient examination
site. Pollutant concentrations were evaluated for associations with vascular
reactivity. Linear regressions were fit to the percent change in brachial
artery diameter (flow mediated and nitroglycerin mediated), with the particulate
pollutant index, apparent temperature, season, age, race, sex, smoking history,
and body mass index as predictors. Models were fit to all subjects and then
stratified by diagnosed diabetes versus at risk for diabetes. Six-day moving
averages of all 4 particle metrics were associated with decreased vascular
reactivity among patients with diabetes but not those at risk. Interquartile
range increases in SO4(2-) were associated with decreased flow-mediated
(-10.7%; 95% CI, -17.3 to -3.5) and nitroglycerin-mediated (-5.4%; 95% CI,
-10.5 to -0.1) vascular reactivity among those with diabetes. Black carbon
increases were associated with decreased flow-mediated vascular reactivity
(-12.6%; 95% CI, -21.7 to -2.4), and PM2.5 was associated with nitroglycerin-mediated
reactivity (-7.6%; 95% CI, -12.8 to -2.1). Effects were stronger in type
II than type I diabetes. CONCLUSIONS: Diabetes confers vulnerability to
particles associated with coal-burning power plants and traffic. |