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    高宇卉, 刘楠楠, 田家瑜, 石东星, 哈里买买提·那斯尔, 王彩红, 孔玮璨, 王谦雨, 张志红. 太原市PM2.5及O3短期暴露对老年2型糖尿病患者血糖和血压的影响[J]. 环境卫生学杂志, 2022, 12(9): 654-661. DOI: 10.13421/j.cnki.hjwsxzz.2022.09.007
    引用本文: 高宇卉, 刘楠楠, 田家瑜, 石东星, 哈里买买提·那斯尔, 王彩红, 孔玮璨, 王谦雨, 张志红. 太原市PM2.5及O3短期暴露对老年2型糖尿病患者血糖和血压的影响[J]. 环境卫生学杂志, 2022, 12(9): 654-661. DOI: 10.13421/j.cnki.hjwsxzz.2022.09.007
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    GAO Yu-hui, LIU Nan-nan, TIAN Jia-yu, SHI Dong-xing, HALIMAIMAITI ·Nasier, WANG Cai-hong, KONG Wei-can, WANG Qian-yu, ZHANG Zhi-hong. Influence of short-term exposure to fine particulate matter and ozone on blood glucose and blood pressure in elderly patients with type 2 diabetes Mellitus in Taiyuan, China[J]. Journal of Environmental Hygiene, 2022, 12(9): 654-661. DOI: 10.13421/j.cnki.hjwsxzz.2022.09.007
    Citation: GAO Yu-hui, LIU Nan-nan, TIAN Jia-yu, SHI Dong-xing, HALIMAIMAITI ·Nasier, WANG Cai-hong, KONG Wei-can, WANG Qian-yu, ZHANG Zhi-hong. Influence of short-term exposure to fine particulate matter and ozone on blood glucose and blood pressure in elderly patients with type 2 diabetes Mellitus in Taiyuan, China[J]. Journal of Environmental Hygiene, 2022, 12(9): 654-661. DOI: 10.13421/j.cnki.hjwsxzz.2022.09.007
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    太原市PM2.5及O3短期暴露对老年2型糖尿病患者血糖和血压的影响

    Influence of short-term exposure to fine particulate matter and ozone on blood glucose and blood pressure in elderly patients with type 2 diabetes Mellitus in Taiyuan, China

      摘要
    • 摘要:
      目的 探讨太原市空气细颗粒物(fine particulate matter, PM2.5)及臭氧(O3)对老年2型糖尿病患者血糖和血压的影响, 为老年2型糖尿病患者的防治提供理论依据。
      方法 于2020年招募太原市某区6个社区老年2型糖尿病患者702人, 通过问卷调查收集研究对象的性别、年龄、文化程度、吸烟饮酒情况和家族史等信息。根据其居住地址匹配同期大气PM2.5、O3质量浓度和气象数据, 运用广义线性模型分析空气污染物浓度与血糖和血压的关系, 并根据是否合并其他疾病将老年2型糖尿病患者总人群分为单纯性老年2型糖尿病患者和老年2型糖尿病合并其他疾病者, 分别探讨PM2.5、O3暴露浓度对总人群、单纯性老年2型糖尿病患者和老年2型糖尿病合并其他疾病者血糖和血压的影响, 并分析了PM2.5、O3暴露浓度对不同亚组老年2型糖尿病患者总人群血糖和血压的影响。
      结果 调整性别、BMI、吸烟等混杂因素后, PM2.5暴露浓度在lag1、lag02、lag03 d与总人群和单纯性老年2型糖尿病患者的收缩压(systolic blood pressure, SBP)升高有关, PM2.5每升高一个四分位间距(interquartile range, IQR), 总人群的SBP分别升高1.08%(0.31%~1.84%)、0.82%(0.04%~1.61%)、0.87%(0.08%~1.67%), 单纯性老年2型糖尿病患者的SBP分别升高1.26%(0.15%~2.37%)、1.24%(0.06%~2.41%)、1.31%(0.11%~2.50%), 并且在lag1 d时总人群的脉压(pulse pressure, PP)随PM2.5浓度的增加而升高2.18%(0.33%~4.03%)。O3暴露浓度在lag03d会引起总人群的SBP降低1.69%(0.06%~3.32%), 并在lag01、lag02 d分别使PP降低3.38%(0.12%~6.64%)、3.80%(0.16%~7.42%)。在单纯性老年2型糖尿病患者中, O3暴露浓度在lag2 d时使舒张压(diastolic blood pressure, DBP)下降3.13%(0.46%~5.81%)。分层分析中, 男性、超重和吸烟者的SBP、PP会随PM2.5的增加而升高。
      结论 太原市PM2.5及O3暴露水平分别与老年2型糖尿病患者的血压升高和降低有关, 在单纯性2型糖尿病患者中更为显著。PM2.5及O3暴露水平与老年2型糖尿病患者的空腹血糖(fasting blood glucose, FBG)无相关性。老年2型糖尿病患者中, 男性、超重和吸烟对PM2.5更敏感。

       

      Abstract:
      Objective To investigate the influence of fine particulate matter (PM2.5) and ozone (O3) on blood glucose and blood pressure in elderly patients with type 2 diabetes mellitus(T2DM) in Taiyuan, China, so as to provide a theoretical basis for the prevention and treatment of T2DM in elderly patients.
      Methods A total of 702 elderly patients with T2DM were recruited from six communities in a district of Taiyuan in 2020. A questionnaire survey was performed to collect the information of the subjects such as gender, age, education level, smoking and drinking status, and family history. Mass concentrations of ambiet PM2.5 and O3 and meteorological data during the same period were matched according to the subjects' residential addresses. Generalized linear model analysis was used to investigate the associations of the concentration of air pollutants with blood glucose and blood pressure. According to the presence or absence of comorbidities, the elderly patients with T2DM were divided into patients with simple type 2 diabetes(ST2DM) and patients with type 2 diabetes combined with other diseases(T2DMCOD). The influence of the exposure concentration of PM2.5 and O3 on blood glucose and blood pressure was analyzed in the total population, the elderly patients with ST2DM, and the elderly patients with T2DMCOD, and in the total population of different subgroups of the elderly patients with T2DM.
      Results After adjustment for the confounding factors such as gender, body mass index, and smoking, PM2.5 exposure concentration on lag1, lag02, and lag03 days was associated with the increased systolic blood pressure (SBP) in the total population and the elderly patients with ST2DM, and for every interquartile range (IQR) increase in PM2.5 mass concentration, SBP of the total population was increased by 1.08% (0.31%-1.84%), 0.82% (0.04%-1.61%), and 0.87% (0.08%-1.67%) on lag01, lag02, and lag03 days, respectively, while SBP of the elderly patients with ST2DM was increased by 1.26% (0.15%-2.37%), 1.24% (0.06%-2.41%), and 1.31% (0.11%-2.50%), respectively. On lag1 day, pulse pressure (PP) of the total population was increased by 2.18% (0.33%-4.03%) with the increase in PM2.5 mass concentration. On lag03 day, SBP of the total population was decreased by 1.69% (0.06% to 3.32%) with the increase in O3 exposure concentration, and on lag01 and lag02 days, PP was decreased by 3.38% (0.12% to 6.64%) and 3.80% (0.16% to 7.42%), respectively. In the elderly patients with ST2DM, diastolic blood pressure(DPB) was decreased by 3.13% (0.46% to 5.81%) with the increase in O3 exposure concentration on lag2 day. Stratified analysis showed that SBP and PP increased with the increase of PM2.5 mass concentration in males, overweight individuals, and smokers.
      Conclusion The exposure levels of PM2.5 and O3 in Taiyuan are associated with the increase and decrease of blood pressure in elderly patients with T2DM, especially in the elderly patients with ST2DM. There are no correlations between PM2.5 and O3 exposure levels and fasting blood glucose (FBG) in elderly patients with T2DM. Among the elderly patients with T2DM, males, overweight, and smoking are more susceptible to PM2.5.

       

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