Modification effect of overweight and obesity on the association between short-term PM2.5 exposure and high blood pressure in adolescents
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摘要:
目的 分析PM2.5短期暴露与青少年血压偏高关联及其超重肥胖修饰效应，为学校对学生健康进行精细化管理和科学防护空气污染危害提供相关依据。 方法 选取2017—2018年北京市中学生年度健康体检数据中数据合格的初一、高一共148 956名学生为研究对象; 采用反距离加权插值法得出研究对象所处区域的气象要素与空气质量; 采用线性混合效应模型估计PM2.5短期暴露对收缩压、舒张压7 d内的累积滞后效应，并分析超重肥胖对PM2.5短期暴露与青少年血压偏高关联的修饰效应。 结果 2017年9月1日至2018年6月30日，北京市PM2.5平均质量体积浓度为(56.53±45.85)μg/m3; 研究对象超重肥胖检出率为34.22%，血压偏高检出率为8.03%。超重肥胖组PM2.5对收缩压的累积滞后效应lag07时最大，即PM2.5日均质量体积浓度每增长10 μg/m3与青少年收缩压偏高相关(OR=1.05，95%CI=1.03~1.07);非超重肥胖组PM2.5对收缩压的累积滞后效应lag05时最大，即PM2.5日均质量体积浓度每增长10 μg/m3与青少年收缩压偏高相关(OR=1.04，95%CI=1.02~1.06)。PM2.5短期暴露不对青少年舒张压偏高造成影响。超重肥胖的青少年对PM2.5短期暴露引起的血压偏高易感性在累积滞后3日内(lag01~lag03)更高。 结论 PM2.5短期暴露与青少年血压具有正相关，且存在滞后效应，超重肥胖青少年在PM2.5短期暴露后血压偏高更显著。 Abstract:Objective To analyze the association between short-term PM2.5 exposure and high blood pressure in adolescents and its modification effect of overweight and obesity, and to provide a reference for the refined management of students' physical health and the scientific prevention and controlling of air pollution. Methods A total of 148 956 junior high school students and senior high school students who passed the annual physical examination data of middle school students in Beijing from 2017 to 2018 were selected; The inverse distance weighted interpolation method was used to get the meteorological elements and air quality of the research area; Linear mixed effect model was used to estimate the cumulative lag effect of short-term PM2.5 exposure on systolic and diastolic blood pressure within 7 days, and analyze the modification effect of overweight and obesity on the association between short-term PM2.5 exposure and high blood pressure in adolescents. Results From September 1, 2017 to June 30, 2018, the average concentration of PM2.5 was (56.53±45.85)μg/m3; The detection rate of overweight and obesity was 34.22%, and the detection rate of high blood pressure was 8.03%. The cumulative lag effect of PM2.5 on systolic blood pressure in overweight and obesity group was the largest at lag07, that is, the daily average concentration of PM2.5 increased by 10 μg/m3 was significantly correlated with higher systolic blood pressure (OR=1.05, 95%CI=1.03-1.07); the cumulative lag effect of PM2.5 on systolic blood pressure in non overweight and obese group was the largest at lag05, that is, the daily average concentration of PM2.5 increased by 10 μg/m3 was significantly correlated with higher systolic blood pressure (OR=1.04, 95%CI=1.02-1.06). Short-term exposure to PM2.5 did not affect the high diastolic blood pressure in adolescents. Overweight and obese adolescents were more susceptible to high blood pressure caused by short-term PM2.5 exposure within 3 days of cumulative lag (lag01-lag03). Conclusion The short-term exposure of PM2.5 has a significant positive correlation with adolescent blood pressure, and shows a lag effect. Overweight and obese adolescents have higher blood pressure after PM2.5 short-term exposure. -
Key words:
- Overweight /
- Obesity /
- Particulate matter /
- Blood pressure /
- Adolescent
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 PM2.5短期暴露与青少年血压效应值的关联[β值(β值95%CI)]
Table 1. Correlation between short-term PM2.5 exposure and systolic blood pressure effect in adolescents[β(β 95%CI)]
血压 组别 人数 lag0 lag01 lag02 lag03 收缩压 超重肥胖组 50 976 0.03(0.01~0.06) 0.07(0.04~0.10) 0.10(0.06~0.13) 0.12(0.08~0.16) 非超重肥胖组 97 980 0.02(0.00~0.04) 0.04(0.02~0.06) 0.07(0.04~0.09) 0.07(0.05~0.10) 舒张压 超重肥胖组 50 976 0.01(-0.01~0.02) 0.01(-0.01~0.03) -0.02(-0.04~0.01) -0.04(-0.07~-0.02) 非超重肥胖组 97 980 -0.01(-0.02~0.00) -0.01(-0.02~0.00) -0.01(-0.03~0.00) -0.04(-0.05~-0.02) 血压 组别 人数 lag04 lag05 lag06 lag07 收缩压 超重肥胖组 50 976 0.17(0.12~0.22) 0.23(0.17~0.28) 0.22(0.16~0.27) 0.22(0.16~0.27) 非超重肥胖组 97 980 0.12(0.09~0.16) 0.20(0.16~0.23) 0.18(0.14~0.21) 0.14(0.10~0.18) 舒张压 超重肥胖组 50 976 -0.05(-0.08~-0.01) -0.02(-0.06~0.01) -0.03(-0.06~0.01) -0.03(-0.06~0.01) 非超重肥胖组 97 980 -0.03(-0.05~-0.01) 0.00(-0.02~0.02) -0.01(-0.04~0.01) -0.02(-0.05~0.00) 
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表 2 PM2.5短期暴露与青少年血压偏高的关联[OR值(OR值95%CI)]
Table 2. Association between short-term PM2.5 exposure and high blood pressure in adolescents[OR(OR 95%CI)]
血压 组别 人数 lag0 lag01 lag02 lag03 收缩压 超重肥胖组 50 976 1.00(1.00~1.01) 1.01(1.00~1.02) 1.03(1.01~1.04) 1.03(1.02~1.05) 非超重肥胖组 97 980 1.01(1.00~1.02) 1.01(1.00~1.02) 1.02(1.00~1.03) 1.02(1.00~1.04) 舒张压 超重肥胖组 50 976 1.00(0.98~1.01) 1.00(0.99~1.02) 1.00(0.98~1.02) 0.99(0.97~1.01) 非超重肥胖组 97 980 1.00(0.98~1.01) 1.00(0.98~1.02) 0.99(0.97~1.01) 0.98(0.96~1.01) 血压偏高 超重肥胖组 50 976 1.00(0.99~1.01) 1.01(1.00~1.02) 1.02(1.01~1.03) 1.02(1.01~1.04) 非超重肥胖组 97 980 1.01(1.00~1.01) 1.01(1.00~1.02) 1.01(1.00~1.03) 1.01(1.00~1.03) 血压 组别 人数 lag04 lag05 lag06 lag07 收缩压 超重肥胖组 50 976 1.04(1.02~1.06) 1.04(1.02~1.06) 1.04(1.03~1.06) 1.05(1.03~1.07) 非超重肥胖组 97 980 1.04(1.02~1.06) 1.04(1.02~1.06) 1.03(1.01~1.05) 1.03(1.01~1.05) 舒张压 超重肥胖组 50 976 0.98(0.96~1.01) 0.99(0.96~1.01) 0.99(0.96~1.01) 0.99(0.96~1.02) 非超重肥胖组 97 980 1.00(0.97~1.03) 1.01(0.98~1.05) 1.01(0.98~1.04) 1.00(0.97~1.04) 血压偏高 超重肥胖组 50 976 1.03(1.01~1.04) 1.03(1.01~1.05) 1.03(1.01~1.05) 1.04(1.02~1.06) 非超重肥胖组 97 980 1.03(1.01~1.05) 1.03(1.01~1.05) 1.03(1.01~1.05) 1.02(1.00~1.04)
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