北京大學朱彤課題組發(fā)現(xiàn)血糖代謝紊亂加劇大氣顆粒物對血管功能的損傷
在中國近50%的成年人血糖代謝紊亂，其中10.9%的成年人罹患糖尿病，35.7%的成年人處于糖尿病前期狀態(tài)。糖尿病和糖尿病前期人群通常面臨著多種心血管疾病風險因素的威脅，包括血糖代謝紊亂、血脂代謝紊亂、高血壓、肥胖、運動不足等。已有研究表明，這類人群可能對大氣顆粒物的不良心血管效應更加易感。血管功能失調(diào)是大氣顆粒物引發(fā)心血管疾病的重要機制之一，但目前對血糖代謝紊亂人群中大氣顆粒物引發(fā)的血管功能損傷的認識還十分有限。
北京大學環(huán)境科學與工程學院朱彤教授課題組于2013—2015年在北京大學校醫(yī)院開展前瞻性定組研究SCOPE（A prospective Study COmparing the cardiometabolic and respiratory effects of air Pollution Exposure on healthy and prediabetic individuals），同時對31名糖尿病前期受試者和81名血糖正常的對照受試者進行跟蹤隨訪。通過在北大校園固定站點連續(xù)觀測的大氣顆粒物濃度數(shù)據(jù)評估受試者的大氣污染暴露水平，測量多項血管功能指標（包括外周血壓、中心血壓、增強壓、增強指數(shù)、反應性充血指數(shù)等）以綜合評價受試者的血管功能，采用線性混合效應模型探究了大氣顆粒物暴露與血管功能的關聯(lián)性及血糖代謝狀態(tài)的修飾作用。
該研究表明，大氣顆粒物暴露與血管功能失調(diào)相關，具體表現(xiàn)為細顆粒物（PM2.5）、粒徑小于100納米的超細顆粒物（UFP）、粒徑在100到560納米的積聚模態(tài)顆粒物（AMP）、黑碳（BC）暴露后，受試者血管彈性降低（脈壓升高、射血時間增長、心內(nèi)膜下心肌的活力率降低），內(nèi)皮功能失調(diào)（反應性充血指數(shù)降低）。該研究進一步在血糖水平較高的人群中觀察到與大氣顆粒物相關的血管功能損傷效應比血糖水平較低的人群更顯著，例如，在UFP和AMP暴露后，血糖水平較高的人群中收縮壓和脈壓顯著升高，血糖水平較低的人群則無顯著變化。這一研究結(jié)果提示，血糖代謝紊亂可能加劇大氣顆粒物對血管功能的損傷，血糖代謝紊亂人群可能面臨更高的由大氣顆粒物引發(fā)的心血管疾病風險，因此有必要開展更深入的研究來闡明易感性產(chǎn)生的機制，同時采取有效的空氣污染控制措施和適當?shù)呐R床干預手段來保護公眾健康。
血糖代謝紊亂加劇大氣顆粒物對血管功能的損傷
該研究近日以“Glucose metabolic disorders enhance vascular dysfunction triggered by particulate air pollution: A panel study”為題發(fā)表于美國心臟協(xié)會心血管著名期刊Hypertension上。北京大學環(huán)境科學與工程學院博士后陳悟、韓逸群（現(xiàn)為英國帝國理工學院博士后）為該論文共同第一作者，朱彤為通訊作者。該項研究獲得國家自然科學基金（21190051、41421064、91844000）和科技部“973項目”（2015CB553401）的支持，并獲得北京大學生物醫(yī)學倫理委員會的批準（IRB00001052-13024）。
SCOPE項目相關文章：
Jiang X, Han Y, Qiu X, et al. Personal exposure to electrophilic compounds of fine particulate matter and the inflammatory response: The role of atmospheric transformation. Journal of Hazardous Materials. 2022;432:128559.
Lin Y, Zhang H, Han Y, et al. Field evaluation of a potential exposure biomarker of methylated polycyclic aromatic hydrocarbons: Association between urinary phenanthrene-2-carboxylic acid and personal exposure to 2-methylphenanthrene. Environmental Science & Technology Letters. 2022;9(2):166-172.
Wang T, Han Y, Li H, et al. Fine particulate matter and vasoactive 20-hydroxyeicosatetraenoic acid: Insights into the mechanisms of the prohypertensive effects of particulate air pollution. Science of The Total Environment. 2022;806(3):151298.
Shi Y, Han Y, Wang Y, et al. Serum branched-chain amino acids modifies the associations between air pollutants and insulin resistance. Ecotoxicology and Environmental Safety. 2021;225:112780.
Wang T, Han T, Li H, et al. Proinflammatory lipid signals trigger the health effects of air pollution in individuals with prediabetes. Environmental Pollution, 2021;290:118008.
Jiang X, Han Y, Qiu X, et al. Organic components of personal PM2.5 exposure associated with inflammation: Evidence from an untargeted exposomic approach. Environmental Science & Technology. 2021;55(15):10589-10596.
Wang T, Han Y, Li H, et al. Changes in bioactive lipid mediators in response to short-term exposure to ambient air particulate matter: A targeted lipidomic analysis of oxylipin signaling pathways. Environmental International, 2021;147:106314.
Chen W, Han Y, Wang Y, et al. Associations between changes in adipokines and exposure to fine and ultrafine particulate matter in ambient air in Beijing residents with and without pre-diabetes. BMJ Open Diabetes Research and Care, 2020;8:e001215.
Fan Y, Han Y, Liu Y, et al. Biases arising from the use of ambient measurements to represent personal exposure in evaluating inflammatory responses to fine particulate matter: Evidence from a panel study in Beijing, China. Environmental Science & Technology Letters, 2020;7(10):746-752.
Chen X, Han Y, Chen W, et al. Respiratory inflammation and short-term ambient air pollution exposures in adult Beijing residents with and without prediabetes: A panel study. Environmental Health Perspectives, 2020;128(6):067004.
Zhang H, Han Y, Qiu X, et al. Association of internal exposure to polycyclic aromatic hydrocarbons with inflammation and oxidative stress in prediabetic and healthy individuals. Chemosphere, 2020;253:126748.
Han Y, Wang Y, Li W, et al. Susceptibility of prediabetes to the health effect of air pollution: a community-based panel study with a nested case-control design. Environmental Health, 2019;18:65.
Wang Y, Han Y, Zhu T, et al. A prospective study (SCOPE) comparing the cardiometabolic and respiratory effects of air pollution exposure on healthy and pre-diabetic individuals. Science China Life Science, 2018;61:46–56.
來源：北京大學
