Diabetes Care:空气污染诱发糖尿病患者炎症反应

《糖尿病护理》杂志日前发表伊朗和印度科学家合作完成的一项新研究[Diabetes Care. 2013 Mar;36(3):625-30]称，空气污染可能诱发2型糖尿病患者全身性炎症反应，增加其发生血管并发症的风险。

血浆C-反应蛋白（CRP）水平与胰岛素抵抗、糖尿病及其并发症呈现相关性，血浆CRP水平下降有助于降低胰岛素抵抗、糖尿病并发症发生风险。伊朗让迪·夏普尔医科大学和印度浦那大学科学家对印度浦那上千名2型糖尿病患者进行了对比研究。研究人员将每日空气污染数据与参试者的C-反应蛋白血浆浓度进行了相关性评估分析。并且，在采集血样前30天，研究人员还对参试者体质指数、糖化血红蛋白水平、空腹血糖值、抗炎活性药物治疗方案、周围气温和相对湿度等因素进行了校正。

研究结果显示，多日平均二氧化硫（最长30天）和一氧化氮（最长7天）浓度的升高与CRP血浆浓度升高存在显著相关性。在新确诊糖尿病患者和没有服用他汀和噻唑烷二酮的糖尿病患者中，空气污染与CRP血浆浓度之间的正相关性最为显著。

研究负责人莫尔塔扎·A·卡法伊博士表示，这项新研究首次表明，空气污染在2型糖尿病全身性炎症反应中起到一定的作用。新研究建议，糖尿病患者在空气污染的时候，要增加复诊的几率，重视遵医嘱调药，减少外出，同时增加室内活动的机会，保持抵抗力。

原文链接：

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Systemic Inflammation (C-Reactive Protein) in Type 2 Diabetic Patients Is Associated With Ambient Air Pollution in Pune City, India

OBJECTIVE

To study the association between ambient air pollutants and serum C-reactive protein (CRP) concentration in 1,392 type 2 diabetic patients in Pune, India.

RESEARCH DESIGN AND METHODS

A cross-sectional study was conducted that linked daily time series of ambient air pollution data (obtained from central monitoring sites) and plasma CRP concentration in type 2 diabetic patients from the Wellcome Trust Genetic (WellGen) Study, recruited between March 2005 and May 2007. Air pollution effects on CRP concentration were investigated with delays (lags) of 0–7 days and multiday averaging spans of 7, 14, and 30 days before blood collection adjusted for age, sex, BMI, hemoglobin, fasting plasma glucose, treatment with agents with anti-inflammatory action, season, air temperature, and relative humidity.

RESULTS

Median CRP concentration was 3.49 mg/L. For 1 SD increase in SO2 and oxides of nitrogen (NOx) concentrations in ambient air, a day before blood collection (lag1), we observed a significant increase in CRP (9.34 and 7.77%, respectively). The effect was higher with lag2 (12.42% for SO2 and 11.60% for NOx) and wore off progressively thereafter. We also found a significant association with multiday averaging times of up to 30 and 7 days for SO2 and NOx, respectively. No significant associations were found between particulate matter with an aerodynamic profile ≤10 µm (PM10) and CRP concentration except in summer. The association was significantly higher among patients with a shorter duration of diabetes, and in those not on statin and thiazolidinedione treatment.

CONCLUSIONS

We demonstrate, for the first time, a possible contribution of ambient air pollution to systemic inflammation in Indian type 2 diabetic patients. This may have implications for vascular complications of diabetes.

来源：医学论坛报
原始链接：http://www.cmt.com.cn/subjectDetail/1/14/158235.html