Endothelial dysfunction: associations with exposure to ambient fine particles in diabetic individuals.
BACKGROUND
Exposure to fine airborne particulate matter [< or =2.5 microm in aerodynamic diameter (PM(2.5))] has been associated with cardiovascular and hematologic effects, especially in older people with cardiovascular disease. Some epidemiologic studies suggest that adults with diabetes also may be a particularly susceptible population.


OBJECTIVE
The purpose of this study was to analyze the short-term effects of ambient PM(2.5) on markers of endothelial function in diabetic volunteers.


METHODS
We conducted a prospective panel study in 22 people with type 2 diabetes mellitus in Chapel Hill, North Carolina (USA), from November 2004 to December 2005. We acquired daily measurements of PM(2.5) and meteorologic data at central monitoring sites. On 4 consecutive days, we measured endothelial function by brachial artery ultrasound in all participants and by pulsewave measurements in a subgroup. Data were analyzed using additive mixed models with a random participant effect and adjusted for season, day of the week, and meteorology.


RESULTS
Flow-mediated dilatation decreased in association with PM(2.5) during the first 24 hr, whereas small-artery elasticity index decreased with a delay of 1 and 3 days. These PM(2.5)-associated decrements in endothelial function were greater among participants with a high body mass index, high glycosylated hemoglobin A1c, low adiponectin, or the null polymorphism of glutathione S-transferase M1. However, high levels of myeloperoxidase on the examination day led to strongest effects on endothelial dysfunction.


CONCLUSIONS
These data demonstrate that PM(2.5) exposure may cause immediate endothelial dysfunction. Clinical characteristics associated with insulin resistance were associated with enhanced effects of PM on endothelial function. In addition, participants with greater oxidative potential seem to be more susceptible.
Schneider
Alexandra
A
Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Ingolstädter Landstrasse 1, Neuherberg, Germany.
Neas
Lucas
L
Herbst
Margaret C
MC
Case
Martin
M
Williams
Ronald W
RW
Cascio
Wayne
W
Hinderliter
Alan
A
Holguin
Fernando
F
Buse
John B
JB
Dungan
Kathleen
K
Styner
Maya
M
Peters
Annette
A
Devlin
Robert B
RB
D000369:Aged, 80 and over; D000393:Air Pollutants / Q000633:toxicity*; D000818:Animals; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D010316:Particle Size
D000393:Air Pollutants