title: Associations between size-fractionated particulate air pollution and blood pressure in a panel of type II diabetes mellitus patients.
abstract: Little is known regarding how the size distribution of particulate matter (PM) air pollution influences its effect on blood pressure (BP), especially among patients with diabetes. The objective of this study was to explore the short-term associations between size-fractionated PM and BP among diabetes patients. We scheduled 6 repeated BP examinations every 2 weeks from 13 April 2013 to 30 June 2013 in a panel of 35 type 2 diabetes mellitus patients recruited from an urban community in Shanghai, China. We measured real-time PM concentrations in the size range of 0.25 to 10 μm. We used linear mixed-effect models to examine the short-term association of size-fractionated PM and BP after controlling for individual characteristics, mean temperature, relative humidity, day of the week, years with diabetes and use of antihypertensive medication. The association with systolic BP and pulse pressure strengthened with decreasing diameter. The size fractions with the strongest associations were 0.25 to 0.40 μm for number concentrations and ≤ 2.5 μm for mass concentrations. Furthermore, these effects occurred immediately even after 0-2h and lasted for up to 48 h following exposure. An interquartile range increase in 24-h average number concentrations of PM0.25-0.40 was associated with increases of 3.61 mmHg in systolic BP and 2.96 mmHg in pulse pressure. Females, patients younger than 65 years of age and patients without antihypertensive treatment were more susceptible to these effects. Our results revealed important size and temporal patterns of PM in elevating BP among diabetes patients in China.
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, & Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China.
authors.forename: Ang
authors.initials: A
authors.lastname: Zhao
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, & Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, Shanghai, China.
authors.forename: Renjie
authors.initials: R
authors.lastname: Chen
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, & Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China.
authors.forename: Cuicui
authors.initials: C
authors.lastname: Wang
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, & Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China.
authors.forename: Zhuohui
authors.initials: Z
authors.lastname: Zhao
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, & Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China.
authors.forename: Changyuan
authors.initials: C
authors.lastname: Yang
authors.affiliation: Tianping Community Health Service Center, Xuhui District, Shanghai, China.
authors.forename: Jianxiong
authors.initials: J
authors.lastname: Lu
authors.affiliation: Tianping Community Health Service Center, Xuhui District, Shanghai, China.
authors.forename: Xuan
authors.initials: X
authors.lastname: Chen
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, & Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, Shanghai, China. Electronic address: haidongkan@gmail.com.
authors.forename: Haidong
authors.initials: H
authors.lastname: Kan
mesh_terms: D000393:Air Pollutants / Q000032:analysis / Q000633:toxicity*; D001794:Blood Pressure / Q000187:drug effects*; D002681:China; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D005260:Female; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects / Q000032:analysis*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010316:Particle Size; D052638:Particulate Matter / Q000032:analysis / Q000633:toxicity*; D013696:Temperature
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter
keywords: Air pollution; Blood pressure; Diabetes; Diameter; Panel study; Particulate matter