title: Elevated particle number concentrations induce immediate changes in heart rate variability: a panel study in individuals with impaired glucose metabolism or diabetes.
abstract: BACKGROUND
  The health effects of short-term exposure to ambient ultrafine particles in micro-environments are still under investigation.
  
  
  METHODS
  Sixty-four individuals with type 2 diabetes and impaired glucose tolerance recorded ambulatory electrocardiograms over five to six hours on 191 occasions in a panel study in Augsburg, Germany. Personal exposure to particle number concentrations (PNC) was monitored for each individual on 5-minute basis concurrently and particulate matter with an aerodynamic diameter<2.5 μm (PM2.5) was acquired from a central monitoring site on an hourly basis.
  
  
  RESULTS
  More than 11,000 5-minute intervals were available for heart rate and measures of heart rate variability including SDNN (standard deviation of NN intervals). A concurrent decrease in 5-minute SDNN of -0.56% (95% confidence limits (CI): -1.02%; -0.09%) and a 5-minute delayed increase in heart rate of 0.23 % (95% CI: 0.11%; 0.36%) was observed with an increase in personal PNC of 16,000 per cm3 in additive mixed models. Models evaluating the association of concurrent 5-minute personal PNC and of 1-hour PM2.5 showed independent effects on SDNN.
  
  
  CONCLUSIONS
  The data suggest that freshly emitted ultrafine particles and aged fine particulate matter are both associated with changes in cardiac function in individuals with type 2 diabetes and impaired glucose tolerance in urban areas.
authors.affiliation: Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, 87564, Neuherberg, Germany. peters@helmholtz-muenchen.de.|German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany. peters@helmholtz-muenchen.de.
authors.forename: Annette
authors.initials: A
authors.lastname: Peters
authors.affiliation: Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, 87564, Neuherberg, Germany. regina.hampel@helmholtz-muenchen.de.
authors.forename: Regina
authors.initials: R
authors.lastname: Hampel
authors.affiliation: Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, 87564, Neuherberg, Germany. cyrys@helmholtz-muenchen.de.|University of Augsburg, Environmental Science Center, Augsburg, Germany. cyrys@helmholtz-muenchen.de.
authors.forename: Josef
authors.initials: J
authors.lastname: Cyrys
authors.affiliation: Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, 87564, Neuherberg, Germany. susanne.breitner@helmholtz-muenchen.de.
authors.forename: Susanne
authors.initials: S
authors.lastname: Breitner
authors.affiliation: Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, 87564, Neuherberg, Germany. uta.geruschkat@helmholtz-muenchen.de.
authors.forename: Uta
authors.initials: U
authors.lastname: Geruschkat
authors.affiliation: Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, 87564, Neuherberg, Germany. ute.kraus@helmholtz-muenchen.de.
authors.forename: Ute
authors.initials: U
authors.lastname: Kraus
authors.affiliation: Cardiology Division, University of Rochester Medical Center, Rochester, NY, USA. wojciech_zareba@urmc.rochester.edu.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Zareba
authors.affiliation: Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, 87564, Neuherberg, Germany. alexandra.schneider@helmholtz-muenchen.de.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Schneider
mesh_terms: D000368:Aged; D000393:Air Pollutants / Q000032:analysis / Q000633:toxicity*; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology*; D004562:Electrocardiography; D005858:Germany; D005951:Glucose Tolerance Test; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects* / Q000032:analysis; D010316:Particle Size; D052638:Particulate Matter / Q000032:analysis / Q000633:toxicity*
chemical_list: D000393:Air Pollutants; D001786:Blood Glucose; D052638:Particulate Matter