title: Size-fractioned ultrafine particles and black carbon associated with autonomic dysfunction in subjects with diabetes or impaired glucose tolerance in Shanghai, China.
abstract: BACKGROUND
  Particles in smaller size fractions, such as ultrafine particles (UFPs) (with diameter less than 100 nm), has become of significant cardiovascular health concerns. However, the biological plausibility underlying potential relationship between UFPs and cardiovascular outcomes is less studied.
  
  
  METHODS
  Fifty-three subjects living in Shanghai with type-2 diabetes (T2D) or impaired glucose tolerance (IGT) were followed for autonomic dysfunctions with three repeated measurements in 2010. Minute-to-minute concentrations of ambient particles in small size-fractions (5-560 nm), black carbon (BC), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) were monitored using a central monitoring laboratory equipped with real-time air monitors close to residential area of the subjects. Generalized linear mixed models, with adjustment for individual risk factors, were applied to assess the effects of air pollution on autonomic dysfunctions in subjects.
  
  
  RESULTS
  Our study showed that significant reduction in the standard deviation of all NN intervals (SDNN) ranging from 3.4% to 8.1% were associated with interquartile range (IQR) increase of number concentration of particles (PNC) in size fractions<100 nm, and reduction from 1.3% to 4.6% with particles of diameter 100-200 nm, in subjects with diabetes or glucose tolerance. Increased exposure to traffic-related pollutants BC, NO2 and CO, and combustion pollutant SO2, were also significantly associated with HRV reductions. However, no effect was observed for particles in size fraction of 200-560 nm and O3. Diabetic risk factor and gender appeared to have significant interactions on autonomic dysfunction associated with UFPs and traffic pollution exposures in certain time-window.
  
  
  CONCLUSIONS
  Our results suggest that underlying diabetes or impaired glucose tolerance may confer reduced autonomic function of heart due to traffic pollution exposure.
authors.affiliation: Department of Occupational & Environmental Health Sciences, and Institute of Environmental Medicine, Peking University School of Public Health, and Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, 100191, China. syitong@umich.edu.
authors.forename: Yitong
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Occupational & Environmental Health Sciences, and Institute of Environmental Medicine, Peking University School of Public Health, and Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, 100191, China. xiaomingsong@bjmu.edu.cn.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Song
authors.affiliation: College of Environmental Sciences and Engineering, Peking University, Beijing, China. qunr1985@126.com.
authors.forename: Yiqun
authors.initials: Y
authors.lastname: Han
authors.affiliation: Center for Diseases Control and Prevention of Luwan District, Shanghai, China. jiyunfang@hpcdc.sh.cn.
authors.forename: Yunfang
authors.initials: Y
authors.lastname: Ji
authors.affiliation: Center for Diseases Control and Prevention of Luwan District, Shanghai, China. gaoshuna@hpcdc.sh.cn.
authors.forename: Shuna
authors.initials: S
authors.lastname: Gao
authors.affiliation: Institute of Environmental Pollution and Health, Shanghai University, Shanghai, China. yushang@shu.edu.cn.
authors.forename: Yu
authors.initials: Y
authors.lastname: Shang
authors.affiliation: Department of Biostatistics, UMDNJ-School of Public Health, Piscataway, New Jersey, US. shouenlu@hotmail.com.
authors.forename: Shou-en
authors.initials: SE
authors.lastname: Lu
authors.affiliation: College of Environmental Sciences and Engineering, Peking University, Beijing, China. tzhu@pku.edu.cn.
authors.forename: Tong
authors.initials: T
authors.lastname: Zhu
authors.affiliation: Department of Occupational & Environmental Health Sciences, and Institute of Environmental Medicine, Peking University School of Public Health, and Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, 100191, China. whuang@bjmu.edu.cn.
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
mesh_terms: D000393:Air Pollutants / Q000032:analysis / Q000633:toxicity*; D001341:Autonomic Nervous System / Q000187:drug effects / Q000503:physiopathology*; D001786:Blood Glucose / Q000032:analysis; D002681:China; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology*; D005260:Female; D005951:Glucose Tolerance Test; D006321:Heart / Q000187:drug effects* / Q000294:innervation / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010316:Particle Size; D052638:Particulate Matter / Q000032:analysis / Q000633:toxicity*; D053260:Soot / Q000032:analysis / Q000633:toxicity; D014507:Urbanization
chemical_list: D000393:Air Pollutants; D001786:Blood Glucose; D052638:Particulate Matter; D053260:Soot