PM2.5暴露影响终止高血压饮食模式与中心性肥胖的相关性
Correlation between dietary approaches to stop hypertension pattern and central obesity affected by PM2.5 exposure
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摘要:
背景 PM2.5及其组分暴露是否影响终止高血压饮食（DASH）模式与中心性肥胖之间的关系尚缺乏证据。
目的 探讨PM2.5及其组分暴露对DASH模式与中心性肥胖患病相关性的影响。
方法 数据来源于“新疆多民族自然人群队列建设及健康随访研究”乌鲁木齐市人群基线调查。根据8种食物组摄入频率计算DASH评分，推荐摄入的食物组摄入频率由低到高分别为1~5分，而限制摄入的食物组摄入频率由高到低分别为1~5分，总分即为DASH评分，评分越高，研究对象对DASH模式的依从性越好；对应用卫星获得的PM2.5和全球大气化学传输模式（GEOS-Chem）估计的有机碳（OC）、黑炭（BC）、硫酸盐（SO42−）、硝酸盐（NO3−）、铵盐（NH4+）及扬尘进行暴露评估；以男性腰围≥90 cm或女性腰围≥85 cm定义为中心性肥胖（WS/T 428—2013《成人体重判定》）。采用logistic回归模型分析DASH模式、PM2.5及其组分对中心性肥胖的影响，采用分层分析探讨PM2.5及其组分对DASH模式和中心性肥胖关联的影响。
结果 研究共纳入9565名城市居民，年龄（62.30±9.42）岁，中心性肥胖患病率为60.75%。调整混杂因素后，DASH评分Q5组比Q1组中心性肥胖患病可能性降低17.5%（
OR =0.825，95%CI ：0.720~0.947）。PM2.5及其组分OC、BC、SO42−、NH4+、扬尘与中心性肥胖患病呈正相关，未见组分NO3−暴露与中心性肥胖有关联。分层分析发现，暴露于低浓度PM2.5及其组分NO3−、NH4+、扬尘的研究对象中，DASH评分Q5组中心性肥胖患病可能性降低，而暴露于高浓度PM2.5及其组分NO3−、NH4+、扬尘的研究对象中，DASH模式对中心性肥胖的保护效应消失。结论 PM2.5及其组分NO3−、NH4+、扬尘暴露会削弱DASH模式对中心性肥胖的保护效应。
Abstract:Background There is a lack of evidence on whether exposure to PM2.5 and its constituents would affect the relationship between the dietary approaches to stop hypertension (DASH) and central obesity.
Objective To investigate the effect of exposure to PM2.5 and its constituents on the correlation between the DASH dietary pattern and the prevalence of central obesity.
Methods The data were obtained from the baseline survey of the "Xinjiang Multi-Ethnic Natural Population Cohort Construction and Health Follow-Up Study" in Urumqi. A DASH score was calculated according to intake frequency of 8 food groups, and summed from intake frequency of recommended food groups scored from 1 to 5 from low to high, and intake frequency of restricted food groups scored from 1 to 5 from high to low. A higher DASH score indicates better compliance with the DASH dietary pattern. We estimated exposure using satellite-derived PM2.5 and a chemical transport model (GEOS-Chem) for its constituents, including organic carbon (OC), black carbon (BC), sulfate (SO42−), nitrate (NO3−), ammonium (NH4+), and soil dust. Central obesity was defined by waist circumference: ≥90 cm for men or ≥85 cm for women according to
Criteria of weight for adults (WS/T 428—2013). A logistic regression model was used to analyze the effects of the DASH dietary pattern as well as PM2.5 and its constituents on central obesity, and a stratified analysis was used to explore the effects of PM2.5 and its constituents on the association between the DASH dietary pattern and central obesity.Results The study included 9 565 urban residents, aged (62.30±9.42) years, with a central obesity prevalence rate of 60.75%. After adjusting for selected confounders, the DASH score Q5 group had a 17.5% lower risk of central obesity than the Q1 group (
OR =0.825, 95%CI : 0.720-0.947). PM2.5 and its constituents OC, BC, SO42−, NH4+, and soil dust were positively associated with the prevalence of central obesity, but no association was observed between constituent NO3− exposure and central obesity. The stratified analysis revealed that the prevalence of central obesity was reduced in the DASH score Q5 group in participants exposed to low concentrations of PM2.5 and its constituents NO3−, NH4+, and soil dust, while the protective effect of the DASH pattern on central obesity disappeared in subjects exposed to high concentrations of PM2.5 and its constituents NO3−, NH4+, and soil dust.Conclusion Exposure to PM2.5 and its constituents NO3−, NH4+, and soil dust could attenuate the protective effect of the DASH pattern on central obesity.
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