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健康老年人短期空气污染暴露与体力活动对神经损伤的影响

泰然健康网
2024-12-07 10:46

摘要:

[背景]越来越多的证据表明空气污染对健康的损害以及体力活动对健康的益处，而空气污染和体力活动对神经系统的影响需要更多研究。

[目的]探究短期空气污染暴露与体力活动对健康老年人神经损伤生物标志的影响。

[方法]采用定组研究方法，在新乡医学院招募身心健康的退休职工，于2018年12月至2019年4月定期进行5次随访。使用问卷获取人口学特征及体力活动信息，根据体力活动强度和时间计算每周的体力活动水平。检测血清中神经损伤生物标志包括脑源性神经营养因子（BDNF）、神经丝轻链（NF-L）、神经元特异性烯醇化酶（NSE）、蛋白基因产物9.5（PGP9.5）和钙结合蛋白S100B（S100B）的浓度。同时收集空气污染数据（包括PM2.5、PM10、O3、SO2、CO、NO2）。采用广义估计方程分析空气污染物浓度、体力活动水平与神经损伤生物标志浓度的关系。

[结果]研究共纳入29名志愿者，年龄（63.5±5.89）岁；男性11人，占比37.93%；初中以上文化程度占半数以上（62.07%），体力活动水平为（80.23±54.51）MET-h·周−1。研究期间PM2.5、PM10、O3、SO2、CO、NO2的日均质量浓度分别为（68.27±60.98）μg·m−3、（130.57±58.71）μg·m−3、（36.86±13.89）μg·m−3、（17.86±10.59）μg·m−3、（4.94±1.34）mg·m−3和（50.83±8.03）μg·m−3。血清BDNF、NF-L、NSE、PGP9.5和S100B的质量浓度分别为（139.12±46.71）μg·L−1、（402.60±183.31）ng·L−1、（11.26±10.32）ng·L−1、（14.32±13.57）ng·L−1和（127.57±41.74）ng·L−1。广义估计方程分析结果表明，较高浓度的PM2.5和O3与血清中NSE浓度增加有关（OR=1.359，95%CI：1.224~1.509，P<0.001；OR=1.286，95%CI：1.076~1.537，P=0.006），而较高浓度的NO2与NSE浓度降低有关（OR=0.692，95%CI：0.549~0.873，P=0.002）；较高浓度的O3和SO2与血清中NF-L浓度降低有关（OR=0.855，95%CI：0.740~0.989，P=0.035；OR=0.813，95%CI：0.700~0.946，P=0.007）；较高浓度的NO2与血清中PGP9.5浓度降低有关（OR=0.866，95%CI：0.777~0.965，P=0.009）；较高体力活动水平与血清中S100B浓度增加有关（OR=1.038，95%CI：1.003~1.074，P=0.034）；未发现体力活动、污染物与血清中BDNF的关系具有统计学意义（P>0.05）。

[结论]短期空气污染暴露和高水平体力活动可能与老年人神经损伤有关。颗粒污染物（PM2.5）与NSE增加有关，气态污染物（O3、NO2、SO2）与NF-L、PGP9.5降低有关。

Abstract:

[Background]Emerging evidence has shown the damage of air pollution and the benefits of physical activity to human health, and the effects of air pollution and physical activity on the nervous system need more research.

[Objective]To explore the effects of short-term air pollution exposure and physical activity on neural damage biomarkers in healthy elderly.

[Methods]Using a design of panel study, physically and mentally healthy retired employees were recruited from Xinxiang Medical University, and were followed up five times regularly from December 2018 to April 2019. The demographic characteristics and physical activity information were obtained by questionnaire, and the weekly physical activity level was calculated according to intensity and duration of physical activity. Biomarkers of neural damage in serum were measured, including brain-derived neurotrophic factor (BDNF), neurofilament light chain (NF-L), neuron specific enolase (NSE), protein gene product 9.5 (PGP9.5), and S100 calcium-binding protein B (S100B). Air pollution data (including PM2.5, PM10, O3, SO2, CO, and NO2) of the follow-up period were collected. Generalized estimation equation was used to analyze the association of air pollution concentration and physical activity level with the concentration of neural damage biomarkers.

[Results]A total of 29 volunteers were included in the study, with an average age of (63.5±5.9) years; there were 11 men accounting for 37.93%; more than half of them (62.07%) received above junior middle school education; the mean physical activity level was (80.23±54.51) MET-h·week−1. The daily average concentrations of PM2.5, PM10, O3, SO2, CO, and NO2 during the study period were (68.27±60.98) μg·m−3, (130.57±58.71) μg·m−3, (36.86±13.89) μg·m−3, (17.86±10.59) μg·m−3, (4.94±1.34) mg·m−3, and (50.83±8.03) μg·m−3, respectively. The average serum concentrations of BDNF, NF-L, NSE, PGP9.5, and S100B were (139.12±46.71) μg·L−1, (402.60±183.31) ng·L−1, (11.26±10.32) ng·L−1, (14.32±13.57) ng·L−1, and (127.57±41.74) ng·L−1, respectively. The results of generalized estimation equation showed that a higher concentration of PM2.5 or O3 was associated with increased serum NSE (OR=1.359, 95%CI: 1.224-1.509, P<0.001;OR=1.286, 95%CI: 1.076-1.537, P=0.006), while a higher concentration of NO2 was associated with decreased serum NSE (OR=0.692, 95%CI: 0.549-0.873, P=0.002); a higher concentration of O3 or SO2 was related to the reduction of serum NF-L concentration (OR=0.855, 95%CI: 0.740-0.989, P=0.035; OR=0.813, 95%CI: 0.700-0.946, P=0.007); a higher concentration of NO2 was associated with decreased PGP9.5 in serum (OR=0.866, 95%CI: 0.777-0.965, P=0.009); a higher level of physical activity was associated with increased serum S100B (OR=1.038, 95%CI: 1.003-1.074, P=0.034); and no significant association of physical activity level or air pollution with BDNF (P>0.05).

[Conclusion]Acute exposure to air pollution and high-level physical activity might affect the neural damage of elderly populations. Specifically, particulate matter (PM2.5) could increase NSE, while gaseous pollutants (O3, NO2, and SO2) could decrease NF-L and PGP9.5.

表 1

研究期间空气污染物浓度及老年志愿者神经损伤生物标志浓度

Table 1

The levels of air pollutants and neural damage biomarkers in elderly volunteers during study period

变量(Variable)$ bar x $$ s $最小值
MinP25P50P75最大值
Max颗粒物浓度
Particulate matter level　PM2.5/(μg·m−3)68.2760.9826.1731.3345.8848.71189.29　PM10/(μg·m−3)130.5758.7178.2187.17117.42120.63246.08气态污染物浓度
Gasous pollutant level　O3/(μg·m−3)36.8613.8918.9628.7932.5042.9660.92　SO2/(μg·m−3)17.8610.5910.3316.4618.3320.0826.42　CO/(mg·m−3)4.941.342.384.665.175.966.36　NO2/(μg·m−3)50.838.0334.7149.4252.9256.8358.96神经损伤生物标志浓度
Neural damage biomarker level　BDNF/(μg·L−1)139.1246.71123.00175.00191.00203.00672.00　NF-L/(ng·L−1)402.60183.3187.84250.63391.08523.89866.52　NSE/(ng·L−1)11.2610.320.323.177.2817.1852.05　PGP9.5/(ng·L−1)14.3213.572.328.2512.0815.49125.52　S100B/(ng·L−1)127.5741.7494.40105.69113.09132.37341.43

表 2

老年志愿者神经损伤生物标志影响因素的GEE模型结果

Table 2

Generalized estimation equation model results on influencing factors of neural damage biomarkers in elderly volunteers

参数(Variable)BDNFNF-LNSEPGP9.5S100 BbOR(95% CI)bOR(95% CI)bOR(95% CI)bOR(95% CI)bOR(95% CI)体力活动 (Physical activity)−0.0090.991(0.963~1.020)0.0051.005(0.882~1.146)0.1591.173(0.942~1.461)0.0161.106(0.887~1.164)0.0371.038(1.003~1.074)*PM2.5浓度(PM2.5 level)/(μg·m−3)　>45.88 (vs. ≤45.88)−0.0190.981(0.962~1.002)0.0281.028(0.983~1.072)0.3071.359(1.224~1.509)*−0.0020.998(0.924~1.078)−0.0240.997(0.945~1.010)PM10浓度(PM10 level)/(μg·m−3)　>117.42 (vs. ≤117.42)−0.0020.998(0.964~1.032)−0.1000.905(0.781~1.047)−0.1470.864(0.681~1.096)0.1351.144(0.986~1.328)−0.0190.981(0.981~1.080)O3浓度(O3 level)/(μg·m−3)　>32.50 (vs. ≤32.50)0.0401.041(0.980~1.105)−0.1560.855(0.740~0.989)*0.2521.286(1.076~1.537)*0.0401.041(0.862~1.257)−0.0030.997(0.952~1.044)SO2浓度(SO2 level)/(μg·m−3)　>18.33 (vs. ≤18.33)0.0051.005(0.942~1.073)−0.2070.813(0.700~0.946)*0.0451.046(0.853~1.283)0.0751.078(0.861~1.350)−0.0050.995(0.946~1.047)CO浓度(CO level)/(mg·m−3)　>5.17 (≤5.17)−0.0130.987(0.939~1.037)0.0571.058(0.982~1.140)−0.0050.995(0.864~1.145)0.0131.013(0.900~1.141)0.0161.016(0.998~1.044)NO2浓度(NO2 level)/(μg·m−3)　>52.92 (≤52.92)0.0351.036(0.982~1.094)−0.0450.956(0.831~1.099)−0.3680.692(0.549~0.873)*−0.1440.866(0.777~0.965)*0.0391.040(0.963~1.122)[注]*：P < 0.05。[Note] *: P < 0.05. [1]

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